Analysis of tumor template from multiple compartments in a blood sample provides complementary access to peripheral tumor biomarkers.

Targeted cancer therapeutics are promised to have a major impact on cancer treatment and survival. Successful application of these novel treatments requires a molecular definition of a patient\u27s disease typically achieved through the use of tissue biopsies. Alternatively, allowing longitudinal monitoring, biomarkers derived from blood, isolated either from circulating tumor cell derived DNA (ctcDNA) or circulating cell-free tumor DNA (ccfDNA) may be evaluated. In order to use blood derived templates for mutational profiling in clinical decisions, it is essential to understand the different template qualities and how they compare to biopsy derived template DNA as both blood-based templates are rare and distinct from the gold-standard. Using a next generation re-sequencing strategy, concordance of the mutational spectrum was evaluated in 32 patient-matched ctcDNA and ccfDNA templates with comparison to tissue biopsy derived DNA template. Different CTC antibody capture systems for DNA isolation from patient blood samples were also compared. Significant overlap was observed between ctcDNA, ccfDNA and tissue derived templates. Interestingly, if the results of ctcDNA and ccfDNA template sequencing were combined, productive samples showed similar detection frequency (56% vs 58%), were temporally flexible, and were complementary both to each other and the gold standard. These observations justify the use of a multiple template approach to the liquid biopsy, where germline, ctcDNA, and ccfDNA templates are employed for clinical diagnostic purposes and open a path to comprehensive blood derived biomarker access

Rates of Bile Acid Diarrhoea After Cholecystectomy:A Multicentre Audit

Introduction: Bile acid diarrhoea (BAD) can occur due to disruption to the enterohepatic circulation, e.g. following cholecystectomy. Post-cholecystectomy diarrhoea has been reported in 2.1–57.2% of patients; however, this is not necessarily due to BAD. The aim of this study was to determine the rates of bile acid diarrhoea diagnosis after cholecystectomy and to consider investigation practices. Methods: A retrospective analysis of electronic databases from five large centres detailing patients who underwent laparoscopic cholecystectomy between 2013 and 2017 was cross-referenced with a list of patients who underwent 75SeHCAT testing. A 7-day retention time of <15% was deemed to be positive. Patient demographics and time from surgery to investigation were collected and compared for significance (p < 0.05). Results: A total of 9439 patients underwent a laparoscopic cholecystectomy between 1 January 2013 and 31 December 2017 in the five centres. In total, 202 patients (2.1%) underwent investigation for diarrhoea via 75SeHCAT, of which 64 patients (31.6%) had a 75SeHCAT test result of >15%, while 62.8% of those investigated were diagnosed with bile acid diarrhoea (BAD). In total, 133 (65.8%) patients also underwent endoscopy and 74 (36.6%) patients had a CT scan. Median time from surgery to 75SeHCAT test was 672 days (SD ± 482 days). Discussion/Conclusion: Only a small proportion of patients, post-cholecystectomy, were investigated for diarrhoea with significant time delay to diagnosis. The true prevalence of BAD after cholecystectomy may be much higher, and clinicians need to have an increased awareness of this condition due to its amenability to treatment. 75SeHCAT is a useful tool for diagnosis of bile acid diarrhoea

Microfluidics for Positron Emission Tomography Probe Development

Owing to increased needs for positron emission tomography (PET), high demands for a wide variety of radiolabeled compounds will have to be met by exploiting novel radiochemistry and engineering technologies to improve the production and development of PET probes. The application of microfluidic reactors to perform radiosyntheses is currently attracting a great deal of interest because of their potential to deliver many advantages over conventional labeling systems. Microfluidics-based radiochemistry can lead to the use of smaller quantities of precursors, accelerated reaction rates, and easier purification processes with greater yield and higher specific activity of desired probes. Several proof-of-principle examples along with the basics of device architecture and operation and the potential limitations of each design are discussed. Along with the concept of radioisotope distribution from centralized cyclotron facilities to individual imaging centers and laboratories (“decentralized model”), an easy-to-use, stand-alone, flexible, fully automated, radiochemical microfluidic platform can provide simpler and more cost-effective procedures for molecular imaging using PET

Outcomes of laser thermal therapy for recurrent head and neck cancer

OBJECTIVE: To review the outcomes of a phase II study using laser-induced thermal therapy (LIFT) as a palliative treatment for 106 patients with recurrent head and neck tumors.STUDY DESIGN: Retrospective study.SETTING: Tertiary hospital in the United States.SUBJECTS and METHODS: the primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method.RESULTS: the best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/- 6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors.CONCLUSION: in this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. the highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT. (c) 2010 American Academy of Otolaryngology Head and Neck Surgery Foundation. All rights reserved.Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of HealthFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Head & Neck Surg, Los Angeles, CA 90095 USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA 90095 USAUniv Miami, Dept Otolaryngol Head & Neck Surg, Miami, FL USAUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilDivision of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K23CA88921Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K22CA131509FAPESP: 08/54714-6Web of Scienc

Outcomes of laser thermal therapy for recurrent head and neck cancer

OBJECTIVE: To review the outcomes of a phase II study using laser-induced thermal therapy (LIFT) as a palliative treatment for 106 patients with recurrent head and neck tumors.STUDY DESIGN: Retrospective study.SETTING: Tertiary hospital in the United States.SUBJECTS and METHODS: the primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method.RESULTS: the best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/- 6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors.CONCLUSION: in this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. the highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT. (c) 2010 American Academy of Otolaryngology Head and Neck Surgery Foundation. All rights reserved.Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of HealthFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Head & Neck Surg, Los Angeles, CA 90095 USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA 90095 USAUniv Miami, Dept Otolaryngol Head & Neck Surg, Miami, FL USAUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilDivision of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K23CA88921Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K22CA131509FAPESP: 08/54714-6Web of Scienc

Microfluidics for Positron Emission Tomography Probe Development

Owing to increased needs for positron emission tomography (PET), high demands for a wide variety of radiolabeled compounds will have to be met by exploiting novel radiochemistry and engineering technologies to improve the production and development of PET probes. The application of microfluidic reactors to perform radiosyntheses is currently attracting a great deal of interest because of their potential to deliver many advantages over conventional labeling systems. Microfluidics-based radiochemistry can lead to the use of smaller quantities of precursors, accelerated reaction rates, and easier purification processes with greater yield and higher specific activity of desired probes. Several proof-of-principle examples along with the basics of device architecture and operation and the potential limitations of each design are discussed. Along with the concept of radioisotope distribution from centralized cyclotron facilities to individual imaging centers and laboratories (“decentralized model”), an easy-to-use, stand-alone, flexible, fully automated, radiochemical microfluidic platform can provide simpler and more cost-effective procedures for molecular imaging using PET