GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • American Society of Clinical Oncology (ASCO)  (2)
  • 1
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 6_suppl ( 2020-02-20), p. 525-525
    Abstract: 525 Background: Circulating tumor cells (CTCs) are promising biomarkers in metastatic urothelial cancer (UC). Unfortunately, efforts in localized disease have been unsuccessful, in part due to limitations of existing technologies that rely on counting cells and epithelial-marker expression. Here, we applied a novel selection-free digital pathology platform in a localized UC cohort. To date, this platform has associated CTC morphology with differential therapeutic response in metastatic UC and castrate-resistant prostate cancer. If feasible in localized UC, we may potentially identify best candidates for adjuvant therapy or bladder sparing, as well as enable sensitive monitoring for recurrence. Methods: N=16 consecutive UC pts included 8 (50%) metastatic controls and 8 (50%) localized (3 (37%) at TURBT and 5 (63%) at cystectomy). Peripheral blood was processed with the Epic CTC platform (pan-CK/CD45/PD-L1/DAPI staining). Approximately 3 million cells per slide were imaged. Unsupervised clustering categorized CTCs into 5 subtypes based on 11 morphologic features (nuclear solidity, speckling, nucleoli and entropy; cytokeratin speckling and ratio; and cytoplasmic/nuclear circularity, area, and convex area ratio). Results: 119 CTCs were detected from 11/16 (69%) pts (5/8 (63%) localized (2 NMIBC, 6 MIBC) and 6/8 (75%) metastatic). All MIBC pts had cystectomy (4/6 (67%) received NAC). 2/8 (25%) metastatic pts had stable disease, 3/8 (38%) were progressing, and 3/8 (38%) had newly detected M1. Median (range) CTC count/mL was similar for localized and metastatic pts (0.4 (0-58.6), 0.75 (0-1.9)). CTCs were detected in a pt with CIS, but not in a pt with TaHG disease. 1/16 (6.3%) pts had a single PD-L1+ CTC. CTCs were successfully assigned into 5 subtypes with predominant features of large, small, or linear cells, high cytoplasmic circularity, and prominent nucleoli. Conclusions: Digital pathology and subtype assignment of CTCs is feasible in localized UC. Ongoing efforts at our center include application of this technology in localized patients receiving investigational checkpoint inhibitor therapy to potentially predict best responders or conversely those at the highest risk for recurrence.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 28_suppl ( 2021-10-01), p. 261-261
    Abstract: 261 Background: Radiation therapists (RTTs) administer radiation treatments to patients with cancer. Treatments are delivered using linear accelerators (LINACs), operated by vendor specific software. Prior to delivering treatment, RTTs perform a time-out, and read aloud critical electronic communications (alerts) entered by members of the radiation oncology care team. Alerts are effective at communicating critical information, including treatment setup and imaging instructions, but can become a source of error due to alert fatigue when placed indiscriminately. Methods: A multicenter retrospective review of alert use per patient was conducted in 4 radiation oncology centers with a total of 6 LINACs. Alert usage was reviewed pre-intervention for 40 randomly selected patients using manual chart review. Each alert was reviewed for frequency and utilization. In attempt of improving communication and reducing alert fatigue, a multidisciplinary process improvement working group (with Radiation Oncologists, RTTs, nursing, physicists, and administration) was formed to review the utilization of alerts in our department and propose interventions. Three months after intervention, an additional 40 chart review was performed. Our aim was to reduce the volume of alerts by 20% within 3 months. A 2-tail t-test was used for statistical analysis. Results: Process improvements were implemented to reduce the volume of alerts per patient. Interventions included 1) defining an alert for all departmental staff, 2) creating guidelines for appropriate utilization of alerts, 3) routing communications not critical to RTTs at the time of radiation treatment administration through other channels, and 4) training staff as to the above. The pre-intervention review yielded 239 alerts. Post-intervention, there were 173 alerts, a reduction of 27% (p =.008). Conclusions: This practice change reduced average alert volume by 27%. As a result, alerts which are critical to safe treatment delivery by RTTs (i.e. daily setup alerts), became more heavily represented. Other alerts, which could be communicated effectively in other ways (i.e. OTVs [weekly on treatment visit with Radiation Oncologist]), were eliminated. By decreasing alert volume, the risk of RTT alert fatigue is reduced, communication improved, and treatment safety enhanced.[Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...