Papers by Stephen Williamson
JAMA Oncology
The durability of the antibody response to COVID-19 vaccines in patients with cancer undergoing t... more The durability of the antibody response to COVID-19 vaccines in patients with cancer undergoing treatment or who received a stem cell transplant is unknown and may be associated with infection outcomes. OBJECTIVE To evaluate anti-SARS-CoV-2 spike protein receptor binding domain (anti-RBD) and neutralizing antibody (nAb) responses to COVID-19 vaccines longitudinally over 6 months in patients with cancer undergoing treatment or who received a stem cell transplant (SCT). DESIGN, SETTING, AND PARTICIPANTS In this prospective, observational, longitudinal cross-sectional study of 453 patients with cancer undergoing treatment or who received an SCT at the University of Kansas Cancer Center in Kansas City, blood samples were obtained before 433 patients received a messenger RNA (mRNA) vaccine (BNT162b2 or mRNA-1273), after the first dose of the mRNA vaccine, and 1 month, 3 months, and 6 months after the second dose. Blood samples were also obtained 2, 4, and 7 months after 17 patients received the JNJ-78436735 vaccine. For patients receiving a third dose of an mRNA vaccine, blood samples were obtained 30 days after the third dose. INTERVENTIONS Blood samples and BNT162b2, mRNA-1273, or JNJ-78436735 vaccines. MAIN OUTCOMES AND MEASURES Geometric mean titers (GMTs) of the anti-RBD; the ratio of GMTs for analysis of demographic, disease, and treatment variables; the percentage of neutralization of anti-RBD antibodies; and the correlation between anti-RBD and nAb responses to the COVID-19 vaccines. RESULTS This study enrolled 453 patients (mean [SD] age, 60.4 [13,1] years; 253 [56%] were female). Of 450 patients, 273 (61%) received the BNT162b2 vaccine (Pfizer), 160 (36%) received the mRNA-1273 vaccine (Moderna), and 17 (4%) received the JNJ-7846735 vaccine (Johnson & Johnson). The GMTs of the anti-RBD for all patients were 1.70 (95% CI, 1.04-2.85) before vaccination, 18.65 (95% CI, 10.19-34.11) after the first dose, 470.38 (95% CI, 322.07-686.99) at 1 month after the second dose, 425.80 (95% CI, 322.24-562.64) at 3 months after the second dose, 447.23 (95% CI, 258.53-773.66) at 6 months after the second dose, and 9224.85 (95% CI, 2423.92-35107.55) after the third dose. The rate of threshold neutralization (Õ†30%) was observed in 203 of 252 patients (80%) 1 month after the second dose and in 135 of 166 patients (81%) 3 months after the second dose. Anti-RBD and nAb were highly correlated (Spearman correlation coefficient, 0.93 [0.92-0.94]; P < .001). Three months after the second dose, anti-RBD titers were lower in male vs female patients (ratio of GMTs, 0.52 [95% CI, 0.34-0.81]), patients older than 65 years vs patients 50 years or younger (ratio of GMTs, 0.38 [95% CI, 0.25-0.57]), and patients with hematologic malignant tumors vs solid tumors (ratio of GMTs, 0.40 [95% CI, 0.20-0.81]). CONCLUSIONS AND RELEVANCE In this cross-sectional study, after 2 doses of an mRNA vaccine, anti-RBD titers peaked at 1 month and remained stable over the next 6 months. Patients older than 65 years of age, male patients, and patients with a hematologic malignant tumor had low antibody titers. Compared with the primary vaccine course, a 20-fold increase in titers from a third dose suggests a brisk B-cell anamnestic response in patients with cancer.
Cancer Research, 2022
Background: Infection with SARS-CoV-2 has led to a global pandemic and has significantly impacted... more Background: Infection with SARS-CoV-2 has led to a global pandemic and has significantly impacted the care of cancer patients. Breast cancer patients receiving active systemic therapy need protection against COVID19 but the efficacy of vaccines in this population is unknown. Although specific biomarkers associated with protection from SARS-CoV-2 infection have yet to be identified, measurement of serum antibody activity is generally accepted as a surrogate of in vivo humoral response to vaccine. This study evaluates the efficiency and durability of binding antibodies to SARS-CoV-2 spike (S) protein in response to COVID19 vaccine in breast cancer patients receiving systemic treatment. Methods: Breast cancer patients, who were unvaccinated, partially or fully vaccinated with Pfizer-BioNTech BNT162b2 (PF), Moderna mRNA-1273 (Mod) or Johnson & Johnson AD26.COV2.S (J&J) were enrolled in this prospective longitudinal study. Eligible patients were on systemic treatment with cytotoxic chemo...
