Search

Your search keyword '"Yvonne L. E. Ang"' showing total 6 results
Start Over Author "Yvonne L. E. Ang"
6 results on '"Yvonne L. E. Ang"'

1. A randomized phase II trial evaluating the addition of low dose, short course sunitinib to docetaxel in advanced solid tumours

Author

Yvonne L. E. Ang, Gwo Fuang Ho, Ross A. Soo, Raghav Sundar, Sing Huang Tan, Wei Peng Yong, Samuel G. W. Ow, Joline S. J. Lim, Wan Qin Chong, Phyu Pyar Soe, Bee Choo Tai, Lingzhi Wang, Boon Cher Goh, and Soo-Chin Lee

Subjects
Tumour vasculature, Anti-angiogenic, Short-course sunitinib, Advanced solid tumours, Docetaxel, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background We previously reported that low-dose, short-course sunitinib prior to neoadjuvant doxorubicin-cyclophosphamide (AC) normalised tumour vasculature and improved perfusion, but resulted in neutropenia and delayed subsequent cycles in breast cancer patients. This study combined sunitinib with docetaxel, which has an earlier neutrophil nadir than AC. Methods Patients with advanced solid cancers were randomized 1:1 to 3-weekly docetaxel 75 mg/m2, with or without sunitinib 12.5 mg daily for 7 days prior to docetaxel, stratified by primary tumour site. Primary endpoints were objective-response (ORR:CR + PR) and clinical-benefit rate (CBR:CR + PR + SD); secondary endpoints were toxicity and progression-free-survival (PFS). Results We enrolled 68 patients from 2 study sites; 33 received docetaxel-sunitinib and 35 docetaxel alone, with 33 breast, 25 lung and 10 patients with other cancers. There was no difference in ORR (30.3% vs 28.6%, p = 0.432, odds-ratio [OR] 1.10, 95% CI 0.38–3.18); CBR was lower in the docetaxel-sunitinib arm (48.5% vs 71.4%, p = 0.027 OR 0.37, 95% CI 0.14–1.01). Median PFS was shorter in the docetaxel-sunitinib arm (2.9 vs 4.9 months, hazard-ratio [HR] 2.00, 95% CI 1.15–3.48, p = 0.014) overall, as well as in breast (4.2 vs 5.6 months, p = 0.048) and other cancers (2.0 vs 5.3 months, p = 0.009), but not in lung cancers (2.9 vs 4.1 months, p = 0.597). Median OS was similar in both arms overall (9.9 vs 10.5 months, HR 0.92, 95% CI 0.51–1.67, p = 0.789), and in the breast (18.9 vs 25.8 months, p = 0.354), lung (7.0 vs 6.7 months, p = 0.970) and other cancers (4.5 vs 8.8 months, p = 0.449) subgroups. Grade 3/4 haematological toxicities were lower with docetaxel-sunitinib (18.2% vs 34.3%, p = 0.132), attributed to greater discretionary use of prophylactic G-CSF (90.9% vs 63.0%, p = 0.024). Grade 3/4 non-haematological toxicities were similar (12.1% vs 14.3%, p = 0.792). Conclusions The addition of sunitinib to docetaxel was well-tolerated but did not improve outcomes. The possible negative impact in metastatic breast cancer patients is contrary to results of adding sunitinib to neoadjuvant AC. These negative results suggest that the intermittent administration of sunitinib in the current dose and schedule with docetaxel in advanced solid tumours, particularly breast cancers, is not beneficial. Trial registration The study was registered ( NCT01803503 ) prospectively on clinicaltrials.gov on 4th March 2013.

Published
2020
Full Text
View/download PDF

2. Best practice in the treatment of advanced squamous cell lung cancer

Author

Yvonne L. E. Ang, Hon-Lyn Tan, and Ross A. Soo

Subjects
Diseases of the respiratory system, RC705-779
Abstract

The management of advanced stage nonsmall cell lung cancer (NSCLC) has been altered by the recognition of histology-based treatment and the use of targeted therapy. Whilst outcomes have improved with adenocarcinoma, treatment options are still limited in advanced stage squamous cell lung cancer. With advances in the molecular characterization of squamous cell cancers (SCCs), new potential targets have been identified. In this review, we discuss the role of histology in the treatment of NSCLC, cytotoxic chemotherapy, existing targeted therapies, the new molecular subsets and novel inhibitors in squamous cell lung carcinoma, and the emerging role of immune checkpoint inhibitors. Based on the results of two recent studies, nivolumab, a programmed death 1 (PD-1) immune checkpoint inhibitor, has been approved by the US Food and Drug Administration (FDA) in the treatment of squamous cell NSCLC in the second-line setting. Well-designed biomarker driven studies are needed to accelerate the development and approval of novel therapies for patients with lung SCC.

