Sir Peter MacCallum Department of Oncology - Research Publications

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    Australia and New Zealand consensus position statement: use of COVID-19 therapeutics in patients with haematological malignancies
    Campbell, A ; Teh, B ; Mulligan, S ; Ross, DM ; Weinkove, R ; Gilroy, N ; Gangatharan, S ; Prince, HM ; Szer, J ; Trotman, J ; Lane, S ; Dickinson, M ; Quach, H ; Enjeti, AK ; Ku, M ; Gregory, G ; Hapgood, G ; Ho, PJ ; Cochrane, T ; Cheah, C ; Greenwood, M ; Latimer, M ; Berkahn, L ; Wight, J ; Armytage, T ; Diamond, P ; Tam, CS ; Hamad, N (Wiley, 2023-02)
    Despite widespread vaccination rates, we are living with high transmission rates of SARS-CoV-2. Although overall hospitalisation rates are falling, the risk of serious infection remains high for patients who are immunocompromised because of haematological malignancies. In light of the ongoing pandemic and the development of multiple agents for treatment, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 management in patients with haematological disorders. It is our recommendation that both patients with haematological malignancies and treating specialists be educated regarding the preventive and treatment options available and that patients continue to receive adequate vaccinations, keeping in mind the suboptimal vaccine responses that occur in haematology patients, in particular, those with B-cell malignancies and on B-cell-targeting or depleting therapy. Patients with haematological malignancies should receive treatment for COVID-19 in accordance with the severity of their symptoms, but even mild infections should prompt early treatment with antiviral agents. The issue of de-isolation following COVID-19 infection and optimal time to treatment for haematological malignancies is discussed but remains an area with evolving data. This position statement is to be used in conjunction with advice from infectious disease, respiratory and intensive care specialists, and current guidelines from the National COVID-19 Clinical Evidence Taskforce and the New Zealand Ministry of Health and Cancer Agency Te Aho o Te Kahu COVID-19 Guidelines.
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    Real-world adjuvant chemotherapy treatment patterns and outcomes over time for resected stage II and III colorectal cancer
    To, YH ; Degeling, K ; McCoy, M ; Wong, R ; Jones, I ; Dunn, C ; Hong, W ; Loft, M ; Gibbs, P ; Tie, J (Wiley, 2023-06)
    BACKGROUND: The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real-world Australian patients. METHODS: CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5-year time periods (A: 2005-2009, B: 2010-2014, C: 2015-2019). Stage III was further stratified as pre- and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time-to-recurrence (TTR), and overall survival (OS) was compared across the time periods. RESULTS: Of 3977 identified patients, 1148 (stage II: 640, stage III: 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post-IDEA, the proportion of patients receiving ≤3 months of oxaliplatin-based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A: 89% vs. B: 88% vs. C: 90%, p = .53) and stage III (72% vs. 76% vs. 72%, p = .08). OS significantly improved for stage II (80%-85%, p = .04) and stage III (69%-77%, <.01) from period A to B. CONCLUSION: AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer-related mortality.
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    Asystole following spinal anaesthesia: the hazards of intrinsic cardiac reflexes.
    Lacey, JR ; Dubowitz, JA ; Riedel, B (Wiley, 2022)
    Unwanted initiation of intrinsic cardiac reflexes can precipitate bradycardia and cardiac arrest after spinal anaesthesia. We report the case of a 40-year-old man who suffered sudden asystolic cardiac arrest following spinal anaesthesia prior to planned abdominal surgery, likely due to the initiation of one or more intrinsic cardiac reflexes including the Bezold-Jarisch reflex, the reverse Bainbridge reflex and the pacemaker stretch reflex. The characteristics of this patient placed him at increased risk of this underappreciated cause of bradycardia and hypotension. We present a summary of the physiology and clinical features relevant to this case and the considerations for avoidance of similar complications after spinal anaesthesia.
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    Clinical characteristics of Australian treatment-naive patients with classical Hodgkin lymphoma from the lymphoma and related diseases registry
    Nguyen, J ; Wellard, C ; Chung, E ; Cheah, CY ; Dickinson, M ; Doo, NW ; Keane, C ; Talaulikar, D ; Berkahn, L ; Morgan, S ; Hamad, N ; Cochrane, T ; Johnston, AM ; Forsyth, C ; Opat, S ; Barraclough, A ; Mutsando, H ; Ratnasingam, S ; Giri, P ; Wood, EM ; McQuilten, ZK ; Hawkes, EA (Wiley, 2023-04)
    Comprehensive clinical characteristics of Australian patients with classical Hodgkin Lymphoma (cHL) have not previously been systematically collected and described. We report real-world data of 498 eligible patients from the first 5 years of the Lymphoma and Related Diseases Registry (LaRDR), including baseline characteristics, histologic subtype, and treatment patterns in first-line therapy. Patient demographics and distribution of histopathological subtypes of cHL are similar to reported international cohorts. Doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) was the most common therapy for both early and advanced-stage disease, and 48% of patients with the early-stage disease received radiotherapy. Treatment patterns are consistent with international guidelines. In comorbid patients ≥60 years of age with advanced-stage disease, there is greater variation in treatment. In patients with a recorded response, the objective response rate (ORR) was 96% in early-stage disease, and 88% in advanced-stage disease. Early progression-free survival data suggest Australian patients with cHL have good outcomes, similar to other international studies.