Journal of Hepatocellular Carcinoma, 2021
Background: Several systemic agents have been approved for use in advanced hepatocellular carcino... more Background: Several systemic agents have been approved for use in advanced hepatocellular carcinoma (aHCC). However, it is unclear which treatment is superior in either the firstor second-line settings due to the paucity of head-to-head comparative trials. Therefore, we have conducted a systematic review and network meta-analysis for the indirect comparison of the systemic agents in the first line and second line settings. Methods: Randomized clinical trials evaluating systemic agents in first and second line settings in aHCC from inception to April 2020 were identified by searching PubMed, EMBASE, and Cochrane Databases and the annual ASCO and ESMO conferences from 2017 to 2020. Studies in English reporting clinical outcomes including overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were included. The primary outcomes of interest were pooled hazard ratios (HR) of OS and pooled odds ratios (OR) of ORR in first line studies and pooled HR of PFS and OR of ORR for second line studies. Additionally, OS for second line agents were reported in the qualitative analysis. Results: Overall, first line studies comprised 8335 patients (13 studies) and second line studies comprised 4612 patients (11 studies). In the first line setting, atezolizumab plus bevacizumab was associated with the highest OS benefit over sorafenib (HR 0.58, 95% CI, 0.42-0.80; P-score 0.993). Additionally, lenvatinib was associated with the greatest ORR benefit (OR 3.34, 95% CI, 2.17-5.14; P-score 0.080) in the first line setting. In the second line setting, cabozantinib was associated with the highest PFS benefit over placebo (HR 0.44, 95% CI, 0.29-0.66; P-score 0.854) as well as the highest ORR benefit (OR 9.40, 95% CI, 1.25-70.83, P-score, 0.266). Conclusion: Atezolizumab plus bevacizumab appears to have superior efficacy among first line agents whereas cabozantinib appears to be superior in the second line setting. Further studies are warranted to determine whether the type of prior therapy received affects the efficacy of subsequent second line therapy.
Journal of Clinical Medicine, 2020
We examined the relationship between the daily rate of change of cancer antigen 19-9 (CA19-9) ove... more We examined the relationship between the daily rate of change of cancer antigen 19-9 (CA19-9) over the first 90 days of treatment (DRC90) and the pretreatment levels of neutrophils, lymphocytes, and platelets with the overall survival (OS) and progression-free survival (PFS) in patients with stage IV pancreatic ductal adenocarcinoma (PDA) who received chemotherapy. We retrospectively evaluated 102 locally advanced and metastatic PDA patients treated at the University of Kansas Cancer Center (KUCC) between January 2011 and September 2019. We compared the ratio of the pretreatment absolute neutrophil count to the pretreatment absolute lymphocyte count (NLR) and the ratio between the pretreatment platelet count to the pretreatment absolute lymphocyte count (PLR) with the OS and PFS. We compared the DRC90 to the OS and PFS. The ratios were analyzed using the log-rank trend test using the mean of the NLR, PLR, and DRC90 as the threshold for two groups within each variable. Patients with ...
Journal of Clinical Medicine, 2020
Several targeted agents including multi-tyrosine kinase inhibitors (mTKIs) and immunotherapy (IO)... more Several targeted agents including multi-tyrosine kinase inhibitors (mTKIs) and immunotherapy (IO) agents have been approved for use beyond the frontline setting in patients with advanced hepatocellular carcinoma (HCC). Due to lack of prospective head-to-head comparative trials, there is no standardized way for alternating those agents beyond frontline. Therefore, we performed a retrospective review of the Kansas University (KU) cancer registry to determine whether IO may be superior to non-IO therapy. Patients with advanced HCC were divided into two groups based on the second-line systemic regimen received (IO vs. non-IO). Progression-free survival (PFS) and overall survival (OS) were calculated under the Kaplan–Meier and Cox proportional hazards models. No statistically significant differences in PFS and OS were found, although a non-significant delayed separation in the survival curve favoring IO was identified (median PFS 3.9 months vs. 3 months; median OS 10 months vs. 10 months...