Published
2015
Full Text
View/download PDF

3. ASO Visual Abstract: Outcomes of a Phase II Study of Intraperitoneal Paclitaxel Plus Systemic Capecitabine and Oxaliplatin (XELOX) for Gastric Cancer with Peritoneal Metastases

Author

Daryl K. A. Chia, Raghav Sundar, Guowei Kim, Jia Jun Ang, Jeffrey H. Y. Lum, Min En Nga, Giap Hean Goh, Je Ee Seet, Cheng Ean Chee, Hon Lyn Tan, Jingshan Ho, Natalie Y. L. Ngoi, Matilda X. W. Lee, Vaishnavi Muthu, Gloria H. J. Chan, Angela S. L. Pang, Yvonne L. E. Ang, Joan R. E. Choo, Joline S. J. Lim, Jun Liang Teh, Aung Lwin, Yuen Soon, Asim Shabbir, Jimmy B. Y. So, and Wei Peng Yong

Subjects
Oxaliplatin, Oncology, Paclitaxel, Stomach Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Humans, Surgery, Fluorouracil, Capecitabine, Peritoneal Neoplasms
Published
2022

4. Outcomes of a Phase II Study of Intraperitoneal Paclitaxel plus Systemic Capecitabine and Oxaliplatin (XELOX) for Gastric Cancer with Peritoneal Metastases

Author

Daryl K. A. Chia, Raghav Sundar, Guowei Kim, Jia Jun Ang, Jeffrey H. Y. Lum, Min En Nga, Giap Hean Goh, Ju Ee Seet, Cheng Ean Chee, Hon Lyn Tan, Jingshan Ho, Natalie Y. L. Ngoi, Matilda X. W. Lee, Vaishnavi Muthu, Gloria H. J. Chan, Angela S. L. Pang, Yvonne L. E. Ang, Joan R. E. Choo, Joline S. J. Lim, Jun Liang Teh, Aung Lwin, Yuen Soon, Asim Shabbir, Jimmy B. Y. So, and Wei Peng Yong

Subjects
Oxaliplatin, Oncology, Paclitaxel, Stomach Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Humans, Surgery, Fluorouracil, Deoxycytidine, Capecitabine, Peritoneal Neoplasms, Platinum
Abstract

Adding intraperitoneal paclitaxel (IP-PTX) to paclitaxel/5-fluoropyrimidine has shown promising results in patients with gastric cancer peritoneal metastases (GCPM) but has not been studied with standard-of-care platinum/fluoropyrimidine combinations. Our goal to was evaluate IP-PTX with capecitabine/oxaliplatin (XELOX) in GCPM.Forty-four patients with GCPM received IP PTX (40 mg/mThe median OS for the IP and SC groups was 14.6 and 10.6 months (hazard ratio [HR] 0.44; 95% confidence interval [CI], 0.26-0.74; p = 0.002). The median PFS for the IP and SC group was 9.5 and 4.4 months respectively (HR 0.39; 95% CI 0.25-0.66; p 0.001). Patients in the SC group were younger (IP vs. SC, 61 vs. 56 years, p = 0.021) and had better performance status (ECOG 0, IP vs. SC, 47.7% vs. 76.9%, p = 0.007) compared with the IP cohort. In IP group, conversion surgery was performed in 36.1% (13/36) of patients, with a median OS of 24.2 (95% CI 13.1-35.3) months and 1-year OS of 84.6%.IP PTX with XELOX is a promising treatment option for GCPM patients. In patients with good response, conversion surgery was feasible with favourable outcomes.

