19 results on '"Meteb Al-Foheidi"'
Search Results
2. Response to Induction Neoadjuvant Hormonal Therapy Using Upfront 21-Gene Breast Recurrence Score Assay—Results From the SAFIA Phase III Trial
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Khalid AlSaleh, Heba Al Zahwahry, Adda Bounedjar, Mohammed Oukkal, Ahmed Saadeddine, Hassen Mahfouf, Kamel Bouzid, Assia Bensalem, Taha Filali, Hikmat Abdel-Razeq, Blaha Larbaoui, Alaa Kandil, Omalkhair Abulkhair, Meteb Al Foheidi, Hassan Errihani, Marwan Ghosn, Nashwa Abdel-Aziz, Maria Arafah, Hamouda Boussen, Farida Dabouz, Haleem Rasool, Mohun Bahadoor, Jihen Ayari, Sharif Kullab, and Jean-Marc Nabholtz
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PURPOSELuminal, human epidermal growth factor receptor 2–negative breast cancer represents the most common subtype of breast malignancies. Neoadjuvant strategies of operable breast cancer are mostly based on chemotherapy, whereas it is not completely understood which patients might benefit from neoadjuvant hormone therapy (NAHT).MATERIALS AND METHODSThe SAFIA trial is a prospective multicenter, international, double-blind, neoadjuvant phase III trial, using upfront 21-gene Oncotype DX Breast Recurrence Score assay (recurrence score [RS] < 31) to select operable luminal human epidermal growth factor receptor 2–negative patients, for induction hormonal therapy HT (fulvestrant 500 mg with or without goserelin) before randomly assigning responding patients to fulvestrant 500 mg (with or without goserelin) plus either palbociclib (cyclin-dependent kinase 4/6 inhibitor) or placebo. The objectives of this interim analysis were to assess the feasibility of upfront RS determination on core biopsies in the Middle-East and North Africa region and evaluate the efficacy of induction NAHT in patients with an RS < 31.RESULTSAt the time of this interim analysis, 258 patients with relative risk were accrued, including 202 patients (RS < 31% to 78.3%) treated with induction NAHT and 182 patients evaluable so far for response. The feasibility of performing the Oncotype DX assays on core biopsy specimens was optimal in 96.4% of cases. Overall, 93.4% of patients showed hormone sensitivity and no difference in NAHT efficacy was noticed between RS 0-10, 11-25, and 26-30. Interestingly, patients with high RS (26-30) showed a trend toward a higher major response rate (P = .05).CONCLUSIONThe upfront 21-gene assay performed on biopsies is feasible in our population and has allowed us to select patients with high hormone sensitivity (RS < 31). This approach could be an alternative to upfront surgery without significant risk of progression, particularly during pandemic times.
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- 2021
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3. Cost-efficiency analysis of conversion to biosimilar filgrastim for supportive cancer care and resultant expanded access analysis to supportive care and early-stage HER2+ breast cancer treatment in Saudi Arabia: simulation study
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Consuela Cheriece Yousef, Mansoor Ahmed Khan, Hind Almodaimegh, Majed Alshamrani, Meteb Al-Foheidi, Hana AlAbdalkarim, Ahmed AlJedai, Anjum Naeem, and Ivo Abraham
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Health Policy - Published
- 2023
4. Combination of palbociclib with adjuvant endocrine therapy for treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer: An experience at two cancer centers in Saudi Arabia
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Meteb Al‑Foheidi, Asem Albeshri, Safwan Moamenkahan, Abdulmajid Abdullah, Muhannad Abualola, Muath Alharbi, Ahmed Refa, Ali Bayer, Ahmed Shaheen, Syed Aga, Muhammad Khan, Mubarak Al‑Mansour, and Ezzeldin Ibrahim
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Cancer Research ,Oncology - Abstract
The addition of palbociclib (a cyclin-dependent kinase 4/6 inhibitor) to endocrine therapy (ET) has been shown to significantly improve progression-free survival (PFS) and overall survival (OS) among patients with hormone receptor-positive (HR
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- 2021
5. Response to Induction Neoadjuvant Hormonal Therapy Using Upfront 21-Gene Breast Recurrence Score Assay-Results From the SAFIA Phase III Trial
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J. Ayari, Hassan Errihani, Ahmed Saadeddine, Taha Filali, Khalid Alsaleh, Haleem Rasool, Hamouda Boussen, Meteb Al Foheidi, Farida Dabouz, Blaha Larbaoui, Adda Bounedjar, Hassen Mahfouf, Assia Bensalem, Marwan Ghosn, Mohammed Oukkal, Maria Arafah, K. Bouzid, Hikmat Abdel-Razeq, Alaa Kandil, Mohun Bahadoor, Nashwa Abdel-Aziz, Omalkhair Abulkhair, Jean-Marc Nabholtz, Heba Al Zahwahry, and Sharif Kullab
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Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.drug_class ,Receptor, ErbB-2 ,medicine.medical_treatment ,Breast Neoplasms ,law.invention ,03 medical and health sciences ,Middle East ,0302 clinical medicine ,Breast cancer ,Randomized controlled trial ,Africa, Northern ,law ,Internal medicine ,Breast Cancer ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Gene ,Neoadjuvant therapy ,business.industry ,ORIGINAL REPORTS ,medicine.disease ,Neoadjuvant Therapy ,Clinical trial ,Receptors, Estrogen ,Estrogen ,030220 oncology & carcinogenesis ,Hormonal therapy ,Female ,Neoplasm Recurrence, Local ,business - Abstract