BMJ Case Reports, 2020
Immune checkpoint inhibitors, including antiprogrammed death cell protein 1 (anti-PD-1) and anti ... more Immune checkpoint inhibitors, including antiprogrammed death cell protein 1 (anti-PD-1) and anti cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4), have been associated with a range of autoimmune-related side effects since their introduction in cancer treatment. Small vessel digital necrosis, referred to as the acral vascular syndrome, is a rare but serious complication that can result in loss of digits. Here we present a case report of acral vascular syndrome and review possible aetiologies. A 45- year-old woman with invasive ductal carcinoma of the left breast presented to the emergency department during neoadjuvant treatment with carboplatin, docetaxel and pembrolizumab with complaints of severe pain in her right third digit. She had physical findings consistent with ischaemic necrosis and gangrene of the distal phalanx. Angiography demonstrated Raynaud’s phenomenon in the distal portion of the digits. Laboratory testing showed a weakly positive RNA polymerase III antibod...
The oncologist, Jan 23, 2018
Patients with hepatocellular carcinoma (HCC) often have limited therapeutic responses to the vasc... more Patients with hepatocellular carcinoma (HCC) often have limited therapeutic responses to the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor sorafenib, which is standard of care in advanced HCC. Targeting the activin receptor-like kinase 1 (ALK1) and VEGF pathways simultaneously by combining the ALK1 ligand trap dalantercept with sorafenib may result in more effective angiogenic blockade and delay tumor progression in patients with advanced HCC.Although the combination was generally well tolerated, there was no additive antitumor activity with the combination of dalantercept plus sorafenib in patients with advanced HCC. No complete or partial responses were observed, and overall survival ranged from 1.9 to 23.3 months.These results suggest that, in this patient population, further development of the possible limited benefits of combination therapy with dalantercept plus sorafenib is not warranted. Targeting the activin receptor-like kinase 1 (ALK1) and vascular e...
Nanomedicine : nanotechnology, biology, and medicine, Aug 18, 2018
Numerous proteases, such as matrix metalloproteinases (MMPs), cathepsins (CTS), and urokinase pla... more Numerous proteases, such as matrix metalloproteinases (MMPs), cathepsins (CTS), and urokinase plasminogen activator (UpA), are dysfunctional (that is, over- or under-expressed) in solid tumors, when compared to healthy human subjects. This offers the opportunity to detect early tumors by liquid biopsies. This approach is of particular advantage for the early detection of pancreatic cancer, which is a "silent killer". We have developed fluorescence nanobiosensors for ultrasensitive (sub-femtomolar) arginase and protease detection, consisting of water-dispersible Fe/FeO core/shell nanoparticles and two tethered fluorescent dyes: TCPP (Tetrakis(4-carboxyphenyl)porphyrin) and cyanine 5.5. Upon posttranslational modification or enzymatic cleavage, the fluorescence of TCPP increases, which enables the detection of proteases at sub-femtomolar activities utilizing conventional plate readers. We have identified an enzymatic signature for the detection of pancreatic adenocarcinomas ...
Scientific reports, Jan 7, 2017
Pancreatic cancer is among the most lethal cancers with poorly tolerated treatments. There is inc... more Pancreatic cancer is among the most lethal cancers with poorly tolerated treatments. There is increasing interest in using high-dose intravenous ascorbate (IVC) in treating this disease partially because of its low toxicity. IVC bypasses bioavailability barriers of oral ingestion, provides pharmacological concentrations in tissues, and exhibits selective cytotoxic effects in cancer cells through peroxide formation. Here, we further revealed its anti-pancreatic cancer mechanisms and conducted a phase I/IIa study to investigate pharmacokinetic interaction between IVC and gemcitabine. Pharmacological ascorbate induced cell death in pancreatic cancer cells with diverse mutational backgrounds. Pharmacological ascorbate depleted cellular NAD+ preferentially in cancer cells versus normal cells, leading to depletion of ATP and robustly increased α-tubulin acetylation in cancer cells. While ATP depletion led to cell death, over-acetylated tubulin led to inhibition of motility and mitosis. Co...
