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  • 1
    In: Oncotarget, Impact Journals, LLC, Vol. 7, No. 13 ( 2016-03-29), p. 17087-17102
    Type of Medium: Online Resource
    ISSN: 1949-2553
    URL: Issue
    Language: English
    Publisher: Impact Journals, LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2560162-3
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  • 2
    In: American Journal of Clinical Oncology, Ovid Technologies (Wolters Kluwer Health)
    Abstract: Most patients receiving curative-intent surgery for pancreatic cancer will experience cancer recurrence. However, evidence that postoperative surveillance testing improves survival or quality of life is lacking. We evaluated the use and characteristics of surveillance with serial imaging and CA 19-9 tumor marker testing at an NCI-designated comprehensive cancer center. Methods: We conducted a retrospective cohort study of patients who entered surveillance after curative-intent resection of pancreatic adenocarcinoma. We abstracted information from the electronic medical record about oncology office visits, surveillance testing (cross-sectional imaging and CA 19-9 tumor marker testing), and pancreatic cancer recurrence, with follow-up through 2 years after pancreatectomy. We conducted analyses to describe the use of surveillance testing and to characterize the sensitivity and specificity of CA 19-9 tumor marker testing for the identification of cancer recurrence. Results: We identified 90 patients entering surveillance after pancreatectomy. CA 19-9 was the most frequently used surveillance test, followed by CT imaging. Forty-seven patients (52.2%) experienced recurrence within two years of pancreatectomy. Recurrence risk was 58.8% versus 31.8% in patients with elevated versus normal CA 19-9 at diagnosis ( P =0.03). Elevated CA 19-9 at any point during surveillance was significantly associated with 2-year recurrence risk ( P 〈 0.001). Elevated CA 19-9 had a sensitivity of 83% (95% CI 0.72–0.95) and specificity of 87% (0.76–0.98) for identification of recurrence within 2 years of pancreatectomy. Conclusions: CA 19-9 demonstrates clinical validity for identifying recurrence of pancreatic cancer during surveillance. Surveillance approaches with reduced reliance on imaging should be prospectively evaluated.
    Type of Medium: Online Resource
    ISSN: 0277-3732
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 3
    Online Resource
    Online Resource
    Elsevier BV ; 2008
    In:  Journal of Surgical Research Vol. 144, No. 2 ( 2008-2), p. 293-
    In: Journal of Surgical Research, Elsevier BV, Vol. 144, No. 2 ( 2008-2), p. 293-
    Type of Medium: Online Resource
    ISSN: 0022-4804
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 1470806-1
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  • 4
    Online Resource
    Online Resource
    American Society of Hematology ; 2009
    In:  Blood Vol. 114, No. 22 ( 2009-11-20), p. 4733-4733
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 4733-4733
    Abstract: Abstract 4733 Autologous stem cell transplant for myeloma improves survival, but the immunologic mechanisms accounting for this improvement are unknown. Our data indicate that NKG2D+CD8+T cells may be one reason for this benefit. NKG2D, one of four NK cell activating receptors, has been identified on some CD8+T cells that mediate TCR-independent and non-MHC restricted tumor cell killing. We identified methods for ex vivo expansion of cyclophosphamide – mobilized blood progenitor cells (BPCs) from myeloma patients, as part of a clinical trial (Cytotherapy 2008). Mobilized BPC are cultured in serum-free media with IL-2 (50 IU/ml) and OKT3 (50ng/ml). After 7 days, the CD8+ T cells are isolated, evaluated and tested. Myeloma cells from patients' marrow aspirates are used as targets in cytotoxicity assays. Phenotypic analysis of the expanded cells and the patients' primary myeloma cells was performed using flow cytometry. Ex vivo expansion of cyclophosphamide-mobilized BPCs induces CD8+ T cells that acquire the NKG2D receptor during ex vivo expansion (P 〈 0.03). Three of the 6 known NKG2D ligands are strongly expressed on patients' myeloma cells, including MICA, ULBP1 and ULBP3. Using cytotoxicity assays, autologous effector cells recognize and kill the patient's autologous tumor cells (E:T 50:1, P 〈 0.001). When using K562 leukemia cells as targets (lack MHC class I), the NKG2D+CD8+ T cells kill K562, supporting an MHC class I-independent mechanism of tumor cell killing. Blocking the NKG2D receptor on CD8+ T cells prevents killing of autologous myeloma cells (P 〈 0.009). NKG2D-mediated cytotoxicity correlates with the amount of ligand expression on the target. The NKG2D receptor on CD8+T cells recognizes ligands expressed on autologous myeloma cells. The NKG2D+CD8+T cells aggressively kill myeloma cells in a non–MHC restricted and TCR-independent manner. Blocking NKG2D on CD8+ T cells prevents killing of autologous myeloma cells. Since tumor cells often down regulate MHC Class I expression, the ability of NKG2D+CD8+ T cells to recognize and kill autologous myeloma cells in a non-MHC restricted manner may contribute to the beneficial effects in the treatment of myeloma. Ongoing experiments are testing these methods in mouse models and defining the molecular mechanisms involved. Disclosures: Szczepiorkowski: Cersus Corporation: Research Funding; CaridianBCT: Research Funding; BASF: Research Funding; Terumo Corporation: Research Funding; Fenwel, Inc - Scientific Advisory Board: Research Funding. Meehan:Berlex Pharmaceutical: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 5