PURPOSE Luminal, human epidermal growth factor receptor 2–negative breast cancer represents the most common subtype of breast malignancies. Neoadjuvant strategies of operable breast cancer are mostly based on chemotherapy, whereas it is not completely understood which patients might benefit from neoadjuvant hormone therapy (NAHT). MATERIALS AND METHODS The SAFIA trial is a prospective multicenter, international, double-blind, neoadjuvant phase III trial, using upfront 21-gene Oncotype DX Breast Recurrence Score assay (recurrence score [RS] < 31) to select operable luminal human epidermal growth factor receptor 2–negative patients, for induction hormonal therapy HT (fulvestrant 500 mg with or without goserelin) before randomly assigning responding patients to fulvestrant 500 mg (with or without goserelin) plus either palbociclib (cyclin-dependent kinase 4/6 inhibitor) or placebo. The objectives of this interim analysis were to assess the feasibility of upfront RS determination on core biopsies in the Middle-East and North Africa region and evaluate the efficacy of induction NAHT in patients with an RS < 31. RESULTS At the time of this interim analysis, 258 patients with relative risk were accrued, including 202 patients (RS < 31% to 78.3%) treated with induction NAHT and 182 patients evaluable so far for response. The feasibility of performing the Oncotype DX assays on core biopsy specimens was optimal in 96.4% of cases. Overall, 93.4% of patients showed hormone sensitivity and no difference in NAHT efficacy was noticed between RS 0-10, 11-25, and 26-30. Interestingly, patients with high RS (26-30) showed a trend toward a higher major response rate ( P = .05). CONCLUSION The upfront 21-gene assay performed on biopsies is feasible in our population and has allowed us to select patients with high hormone sensitivity (RS < 31). This approach could be an alternative to upfront surgery without significant risk of progression, particularly during pandemic times.
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- 2021
6. First GCC stakeholder meeting on approval process, interchangeability/substitution and safety of biosimilars 2017 – Report
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Ali M Alhomaidan, Tore Kristian Kvien, Mohammad A Alsenaidy, Aws Alshamsan, Musaed Alkholief, Ahmed Al-Jedai, Meteb Al-Foheidi, and Gianluca Trifirò
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Process management ,Process (engineering) ,Drug Guides ,Substitution (logic) ,Stakeholder ,Biosimilar ,Pharmacy ,Business ,Interchangeability - Published
- 2018
7. The first BGICC consensus and recommendations for breast cancer awareness, early detection and risk reduction in low- and middle-income countries and the MENA region
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Meteb Al-Foheidi, Fatina M. Al Tahan, Ahmed Saadeddin, Hannah Chung, Banu Arun, Hany Abdel-Aziz, Mohamed Sabry, Manal Abdel-Wahab, Nivine Gado, Marwan Ghosn, Armando E. Giuliano, Azza Nasr, Hagar Elghazawy, Khaled Abdel Karim, Mona Frolova, Benjamin O. Anderson, Nermean Bahie Eldin, Heba M. El-Zawahry, Mohamed A Shehata, Lobna R. Ezz Elarab, Hussein Maki, Adel T. Aref, Rasha Kamal, Nivine Chalabi, Cheng Har Yip, Hesham Elghazaly, Jessica W.T. Leung, Charles M. Balch, and Gilda Cardenosa
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Cancer Research ,Health Knowledge, Attitudes, Practice ,Early detection ,Breast Neoplasms ,Disease ,03 medical and health sciences ,Middle East ,0302 clinical medicine ,Breast cancer ,Africa, Northern ,Environmental health ,Medicine ,Humans ,Socioeconomic status ,Developing Countries ,Early Detection of Cancer ,Modalities ,business.industry ,Breast cancer awareness ,Breast Self-Examination ,Congresses as Topic ,medicine.disease ,Clinical research ,Oncology ,Low and middle income countries ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Income ,Female ,business ,Risk Reduction Behavior ,Mammography - Abstract
In low-middle income countries (LMICs) and the Middle East and North Africa (MENA) region, there is an unmet need to establish and improve breast cancer (BC) awareness, early diagnosis and risk reduction programs. During the 12th Breast, Gynecological & Immuno-oncology International Cancer Conference - Egypt 2020, 26 experts from 7 countries worldwide voted to establish the first consensus for BC awareness, early detection and risk reduction in LMICs/MENA region. The panel advised that there is an extreme necessity for a well-developed BC data registries and prospective clinical studies that address alternative modalities/modified BC screening programs in areas of limited resources. The most important recommendations of the panel were: (a) BC awareness campaigns should be promoted to public and all adult age groups; (b) early detection programs should combine geographically distributed mammographic facilities with clinical breast examination (CBE); (c) breast awareness should be encouraged; and (d) intensive surveillance and chemoprevention strategies should be fostered for high-risk women. The panel defined some areas for future clinical research, which included the role of CBE and breast self-examination as an alternative to radiological screening in areas of limited resources, the interval and methodology of BC surveillance in women with increased risk of BC and the use of low dose tamoxifen in BC risk reduction. In LMICs/MENA region, BC awareness and early detection campaigns should take into consideration the specific disease criteria and the socioeconomic status of the target population. The statements with no consensus reached should serve as potential catalyst for future clinical research.