Journal of Clinical Oncology, 2004
3621 Background: After reducing doses of CPT-11 from 125 to 100 (doses in mg/m2) and 5FU from 500... more 3621 Background: After reducing doses of CPT-11 from 125 to 100 (doses in mg/m2) and 5FU from 500 to 400 (LV unchanged, 20 ) due to increased toxicity & early mortality (Rothenberg, JCO 2001), Intergroup N9741 concurrently randomized 355 of a planned 600 patients (pts) with CRC to FOLFOX-4 or R-IFL. Randomization was terminated early due to superior results on FOLFOX. Methods: The regimens were: FOLFOX 4 (Oxal 85 d 1 + LV 200/5-FU 400 bolus + 600 as a 22 hour infusion d 1,2 q 2 week); R-IFL (CPT-11 100 + LV 20/5FU bolus 400 weekly x 4, q 6 week. Results: Pts/arm were: FOLFOX-154, R-IFL-151. 60 day all-cause mortality was FOLFOX 2.0%, R-IFL 2.7%. Common grade ≥3 toxicities are below. With median follow-up of 18.0 months, median time to progression (TTP) (primary endpoint) for FOLFOX is significantly better than for R-IFL: 10.1 vs 6.5 months (mo) respectively (Logrank p<0.0001). The median survival (OS) is significantly greater for FOLFOX than R-IFL: 20.5 vs 16.3 mo (p = 0.026). Confirmed response rates (RR...
American journal of clinical oncology, Jan 15, 2016
To evaluate the expression of programmed cell death-ligand 1 (PD-L1) in anal cancer. In a retrosp... more To evaluate the expression of programmed cell death-ligand 1 (PD-L1) in anal cancer. In a retrospective cohort analysis, subjects with squamous cell carcinoma of the anal canal were tested for PD-L1 expression, then followed for recurrence and survival. Crude recurrence rates (CRRs), crude mortality rates (CMRs), and crude event rates (CERs) were assessed for PD-L1-dependent differences using Poisson regression. All 3 types of crude rate were expressed as the number that occurred per hundred person-years (hPY) of follow-up. Samples from 41 subjects were evaluated for PD-L1 expression; 23 (56%) were positive. Subjects with PD-L1-expressing versus PD-L1-negative tumors respectively had CRRs of 30.8 versus 12.1 recurrences/hPY (P=0.082), CMRs of 16.7 versus 12.0 deaths/hPY (P=0.47), and CERs of 39.2 versus 16.9 events/hPY (P=0.069). PD-L1 positivity was associated with worse CRR and CER, and marginally worse CMR. The effect on progression-free and overall survival needs to be validated...
Cancer Research, 2013
Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC Background: Mammalian... more Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC Background: Mammalian target of rapamycin (mTOR) is a downstream regulatory protein of PI3K/AKT signal transduction pathway. The activation of cell surface receptors including IGF-1R (Insulin-Growth Factor-1Receptor) and EGFR (Epidermal Growth Factor Receptor) signals through PI3K/AKT pathway and is essential in cell proliferation, angiogenesis and anti-apoptosis process. Over activation of PI3K/AKT is a potential mechanism of resistance to mTOR inhibitors. mTOR inhibition could be a potential novel strategy in the treatment of lung cancer. Docetaxel (D) is commonly used in lung cancer treatment. Previously, we demonstrated that the sequence of D followed by mTOR inhibitor temsirolimus (T) in lung cancer cell lines (LCCL) had increased suppression of cell proliferation as compared to reverse sequence of T→D. The reason for this difference in decrease in proliferation effect is unclear. We hypothesized that D→T sequence can suppress the over activation of PI3K/AKT mechanism of resistance. We studied the expression of pmTOR, AKT and PI3K expression in lung cancer cell lines treated with different sequences of D and T and at different time points. Methods: Adenocarcinoma LCCL H2122 and H1437 were treated with T 1000nM or D 100nM for 24, 48 and 72h. We then treated both LCCL with D exposed for 24h followed by addition of T and the reverse sequence in both LCCL and prepared cell lysate at 24, 48 and 72h time points. We determined the expression of pmTOR, pAKT and PI3K by western blot using antibody from Cell Signaling. Results: T alone suppressed pmTOR after 24h but not at 48 and 72h in both LCCL. AKT was not suppressed. PI3K increased after 48h in both LCCL. The sequence of D→T suppressed expression of pmTOR and decreased expression of pAKT and PI3K at 48 and 72h in the H1437. We observed suppression of mTOR and PI3K but not AKT in the H2122. The opposite sequence of T→D did not suppress the expression of pmTOR and did not suppress the expression of pAKT and PI3K. Conclusion: The combination of D → T has synergistic inhibition of mTOR and it is able to suppress the over activation of AKT/PI3K pathway when compared with reverse sequence. This suggests that sequence of D→T can overcome the over activation of PI3K/AKT mechanism of resistance and it would be the ideal treatment sequence when using D in combination with mTOR inhibitor in the treatment of lung cancer. Expression of AKT/PI3K could be used as a biomarker of response to this regimen. Citation Format: Chao H. Huang, Peter J. VanVeldhuizen, Stephen K. Williamson, Ayten Gadashova, Faris Farassati. Docetaxel followed by temsirolimus suppresses mTOR pathway and can overcome PI3K / AKT over activation mechanism of resistance in lung cancer cell line. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5654. doi:10.1158/1538-7445.AM2013-5654
Cancer Chemotherapy and Pharmacology, 2015