Published
2021

5. Noninvasive and invasive ventilation in acute respiratory failure associated with bronchiectasis

Author

Tow Keang Lim, Erlinda A. Santiago, Yvonne L. E. Ang, Kay Choong See, Eleanor Dela Pena, Jason Phua, and Amartya Mukhopadhyay

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Statistics, Nonparametric, Risk Factors, Intensive care, Anesthesiology, medicine, Humans, Hospital Mortality, Intensive care medicine, APACHE, Aged, Retrospective Studies, Aged, 80 and over, Mechanical ventilation, Chi-Square Distribution, Bronchiectasis, business.industry, Respiratory disease, Retrospective cohort study, Length of Stay, medicine.disease, Respiration, Artificial, Intensive Care Units, Logistic Models, Treatment Outcome, Respiratory failure, Acute Disease, Breathing, Female, Respiratory Insufficiency, business
Abstract

To describe the outcomes of patients with bronchiectasis and acute respiratory failure (ARF) treated with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) after a failure of conservative measures, and to identify the predictors of hospital mortality and NIV failure.Retrospective review of bronchiectatic patients on NIV (n = 31) or IMV (n = 26) for ARF over 8 years in a medical intensive care unit (ICU) experienced in NIV.At baseline, the NIV group had more patients with acute exacerbations without identified precipitating factors (87.1 vs. 34.6%, p0.001), higher pH (mean 7.25 vs. 7.18, p = 0.008) and PaO(2)/FiO(2) ratio (mean 249.4 vs. 173.2, p = 0.02), and a trend towards a lower APACHE II score (mean 25.3 vs. 28.4, p = 0.07) than the IMV group. There was no difference in hospital mortality between the two groups (25.8 vs. 26.9%, p0.05). The NIV failure rate (need for intubation or death in the ICU) was 32.3%. Using logistic regression, the APACHE II score was the only predictor of hospital mortality (OR 1.19 per point), and the PaO(2)/FiO(2) ratio was the only predictor of NIV failure (OR 1.02 per mmHg decrease).The hospital mortality of patients with bronchiectasis and ARF approximates 25% and is predicted by the APACHE II score. When selectively applied, NIV fails in one-third of the patients, and this is predicted by hypoxemia. Our findings call for randomised controlled trials to compare NIV versus IMV in such patients.

Published
2010

6. Record-based, stepwise screening for type 2 diabetes integrated into an annual cardiovascular care review system: Findings from a UK general practice

Author

Rebecca K. Simmons, Clare Goodhart, Yvonne L. E. Ang, and Benjamin G Fisher

Subjects
Program evaluation, Blood Glucose, Male, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, General Practice, Type 2 diabetes, Risk Assessment, Predictive Value of Tests, Risk Factors, Diabetes mellitus, Internal Medicine, medicine, Humans, Mass Screening, Mass screening, Aged, Aged, 80 and over, Glycated Hemoglobin, Medical Audit, Nutrition and Dietetics, business.industry, Attendance, nutritional and metabolic diseases, Middle Aged, medicine.disease, Early Diagnosis, Diabetes Mellitus, Type 2, England, Cardiovascular Diseases, Family medicine, Predictive value of tests, Physical therapy, Feasibility Studies, Female, Family Practice, business, Risk assessment, Biomarkers, Kidney disease, Program Evaluation
Abstract

Aims Screening high-risk individuals for type 2 diabetes (T2DM) is recommended by many organisations. We report results from a pragmatic stepwise T2DM screening programme integrated into an annual review system in a UK general practice. Methods Patients with hypertension, cardiovascular disease or chronic kidney disease attending an annual review were screened for dysglycaemia by random blood glucose (RBG) measurement. At the discretion of the usual doctor, individuals with an RBG≥6.1mmol/l were invited to return for fasting blood glucose (FBG) or HbA 1C measurement, allowing diagnosis of T2DM. Results 786 eligible patients were invited for T2DM screening as part of their annual review. 544 attended screening, of whom 120 had an RBG≥6.1mmol/l. 40 individuals attended FBG measurement and 8 individuals attended HbA 1C measurement, leading to 9 T2DM diagnoses. The positive predictive value of the test for T2DM was 19% and the laboratory cost was £91 per patient diagnosed with T2DM. Conclusions It is feasible to integrate a simple T2DM screening programme within an annual review system in a UK general practice. Different strategies may be required to increase initial attendance and ensure completion of the screening programme.

Published
2011

Catalog

Books, media, physical & digital resources
See catalog results