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- 2021
8. Efficacy and safety of second‑generation CAR T‑cell therapy in diffuse large B‑cell lymphoma: A meta‑analysis
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Meteb Al‑Foheidi, Ezzeldin M. Ibrahim, and Mubarak Al‑Mansour
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Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,diffuse large B-cell lymphoma ,chimeric antigen receptor T-cell efficacy ,chimeric antigen receptor T cells ,03 medical and health sciences ,0302 clinical medicine ,Autologous stem-cell transplantation ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,medicine ,chimeric antigen receptor T-cell therapy ,Chemotherapy ,business.industry ,Cancer ,Articles ,Immunotherapy ,medicine.disease ,Lymphoma ,Cytokine release syndrome ,030220 oncology & carcinogenesis ,chimeric antigen receptor T-cell safety ,B-cell non-Hodgkin's lymphoma ,030211 gastroenterology & hepatology ,Chimeric Antigen Receptor T-Cell Therapy ,business ,Diffuse large B-cell lymphoma - Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphoma (NHL), representing 30% of all lymphoma cases. Within the first 2-3 years following immunochemotherapy, 30-40% of patients will experience a relapse or a refractory disease, thereby exhibiting a poor prognosis. High-dose immunotherapy followed by autologous stem cell transplantation is the standard care for relapsed/refractory (RR) patients with DLBCL. However, >60% of patients are ineligible for a transplant, presenting a therapeutic challenge. Chimeric antigen receptor (CAR) T-cell therapy has shown promising efficacy in patients with DLBCL, including those with R/R disease. The present study conducted a meta-analysis that showed highly favorable outcomes [objective response rate (ORR): 69%; complete remission (CR): 49%] in B-cell NHL patients (n=419) who were treated with second-generation CAR T cells. The response rate varied in different types of B-cell NHL. In 306 patients with R/R DLBCL eligible for rate evaluation, the ORR and CR rate mean estimates were 68% [95% confidence interval (CI), 55-79%] and 46% (95% CI, 38-54%), respectively. Thus, the findings indicated that immunotherapy with CAR T cells has improved outcomes for patients with R/R DLBCL and other subtypes of B-cell NHL compared with standard chemotherapy regimens. The study revealed that grade ≥3 anemia (34%) and thrombocytopenia (30%) were the most common adverse effects of CAR T-cell therapy. Incidence of grade ≥3 cytokine release syndrome and neurotoxicity associated with CAR T-cell therapy was effectively managed.
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- 2020
9. Hodgkin Lymphoma Outcome: A Retrospective Study from 3 Tertiary Centers in Saudi Arabia
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Mubarak Al-Mansour, Ruaa G Shafi, Hani Al Hashmi, Ahmed Alsaeed, Ezzeldin M. Ibrahim, Meteb Al-Foheidi, and Solaf Kanfar
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Adult ,Male ,Cancer Research ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Saudi Arabia ,Outcome assessment ,Outcome (game theory) ,Disease-Free Survival ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,immune system diseases ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,Prevalence ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,Chemoradiotherapy ,Hematology ,Middle Aged ,Prognosis ,Hodgkin Disease ,Survival Rate ,Oncology ,030220 oncology & carcinogenesis ,Hodgkin lymphoma ,Female ,business - Abstract
Background: Hodgkin lymphoma (HL) exhibits considerable clinicopathological variations in different parts of the world. This study was prompted by the limited availability of HL data in developing countries (particularly long-term outcomes). Methods: We performed a retrospective review of eligible adult HL patients treated at 3 tertiary centers in Saudi Arabia between January 1997 and December 2012. Results: The review included 340 patients with a median age of 26 years (range 15-82 years); 53% were male, 74% had an advanced stage, 22% had bulky disease, and 70% had low-to-intermediate risk according to the International Prognostic Score. Nodular sclerosis was the most common histological subtype (59%). Adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) was offered to 92% and radiotherapy to 43%. Initial therapy outcomes were complete response, partial response, and progressive disease in 91%, 5%, and 2% of patients, respectively. At a median follow-up of 39 months, the actuarial freedom from treatment failure at 5 years was 74%, with a 5-year overall survival of 91%. Multivariate analysis showed that advanced disease stage and high-risk international prognostic index independently predicted an adverse outcome. Conclusion: Our Saudi patient population exhibited outcomes that were comparable to those reported in developed countries.