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 5, No. Supplement_1 ( 2021-05-03), p. A423-A424
    Abstract: Total pancreatectomy with intraportal islet cell autotransplantation (TPIAT) allows for the islets to be isolated and subsequently re-infused to prevent the complications associated with post-pancreatectomy diabetes in patients with chronic or recurrent pancreatitis. TPIAT requires a complex islet isolation process of the explanted pancreas, and historically required a specialized lab to perform islet cell isolation. We report our unique 5-year experience comparing our new technique of intra-operative islet isolation to the prior use of off-site specialized islet lab, thereby making the isolation process simpler, faster, and more accessible. Method: We performed a retrospective, comparative effectiveness analysis of 50 adult patients who underwent TPIAT at our tertiary care center from 2012 to 2020 (excluding patients with partial- or completion pancreatectomy with IAT). From 2012–2015, isolation occurred at a remote location 130 miles away in which the pancreas was explanted at our center, transported to the islet isolation lab, and returned the same day to our center for portal system infusion. From 2015–2020, islet isolation was performed using the novel intra-operative technique at our institution without a specialized islet isolation lab. We measured the islet equivalents per body weight (IEQ/kg), monitored glycemic control, and compared insulin-independent rate for patients in each group yearly up to 5 years. Results: Twenty patients underwent TPIAT with remote isolation while thirty patients underwent intra-operative isolation of islet cells. Baseline characteristics were similar between these groups. Mean islet yields-IEQ/kg (4,294 remote group vs. 3,015 intra-op group, p=0.06) were not different between the groups. Post-operative mean c-peptide levels at 1 and 3 years were stable over time and were not different between the groups (1.51 and 1.65 ng/mL remote group vs. 0.91 and 0.98 ng/mL intra-operative group, p=0.1 and 0.15 respectively). Mean HbA1c levels at 1–5 years were 7.5–8.2% in the remote group vs. 7.1–7.4% intra-op group, p=0.67, which suggests reasonable and durable glycemic control in both groups. Insulin independent rate was also very similar (43% vs 41%, p=0.10) at 3 years after the surgery when both groups reached the same number of patients (n=20) for the comparison. Average cost of hospitalization was less in the intra-operative group ($104,398 remote vs $78,986 intra-op). Conclusion: Intra-operative islet isolation has similar effectiveness in regard to glycemic outcomes and insulin independent rates but at a lower cost when compared with the use of a dedicated islet cell isolation lab. This technique can allow many more centers without a dedicated islet cell lab to offer islet cell auto-transplantation, which in turn will help reduce the burden of difficult diabetes care post-pancreatectomy and improve quality of life for the appropriate patients.
    Type of Medium: Online Resource
    ISSN: 2472-1972
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2021
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  • 6
    In: Transfusion, Wiley, Vol. 54, No. 6 ( 2014-06), p. 1515-1521
    Abstract: The NKG 2 D receptor, one of the natural killer ( NK ) cell–activating receptors, is expressed on the surface of CD 3+ CD 8+ T cells, γδ+ T cells, NK cells, NKT cells, and a few CD 4+ T cells. We show, for the first time, a critical role for the NKG 2 D receptor on CD 3+ CD 8+ T cells isolated from myeloma patients, in identifying and killing autologous myeloma cells isolated from the same patients’ marrow. We also show that blocking NKG 2 D using anti‐ NKG 2 D reverses the cytotoxicity while blocking HLA ‐ I using antibodies does not have the same effect, showing that the autologous cytotoxicity is NKG 2 D dependent and major histocompatibility complex ( MHC )‐ I independent. We further confirmed the NKG 2 D specificity by small interfering RNA ( siRNA ) down regulation of NKG 2 D receptor. Study Design and Methods Using ex vivo expansion methods that enrich for NKG 2 D + CD 3+ CD 8+ T cells, we investigated whether these ex vivo expanded NKG 2 D + CD 3+ CD 8+ T cells would recognize and lyse autologous and allogeneic myeloma cells, independent of T ‐cell receptor or MHC ‐ I expression. Results Myeloma cell lysis by the NKG 2 D + CD 3+ CD 8+ T cells correlated with the amount of NKG 2 D ligand expression. With receptor–ligand interaction, interferon‐γ and tumor necrosis factor‐α were released. Blocking the NKG 2 D receptor by using either monoclonal antibodies or si RNAs inhibited the receptor's function and prevented myeloma cell lysis. Conclusion Clinical trials are ongoing to determine a correlation with the number and function of NKG 2 D + CD 3+ CD 8+ T cells and clinical outcomes in transplanted myeloma patients, including lymphocyte recovery following transplant and overall survival.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 7
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Transplantation Direct Vol. 8, No. 5 ( 2022-05), p. e1314-
    In: Transplantation Direct, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 5 ( 2022-05), p. e1314-
    Type of Medium: Online Resource
    ISSN: 2373-8731
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2890276-2
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  • 8