Purpose-This multicenter, open-label, dose-escalating, phase I study evaluated the safety, tolera... more Purpose-This multicenter, open-label, dose-escalating, phase I study evaluated the safety, tolerability, pharmacokinetics and preliminary tumor response of a nanoparticulate formulation of paclitaxel (Nanotax ®) administered intraperitoneally for multiple treatment cycles in patients with solid tumors predominantly confined to the peritoneal cavity for whom no other curative systemic therapy treatment options were available. Methods-Twenty-one patients with peritoneal malignancies received Nanotax ® in a modified dose-escalation approach utilizing an accelerated titration method. All patients enrolled had previously received chemotherapeutics and undergone surgical procedures, including 33 % with
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1991
A phase II trial of esorubicin (4' deoxydoxorubicin) was conducted by the Southwest Oncology ... more A phase II trial of esorubicin (4' deoxydoxorubicin) was conducted by the Southwest Oncology Group in 88 assessable patients with non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) at the time of first relapse. Esorubicin was administered at two dose levels: 25 mg/m2 for patients at risk for excessive myelosuppression, and at 30 mg/m2 for all others at 21-day intervals. Overall, 33 of 88 patients (38%) responded to treatment including three complete remissions (CRs; 3%) and 30 partial remissions (PRs; 34%), with the median duration of response lasting 6.2 months. Response rates did not differ significantly by histologic subtype: 31% of 26 patients with favorable NHL, 33% of 43 patients with unfavorable NHL, and 58% of 19 patients with HD. Twelve of 33 responding patients (36%) had relatively durable remissions lasting from 1 to more than 4 years. Leukopenia (less than 3,000 cells per microliter) was seen in 65 of 88 patients (74%) and was severe (less than 1,000 cel...
Oncology Reviews, 2011
Fluorouracil (5-FU) remains the most widely used agent for colorectal cancer. Capecitabine is a r... more Fluorouracil (5-FU) remains the most widely used agent for colorectal cancer. Capecitabine is a rationally designed 5-FU pro-drug developed to mimic the continuous infusion of 5-FU while avoiding complications and inconvenience of intravenous administration. Capecitabine is absorbed intact from the gastrointestinal tract, converted enzymatically to active 5-FU, and released directly into the tumor. Capecitabine's efficacy and safety are shown in multiple phase III trials across different disease stages and therapy lines. Three randomized phase III trials demonstrated the equivalence of capecitabine plus oxaliplatin (XELOX) versus 5-FU/leucovorin (LV)/oxaliplatin (FOLFOX). The safety of capecitabine compared with 5-FU depends on the regimen of 5-FU used. The adverse event rate with oxaliplatin in combination with infusional 5-FU is similar to that of capecitabine plus oxaliplatin but is associated with more neutropenia and venous thrombotic events; capecitabine plus oxaliplatinbased regimens tend to be associated with more grade 3 diarrhea and hand-foot skin reaction. Combination therapy with capecitabine and irinotecan (CapeIRI) versus 5-FU/ LV and irinotecan (FOLFIRI) had more variable results; some former schedules resulted in excessive treatmentrelated toxicity. More recent data show that lower capecitabine and irinotecan doses, different schedules, and combination with targeted agents (e.g, bevacizumab) have resulted in more favorable outcomes.
Oncology Reports, 2013
To evaluate the prognostic values of different protein expression in the progression of squamous ... more To evaluate the prognostic values of different protein expression in the progression of squamous cell carcinoma of the head and neck (SCCHN) patients, we conducted immunohistochemical (IHC) analysis in tissue samples of different patients enrolled on SWOG protocol S0420. S0420 was a phase II trial to evaluate the efficacy and safety of single-agent sorafenib in chemotherapy-naïve patients with metastatic or recurrent SCCHN. The primary end point was response probability, i.e., confirmed complete (CR) and partial response (PR). Sorafenib was administered orally at 400 mg twice daily on a continuous basis in 28-day cycles to eligible patients. Responses were evaluated according to RECIST (Response Evaluation Criteria in Solid Tumors) criteria. IHC analysis was performed for various markers and data were analyzed statistically. IHC data were obtained from 19 patients enrolled on S0420. There was a high frequency of cases with expression of the angiogenesis markers SMA, HIF-1α, Raf-1, VEGF and VEGF-R. None of the markers were significantly associated with response. Negative HER-2 status was associated with longer progression-free survival (PFS), P=0.04. Negative NRP-1 status was associated with longer overall survival (OS), P=0.04. There were no other significant associations. An almost universal overexpression of angiogenesis markers in the samples analyzed supports the evaluation of angiogenesis inhibition as a potential target for therapy. High levels of NRP-1 and HER-2 in SCCHN samples appear to be associated with decreased survival and earlier progression of disease, respectively, in SCCHN patients and may represent targets for therapy.