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- 2017
10. Prediction of response to neoadjuvant hormonal therapy (NAHT) using upfront oncotype Dx recurrence score (RS): Results from the SAFIA phase III trial
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Jean-Marc Nabholtz, Mohun Bahadoor, Mohammed Oukkal, Alaa Kandil, Marwan Ghosn, Hassan Errihani, K. Bouzid, Assia Bensalem, Blaha Larbaoui, Farida Dabouz, Nashwa A Abdulaziz, Heba Mohamed El Zawahry, Taha Fillali, Meteb Al-Foheidi, Hasen Mahfouf, Khalid Alsaleh, Adda Bounedjar, and Sherif A Kullab
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Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Recurrence score ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Hormonal therapy ,Oncotype DX ,business ,030215 immunology - Abstract
594 Background: While hormonal therapy (HT) is a fundamental treatment in breast cancer therapy, neoadjuvant NAHT is not considered standard. The SAFIA trial is a prospective international neoadjuvant Phase III investigating the potential role of the addition of palbociclib (P) in patients (pts) sensitive to HT. We report the results of induction Faslodex (+/- zoladex) in pts initially selected by RS < 31, in order to assess their individual HT sensitivity before double-blind randomization HT vs HT + P followed by surgery. Materials and Methods: A total of 308 pts (stages II and IIIA Luminal A/B HER2 negative) in 24 centers and 6 countries (Middle-East/Maghreb) underwent upfront RS to select pts for induction HT. Pts with RS < 31 received induction neoadjuvant fulvestrant (500 mg i.m Day 1, 14, 28 then q.4 weeks) + goseriline (3.6 mg s.c q.4 w for pre and peri-menopausal pts) for 4 months, followed by clinical and radiological assessment of the disease response before randomization. Response was defined as no progression: Complete Response-CR/ Partial Response-PR: > 50% and Minor Response-MR: < 50% to > 0%/ No Response-NR: progression > 0%. Results: A total of 70 pts (22%) with RS > 31 were excluded, leaving 238 eligible pts for NAHT, age (25-84); pre-peri/ post menopause: 135 (57%)/103 (43%); Luminal A/B: 112 (49%)/114 (51%); Stage II/IIIA: 196 (87%) / 29 (13%). One hundred and seventy-seven pts (177) have validated responses to induction NAHT: CR: 9 pts (5%) / MR: 105 pts (59%) for major response rate: 64% / MR: 56 pts (32%) / NR: 7 pts (4%); available RS 0-10: 23 pts (16%) / RS 11-18: 67 pts (47%) / RS 19-25: 34 pts (24%) / RS 26-30: 18 pts (13%). Correlations between Response to NAHT and RS are shown in the table below (not statistically significant). Conclusions: In our population, upfront Oncotype DX RS < 31 allowed to select pts for induction NAHT without loss of chances with a no-progression rate (CR+PR = MR) of 96%. No significant correlation was found between RS and response to NAHT. Upfront RS > 31 (22%) is selecting pts candidates for neoadjuvant chemotherapy with a potential high risk of endocrine resistance. Clinical trial information: ICRG1201 .