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 70, No. 8_Supplement ( 2010-04-15), p. 2400-2400
    Abstract: Introduction. Phase III trials have shown that a vaccine consisting of irradiated autologous tumor cells plus bacille Calmette-Guerin (BCG) can induce anti-tumor immune responses in patients after resection of colorectal cancer. We have demonstrated in preclinical studies that an intranodally injected tumor lysate pulsed dendritic cell (DC) vaccine induces a more potent immune response than tumor cells plus BCG. Preclinical studies also indicate that DC maturation via signaling through CD40 increases vaccine potency. Patients and Methods. Twenty six patients who had undergone resection of colorectal metastases were treated with an intranodal injection of a vaccine consisting of autologous tumor lysate pulsed dendritic cells. Keyhole limpet hemocyanin (KLH) was added to the lysate as an adjuvant and a control protein. Patients were randomized to receive DCs that had been either activated or not activated with rhCD40L. Immune responses were evaluated with a dye dilution proliferation assay, an IFNγ ELISPOT assay and delayed type hypersensitivity (DTH) testing. All patients were followed for a minimum of 5.5 years after vaccination. Results. The vaccine was administered to all patients with minimal toxicity. Immunization induced an autologous tumor specific proliferative T cell immune response in 8 of 24 assessable patients (33%), a tumor specific IFNγ secretory response in 10 of 24 patients (42%) and a DTH response to autologous tumor cells in 14 of 23 patients (61%). KLH specific responses were induced in 54%, 83% and 60% of patients by proliferation, IFNγ ELISPOT and DTH assays, respectively. Use of this whole cell antigen source induced peptide (CEA, Her-2 neu, Muc-1) specific T cell immune responses in half of the assayed patients. Relapse free survival (RFS) was 58%, 41% and 37% at 1, 2 and 5 years. Patients with evidence of a vaccine induced anti-tumor proliferative T cell immune response one week after vaccination had a markedly better RFS at 5 years (67% vs 31%, p=0.057) than non-responders. There was a trend towards better RFS at 5 years (67% vs 23%, p= 0.09) in patients who developed a vaccine induced tumor specific IFNγ T cell response. No association was observed between induction of KLH specific immune responses and RFS. DCs grown in the presence of rhCD40L were observed to have a significantly greater expression of the costimulatory molecule CD86 and the maturation marker CD83. However, rhCD40L DC activation did not significantly affect the percentage of patients with positive immune responses. Conclusions. Adjuvant treatment of patients after resection of colorectal metastases with a tumor lysate pulsed dendritic cell vaccine induced tumor specific immune responses in a high proportion of patients. There was an association between induction of tumor specific immune responses and recurrence free survival. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2400.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2010
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 9
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 10 ( 2020-9-16)
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2649216-7
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  • 10
    In: Molecular Biology of the Cell, American Society for Cell Biology (ASCB), Vol. 31, No. 12 ( 2020-06-01), p. 1259-1272
    Abstract: Actin-based tubular connections between cells have been observed in many cell types. Termed “tunneling nanotubes (TNTs),” “membrane nanotubes,” “tumor microtubes (TMTs),” or “cytonemes,” these protrusions interconnect cells in dynamic networks. Structural features in these protrusions vary between cellular systems, including tubule diameter and the presence of microtubules. We find tubular protrusions, which we classify as TMTs, in a pancreatic cancer cell line, Dartmouth-Hitchcock Pancreatic Cancer (DHPC)-018. TMTs are present in DHPC–018-derived tumors in mice, as well as in a mouse model of pancreatic cancer and a subset of primary human tumors. DHPC-018 TMTs have heterogeneous diameter (0.39–5.85 µm, median 1.92 µm) and contain actin filaments, microtubules, and cytokeratin 19-based intermediate filaments. TMTs do not allow intercellular transfer of cytoplasmic GFP. Actin filaments are cortical within the protrusion, as opposed to TNTs, in which filaments run down the center. TMTs are dynamic in length, but are long lived (median 〉 60 min). Inhibition of actin polymerization, but not microtubules, results in TMT loss. Extracellular calcium is necessary for TMT maintenance. A second class of tubular protrusion, which we term cell-substrate protrusion, has similar width range and cytoskeletal features but makes contact with the substratum as opposed to another cell. Similar to previous work on TNTs, we find two assembly mechanisms for TMTs, which we term “pull-away” and “search-and-capture.” Inhibition of Arp2/3 complex inhibits TMT assembly by both mechanisms. This work demonstrates that the actin architecture of TMTs in pancreatic cancer cells is fundamentally different from that of TNTs and demonstrates the role of Arp2/3 complex in TMT assembly.
    Type of Medium: Online Resource
    ISSN: 1059-1524 , 1939-4586
    Language: English
    Publisher: American Society for Cell Biology (ASCB)
    Publication Date: 2020
    detail.hit.zdb_id: 1474922-1
    SSG: 12
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