Lung Cancer, 1994
We designed an all-oral regimen of etoposide and cyclophosphamide for use in advanced non-small-c... more We designed an all-oral regimen of etoposide and cyclophosphamide for use in advanced non-small-cell lung cancer. Eligible patients were chemotherapy-naive and had histologically confirmed assessable or measurable stage IV non-small-cell lung cancer. Patients received etoposide 50 mg/m2/d orally days 1 through 14 and cyclophosphamide 50 mg/m2/d orally days 1 through 14 every 28 days. Doses on later cycles were adjusted for myelosuppression. Sixty-six patients (64 eligible patients) received 192 cycles of oral extended etoposide/cyclophosphamide therapy (median, two cycles; range, zero to 15). Therapy was well tolerated with the mean dose per cycle being 104% of the originally scheduled dose. Two patients (3%) achieved a complete response and six (9%) achieved a partial response. Leukopenia, anemia, nausea/vomiting, and alopecia were the most common toxicities. Median survival was 6 months, and the 1-year survival rate was 25.6%, comparable to more intensive treatments. Oral extended etoposide/cyclophosphamide is a well-tolerated alternative for the treatment of stage IV non-small-cell lung cancer and can be used as a basis for the design of further outpatient regimens.
The Journal of Urology, 2000
We performed a phase II study to determine whether pain associated with prostate cancer bone meta... more We performed a phase II study to determine whether pain associated with prostate cancer bone metastasis would respond to vitamin D replacement and parameters of muscle strength would be improved by vitamin D replacement therapy. After a 4-week placebo period, eligible patients received orally 2,000 units vitamin D daily for 12 weeks. Pain questionnaires and measurements of muscle strength were competed at study enrollment and every 4 weeks thereafter. Serum calcium and vitamin D were measured at each clinic visit. A total of 16 patients with advanced hormone refractory prostate cancer were enrolled in this phase II study, of whom 7 (44%) had decreased baseline vitamin D. With vitamin D treatment, 4 patients (25%) had improvement in pain scores and 6 (37%) had improvement in muscle strength measurements. Improvement in pain scores correlated with improvement in subjective symptoms but did not result in a significant decrease in regular scheduled analgesic requirements. Vitamin D deficiency develops in a significant percent of patients with advanced hormone refractory prostate cancer. Supplementation with vitamin D may be a useful adjunct for improving pain, muscle strength and quality of life in this patient population.
Journal of Thoracic Oncology, 2007
Journal of Thoracic Oncology, 2007
Methods: Two hundred and eighty patients with lung adenocarcinoma recurred who underwent pulmonar... more Methods: Two hundred and eighty patients with lung adenocarcinoma recurred who underwent pulmonary resection after 1997 at our institution. Since there were significant bias in terms of potential prognostic factors between patients treated with and without gefitinib, we created pairs of cases (gefitinib treated patients: group A) and controls (treated without Gefitinib: group B) by matching gender, age, pathological stage, and smoking status. In this way we created 81 pairs of patients from 280. We compared clinicopathological factors and survivals between two groups. Results: Between group A and B, there was no difference in terms of gender, age, pathological stage, and smoking status because of matching procedure. There was a significant difference in overall survival between two groups (MST 62.6 month vs. 40.9 months, P=0.015). When we compared recurrence free survival (RFS) and post-recurrence survival (PRS), there was significant difference in PRS (MST 37.9 month vs. 17.0 months, P<0.001) but not in RFS (MST 23.7 month vs. 16.9 months, P=0.34). Conclusions: Although it is desirable to prove clinical benefit of gefitinib by prospective phase III trial, this present study strongly suggested that gefitinib could improve survival of Japanese patients with adenocarcinoma of the lung than treatment without gefitinib.
Uploads
Papers by Stephen Williamson