- Published
- 2020
11. The predictive and prognostic role of phosphatase phosphoinositol-3 (PI3) kinase (PIK3CA) mutation in HER2-positive breast cancer receiving HER2-targeted therapy: a meta-analysis
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Meteb Al-Foheidi, Mubarak Al-Mansour, Ghieth A. Kazkaz, and Ezzeldin M. Ibrahim
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Oncology ,Cancer Research ,medicine.medical_specialty ,Class I Phosphatidylinositol 3-Kinases ,Receptor, ErbB-2 ,medicine.medical_treatment ,Antineoplastic Agents ,Breast Neoplasms ,Disease-Free Survival ,Targeted therapy ,Phosphatidylinositol 3-Kinases ,Breast cancer ,Trastuzumab ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Molecular Targeted Therapy ,neoplasms ,Gynecology ,Chemotherapy ,business.industry ,Kinase ,Odds ratio ,medicine.disease ,Survival Analysis ,Metastatic breast cancer ,Neoadjuvant Therapy ,Treatment Outcome ,Meta-analysis ,Mutation ,Female ,business ,medicine.drug - Abstract
The association between PIK3CA mutation and resistance to anti-HER2 therapy (AHT) is not precisely defined. This meta-analysis intended to explore the clinical utility of PIK3CA mutation in HER2-positive breast cancer treated with AHT. Literature search identified 19 eligible studies. There were 1720 patients with advanced, 828 with early and 1290 patients treated in the neoadjuvant setting. In metastatic breast cancer, AHT showed no differential objective response benefit between the wild type (WT) and the mutated type (MT) PIK3CA subgroups (odds ratio [OR] = 1.09; 95 % CI 0.60–2.00; P = 0.78). AHT favorable affected progression-free survival (PFS) irrespective of PIK3CA mutation. There was no PFS difference between WT and MT regardless of the offered therapy. In early breast cancer, trastuzumab combined with the same chemotherapy conferred consistent relapse-free survival benefit in WT and MT subgroups (WT: HR = 0.59; 95 % CI 0.44–0.80; P
- Published
- 2015
12. The prognostic value of tumor-infiltrating lymphocytes in triple-negative breast cancer: a meta-analysis
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Ezzeldin M. Ibrahim, Meteb Al-Foheidi, Mubarak Al-Mansour, and Ghieth A. Kazkaz
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Oncology ,Cancer Research ,medicine.medical_specialty ,Pathology ,Population ,H&E stain ,Triple Negative Breast Neoplasms ,chemical and pharmacologic phenomena ,CD8-Positive T-Lymphocytes ,Disease-Free Survival ,Lymphocytes, Tumor-Infiltrating ,Breast cancer ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Stage (cooking) ,education ,Lymph node ,Triple-negative breast cancer ,education.field_of_study ,Tumor-infiltrating lymphocytes ,business.industry ,Hazard ratio ,Forkhead Transcription Factors ,hemic and immune systems ,Prognosis ,medicine.disease ,medicine.anatomical_structure ,Female ,Immunotherapy ,Neoplasm Recurrence, Local ,business - Abstract
In a recent meta-analysis, we demonstrated that rich tumor-infiltrating lymphocytes (TILs) were significantly correlated to a favorable breast cancer (BC) outcome largely in estrogen receptor-negative tumors. It is known that TILs predominate in triple-negative (TN) BC, and to the best of our knowledge, there is no published meta-analysis that examined their prognostic value exclusively in that subtype. Therefore, we planned this meta-analysis to explore the clinical utility of rich TILs in TN-BC. According to predefined selection criteria, literature search identified eight eligible studies. The meta-analysis included data on 2,987 patients with early stage BC. The median percentage of lymph node positivity was 47% (95% confidence interval [CI] 23-82%). Over a median follow-up of 113 months (95% CI 80-144 months), it was found that rich TILs were associated with 30% (hazard ratio [HR] = 0.70; 95% CI 0.56-0.87; P = 0.001), 22% (HR = 0.78; 95% CI 0.68-0.90; P = 0.0008), and 34% (HR = 0.66; 95% CI 0.53-0.83; P = 0.0003), reduction in the risk of recurrence, distant recurrence, and death, respectively. In addition, for every 10% increments in rich TILs, there was an approximate 15-20% reduction in any recurrence, distant recurrence, or mortality. Moreover, rich TILs predicted superior overall survival (OS) benefit irrespective of the disease phenotype (TN-BC or core-basal phenotype), TILs location (intratumoral or stromal), or TILs qualification as either TILs-non-specified, cytotoxic (CD8+) or regulatory (forkhead box protein 3, FOXP3+) T cells. Data on 5-negative phenotype population were limited, and rich TILs failed to demonstrate a prognostic significance in this phenotype. To investigate the heterogeneity that was shown in the analyses of disease-free survival and OS, a set of meta-analyses showed that the method used in TILs detection (hematoxylin and eosin stains vs. immunohistochemistry) could explain most of the variability in the pooled estimates. Rich TILs were significantly associated with better survival outcome in early TN-BC and should be considered as a strong prognostic factor in this subtype. The results from the current meta-analysis support integrating immunotherapy with conventional therapy in future BC research.
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- 2014
13. The Prognostic and Predicting Roles of Tumor-Infiltrating Lymphocytes in Breast Cancer: A Meta-Analysis
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Ghieth A. Kazkaz, Ezzeldin M. Ibrahim, Mubarak Al-Mansour, Tahir E. Yunus, and Meteb Al-Foheidi
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Oncology ,Cancer Research ,medicine.medical_specialty ,Pathology ,Tumor-infiltrating lymphocytes ,business.industry ,Lymphocyte ,medicine.medical_treatment ,Hazard ratio ,Immunotherapy ,Disease ,medicine.disease ,Confidence interval ,medicine.anatomical_structure ,Breast cancer ,Meta-analysis ,Internal medicine ,medicine ,business - Abstract
Background: The relationship between lymphocyte infiltrates (LIs) and breast cancer outcome remains controversial. We performed this meta-analysis to elucidate the relationship. Methods: A literature search identified 21 eligible studies. Results: 16,097 patients were included. Multivariate analyses data for patients with unspecified receptors status showed that rich LIs expression was associated with 52% (hazard ratio (HR) = 0.48; 95% confidence interval (CI), 0.30-0.77), and 29% (HR = 0.71; 95% CI, 0.63-0.80) reduction in the risk of relapse and death, respectively. In the neoadjuvant setting, rich LIs predicted a 28% increase in complete pathological response rate. The prognostic and predictive utility of rich LIs was restricted to patients with estrogen receptor negative (ER-) or triple negative disease. Only rich CD8+ T cells tumors demonstrated clinical utility. Conclusion: LIs significantly correlated to outcome predominantly in ER- tumors. Integrating immunotherapy with conventional therapy may warrant future research in breast cancer.
- Published
- 2014
14. Increased Risk of Second Lung Cancer in Hodgkin’s Lymphoma Survivors: A Meta-analysis
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Osama A. Elmasri, Ezzeldin M. Ibrahim, Mubarak Al-Mansour, Khaled M. Abouelkhair, Meteb Al-Foheidi, Ghieth A. Kazkaz, Ali M. Bayer, and Turki M Al-Fayea
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Lung Neoplasms ,Adolescent ,Population ,Young Adult ,Risk Factors ,Internal medicine ,Outcome Assessment, Health Care ,Humans ,Medicine ,Survivors ,Young adult ,education ,Lung cancer ,education.field_of_study ,business.industry ,Incidence ,Incidence (epidemiology) ,Neoplasms, Second Primary ,Middle Aged ,medicine.disease ,Hodgkin's lymphoma ,Combined Modality Therapy ,Hodgkin Disease ,Confidence interval ,Relative risk ,Female ,business ,Lung cancer screening - Abstract
Patients treated for Hodgkin’s lymphoma (HL) have a higher risk of developing second lung cancer (SLC) compared with the general population. The aim of this meta-analysis was to quantify such risk and to analyze contributing risk factors in HL survivors. According to predefined selection criteria, a literature search identified 21 studies that were included in the analysis. After eliminating overlapping or duplicate data, 793 (76 % males) incidences of SLC were encountered in 74,831 patients (58 % males) with HL over a median follow-up of 11.5 years. The median age at HL diagnosis and the median age at SLC diagnosis were 33.0 and 45.9, respectively. The mean latency between treatment of HL and development of SLC was 11.5 years. The pooled relative risk (RR) of SLC was 4.62 (95 % confidence interval [CI], 3.18–6.70], I 2 = 98 %), with a median absolute excess rate of 10.4 per 10,000 person-years. RR was positively related to study size, male-to-female ratio, institutional versus population-based data sets, and the use of any radiotherapy (RT) or combined modality therapy (CMT), while age at diagnosis of HL was not significant. The highest risk was shown among patients aged 15–24 years (RR = 8.76 [95 % CI, 4.55–16.89]), while the lowest risk occurred in patients ≥55 years at primary treatment (RR = 2.88 [95 % CI, 2.33–3.56]). RR increased by increasing duration of follow-up, reaching the highest value at 10–14 years (RR = 4.17 [95 % CI, 3.62–8.81]), but did not increase after ≥15 years (RR = 4.01 [95 % CI, 2.68–5.98]). RT only, CMT, or chemotherapy only was associated with RR (95 % CI) of 4.88 (3.14–7.60), 5.15 (4.08–6.50), and 2.39 (1.60–3.55), respectively. Patients with SLC demonstrated poor prognosis. The current meta-analysis provided a detailed estimate of the risk of SLC among HL survivors. The obtained results may provide guidelines concerning lung cancer screening for this population.
- Published
- 2012
15. Bleomycin pulmonary toxicity in adult Saudi patients with Hodgkin's lymphoma
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Wafa'a A Al-Jizani, Ghieth A. Kazkaz, Turki M Al-Fayea, Ruaa U Shafi, Mubarak Al-Mansour, Ezzeldin M. Ibrahim, Ali M. Bayer, and Meteb Al-Foheidi
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Adult ,Lung Diseases ,Male ,Cancer Research ,medicine.medical_specialty ,Pulmonary toxicity ,medicine.medical_treatment ,Saudi Arabia ,Bleomycin ,Gastroenterology ,Disease-Free Survival ,chemistry.chemical_compound ,Internal medicine ,medicine ,Humans ,Lung ,Aged ,Chemotherapy ,business.industry ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Hodgkin's lymphoma ,Hodgkin Disease ,Surgery ,Lymphoma ,Treatment Outcome ,Oncology ,chemistry ,Concomitant ,Toxicity ,Female ,business - Abstract
Background: Bleomycin pulmonary toxicity (BPT) has been described in Hodgkin's lymphoma (HL) patients treated with bleomycin-containing chemotherapy regimens. Methodology: We reviewed the records of 164 consecutive HL patients. Results: BPT was observed in 24 of 164 patients (15%). Older age and history of concomitant lung disease were significantly associated with approximately threefold (odds ratio: 3.38; 95% CI: 1.25–9.13; p = 0.02) and sevenfold (odds ratio: 7.19; 95% CI: 2.64–19.54; p < 0.0001) increase in BPT risk, respectively. The actuarial 5-year progression-free and overall survival for BPT and non-BPT groups, were not significantly different. Conclusion: In Saudi Arabian HL patients, the risk of BPT and its effect on survival outcome were comparable to that reported from developed countries.
- Published
- 2015
16. Breast cancer screening: review of benefits and harms, and recommendations for developing and low-income countries
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Mubarak Al-Mansour, Ezzeldin M. Ibrahim, and Meteb Al-Foheidi
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Cancer Research ,medicine.medical_specialty ,Health Planning Guidelines ,Cost-Benefit Analysis ,Developing country ,Breast Neoplasms ,Disease ,Breast cancer screening ,Breast cancer ,medicine ,Humans ,Overdiagnosis ,Developing Countries ,Poverty ,Early Detection of Cancer ,Randomized Controlled Trials as Topic ,Gynecology ,Modalities ,medicine.diagnostic_test ,business.industry ,Public health ,Cancer ,Hematology ,General Medicine ,medicine.disease ,Oncology ,Family medicine ,Female ,business ,Mammography - Abstract
Breast cancer is the most common cancer in women worldwide. The disease remains a public health concern as recent evidence indicates that the breast cancer burden has increased mainly in developing and low-income countries (DLICs). Despite the demonstrated benefits, the debate about the real benefits and harms of breast cancer screening is ongoing. Many experts believe that the benefits of screening, in terms of reduced breast cancer mortality, outweigh the harms, whereas others think the opposite. In this review, we assess the clinical utility of available screening modalities, present evidence, overdiagnosis, cost-effectiveness, and other pertinent issues. We also examine relevant data from DLICs to underscore the barriers and challenges that impede implementation of screening strategies in those populations. We also provide recommendations concerning rational preventive strategies for breast cancer control for women in DLICs.
- Published
- 2012
17. Risk of second breast cancer in female Hodgkin’s lymphoma survivors: a meta-analysis
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Osama A. Elmasri, Meteb Al-Foheidi, Ezzeldin M. Ibrahim, Ghieth A. Kazkaz, and Khaled M. Abouelkhair
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Risk ,Oncology ,Cancer Research ,medicine.medical_specialty ,Population ,Breast Neoplasms ,lcsh:RC254-282 ,Breast cancer screening ,Breast cancer ,Internal medicine ,Genetics ,Humans ,Medicine ,Survivors ,Risk factor ,education ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Age Factors ,Neoplasms, Second Primary ,Hodgkin's lymphoma ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Hodgkin Disease ,Lymphoma ,Relative risk ,Meta-analysis ,Female ,business ,Follow-Up Studies ,Research Article - Abstract
Background Women treated for Hodgkin’s lymphoma (HL) have an elevated risk of developing second breast cancer (SBC) compared with the general population. We planned this meta-analysis to quantify the long-term risk of SBC and analyze the contributing risk factors among HL survivors. Methods According to predefined selection criteria, literature search identified 34 studies that were included in the analyses. Results After eliminating overlapping or duplicate data, 957 incidences of SBC were encountered in 24,505 females with HL over a median follow-up of 14.9 years. The medians: age at the diagnosis of HL, age at diagnosis of SBC, and latency since HL treatment to the development of SBC were 23.7, 35.0, and 17.7 years, respectively. The pooled relative risk (RR) of SBC was 8.23 (95% CI, 5.43-12.47, I2 = 96%), with a median absolute excess rate of 22.9 per 10,000 person-years. The RR was found inversely related to age at diagnosis of HL with the highest rate (68.7; [95%CI, 28.08-168.11], I2 = 79%), occurred in young patients (≤ 15 years old), where the RR in older women (≥ 40 years old) was not significant (0.55; [95% CI, 0.09-3.52]). Analysis of RR by 5-year increments since the treatment of HL showed that the risk was highest after 15–19 years of latency (13.87; [95% CI, 7.91-24.30], I2 = 89%). Analysis of the effect of treatment modalities showed that the RR rates were (4.70; [95% CI, 3.28-6.75], I2 = 74%), (5.65; [95%CI, 2.94-10.88], I2 = 91%), and (1.19; [95% CI, 0.50-2.82], I2 = 65%), for radiotherapy (RT) only, combined RT and chemotherapy (CT), and CT only, respectively. To investigate the demonstrated heterogeneity, meta-regression analysis was performed when feasible. In most such analyses, the natural logarithm of RR was inversely associated with age at HL diagnosis. Conclusions We conclude that, the current meta-analysis provided the most recent comprehensive estimate of the risk of SBC in a broad-range of HL survivors. Younger age at diagnosis proved to be a dominant risk factor. The obtained results would serve providing breast cancer screening recommendations for HL survivors.
- Published
- 2012
18. Hodgkin's Lymphoma Outcome: A Retrospective Study from Three Tertiary Centers in Saudi Arabia
- Author
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Solaf Kanfar, Hani Al Hashmi, Meteb Al-Foheidi, Mubarak Al-Mansour, Ezzeldin M. Ibrahim, Ahmad Alsaeed, and Ruaa U Shafi
- Subjects
education.field_of_study ,medicine.medical_specialty ,Multivariate analysis ,business.industry ,Immunology ,Population ,Retrospective cohort study ,Cell Biology ,Hematology ,Hodgkin's lymphoma ,medicine.disease ,Biochemistry ,Surgery ,International Prognostic Index ,ABVD ,Nodular sclerosis ,Internal medicine ,medicine ,Stage (cooking) ,education ,business ,medicine.drug - Abstract
Background: Hodgkin lymphoma (HL) demonstrates considerable clinicopathologic variations in different parts of the world. Prompted by the limited availability of data particularly the long-term outcome of HL in developing countries, we carried out this retrospective data analyses. Methods: A retrospective review of eligible adult HL patients managed at three tertiary centers in Saudi Arabia between January 1997 to December 2012. Results: The review included 340 patients with median age of 26 years (range15-82). 53% of patients were male, 74% had an advanced stage, 19% had bulky disease, and 70% had low to intermediate risk according to Hasenclever index. Nodular sclerosis was the most common histological subtype (59%). ABVD was given to 92% and radiotherapy to 43%. Response to initial therapy was complete, partial, and disease progression was reported in 91%, 5%, and 2 % of patients, respectively. At a median follow-up of 50 months, the actuarial freedom from treatment-failure at 5-year was 74%, and with an overall survival of 91%. Multivariate analysis showed that advanced disease stage and high-risk international prognostic index independently projected an adverse outcome. Conclusion: This study confirms that our patients population demonstrated a comparable outcome to that reported from developed countries. Disclosures No relevant conflicts of interest to declare.
- Published
- 2015
19. Bleomycin Pulmonary Toxicity in Adult Saudi Patients with Hodgkin’s Lymphoma
- Author
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Ghieth A. Kazkaz, Turki M Al-Fayea, Ezzeldin M. Ibrahim, Ali M. Bayer, Mubarak Al-Mansour, Meteb Al-Foheidi, Wafa A Al-jizani, and Shafi Ruaa
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medicine.medical_specialty ,Pulmonary toxicity ,business.industry ,Incidence (epidemiology) ,Immunology ,Cell Biology ,Hematology ,Odds ratio ,Hodgkin's lymphoma ,medicine.disease ,Bleomycin ,Biochemistry ,Chemotherapy regimen ,Lymphoma ,chemistry.chemical_compound ,chemistry ,Concomitant ,Internal medicine ,medicine ,business - Abstract
Background: Bleomycin pulmonary toxicity (BPT) has been well described in Hodgkin's lymphoma (HL) patients treated with bleomycin-containing chemotherapy regimens. As the effects of genetic susceptibility or race on the development of BPT are largely unknown, we intended to examine BPT incidence, risk factors, and its effects on survival in a series of newly diagnosed Saudi Arabian adult HL patients receiving first-line bleomycin-containing chemotherapy. Methods: We carried out a retrospective review of the relevant records of 164 consecutive eligible adult HL patients treated at two centers. Results: BPT was observed in 24 of 164 patients (15%) at a median duration of 4.3 months (range, 1 to 58 months). Older age and history of concomitant lung disease were significantly associated with approximately three- (odds ratio [OR] = 3.38; 95% confidence interval [CI], 1.25-9.13; P = 0.02) and seven-fold (OR = 7.19; 95% CI, 2.64-19.54; P Conclusion: In Saudi Arabian adult HL patients, the risk of BPT and its effect on survival outcome were comparable to that reported from developed countries. Earlier incidence time of BPT aversely influenced OS. Future studies should consider testing the efficacy and safety of non-bleomycin-containing regimens in HL. Disclosures No relevant conflicts of interest to declare.
- Published
- 2014
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