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    BRINGING THE BENCH TO THE BEDSIDE: UPDATES ON THE MIND STUDY AND WHAT A ROUTINELY AVAILABLE SIMPLE BLOOD TEST FOR NEUROFILAMENT LIGHT WOULD MEAN AT THE CLINICAL COAL FACE FOR PATIENTS AND FAMILIES, PSYCHIATRISTS, NEUROLOGISTS, GERIATRICIANS AND GENERAL PRACTITIONERS
    Eratne, D ; Lewis, C ; Cadwallader, C ; Kang, M ; Keem, M ; Santillo, A ; Li, QX ; Stehmann, C ; Loi, SM ; Walterfang, M ; Watson, R ; Yassi, N ; Blennow, K ; Zetterberg, H ; Janelidze, S ; Hansson, O ; Berry-Kravitz, E ; Brodtmann, A ; Darby, D ; Walker, A ; Dean, O ; Masters, CL ; Collins, S ; Berkovic, SF ; Velakoulis, D (SAGE PUBLICATIONS LTD, 2022-05)
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    How prostate-specific membrane antigen positron emission tomography is refining risk calculators in the primary prostate diagnostic pathway
    Ptasznik, G ; Kelly, BD ; Murphy, D ; Lawrentschuk, N ; Kasivisvanathan, V ; Page, M ; Ong, S ; Moon, D (WILEY, 2024-02)
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    Artificial intelligence takes center stage: exploring the capabilities and implications of ChatGPT and other AI-assisted technologies in scientific research and education
    Borger, JG ; Ng, AP ; Anderton, H ; Ashdown, GW ; Auld, M ; Blewitt, ME ; Brown, D ; Call, MJ ; Collins, P ; Freytag, S ; Harrison, LC ; Hesping, E ; Hoysted, J ; Johnston, A ; Mcinneny, A ; Tang, P ; Whitehead, L ; Jex, A ; Naik, SH (WILEY, 2023)
    The emergence of large language models (LLMs) and assisted artificial intelligence (AI) technologies have revolutionized the way in which we interact with technology. A recent symposium at the Walter and Eliza Hall Institute explored the current practical applications of LLMs in medical research and canvassed the emerging ethical, legal and social implications for the use of AI-assisted technologies in the sciences. This paper provides an overview of the symposium's key themes and discussions delivered by diverse speakers, including early career researchers, group leaders, educators and policy-makers highlighting the opportunities and challenges that lie ahead for scientific researchers and educators as we continue to explore the potential of this cutting-edge and emerging technology.
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    Synchronous vs independent reading of prostate-specific membrane antigen positron emission tomography (PSMA-PET) and magnetic resonance imaging (MRI) to improve diagnosis of prostate cancer
    Doan, P ; Counter, W ; Papa, N ; Sheehan-Dare, G ; Ho, B ; Lee, J ; Liu, V ; Thompson, JE ; Agrawal, S ; Roberts, MJ ; Buteau, J ; Hofman, MS ; Moon, D ; Lawrentschuk, N ; Murphy, D ; Stricker, PD ; Emmett, L (Wiley, 2023-05-01)
    Objectives: To identify whether synchronous reading of multiparametric magnetic resonance imaging (mpMRI) and 68Ga-PSMA-11 positron emission tomography (PET)/computed tomography (prostate-specific membrane antigen [PSMA-PET]) images can improve diagnostic performance and certainty compared with mpMRI/PSMA-PET reported independently and synthesized, while also assessing concordance between imaging modalities and agreement with histopathology. Methods: This was a retrospective analysis of 100 patients randomly selected from the PRIMARY trial, a prospective Phase II multicentre imaging trial. Three dual-trained radiologist/nuclear medicine physicians re-reported the mpMRI and PSMA-PET both independently and synchronously for the same patients in random order, blinded to previous results. Diagnostic performance was assessed for mpMRI/PSMA-PET images read synchronously or independently and then synthesized. Agreement between imaging results and histopathology was examined. ‘Concordance’ between imaging modalities was defined as overlapping lesions. Reporting certainty was evaluated by the individual reporters for each modality. Results: International Society of Urological Pathology Grade Group ≥2 cancer was present in 60% of patients on biopsy. Synchronous reading of mpMRI/PSMA-PET increased sensitivity compared to mpMRI or PSMA-PET alone (93% vs 80% vs 88%, respectively), although specificity was not improved (63% vs 58% vs 78%, respectively). No significant difference in diagnostic performance was noted between mpMRI/PSMA-PET read synchronously and mpMRI or PSMA-PET reported independently and then synthesized. Most patients had concordant imaging (60%), while others had discordant lesions only (28%) or a mixture (concordant and discordant lesions; 12%). When mpMRI/PSMA-PET findings were concordant and positive, 95% of patients had clinically significant prostate cancer (csPCa). When PSMA-PET alone was compared to synchronous PSMA-PET/MRI reads, there was an improvement in reader certainty in 20% of scans. Conclusion: Synchronous mpMRI/PSMA-PET reading improves reader certainty and sensitivity for csPCa compared to mpMRI or PSMA-PET alone. However, synthesizing the results of independently read PSMA-PET and mpMRI reports provided similar diagnostic performance to synchronous PSMA-PET/MRI reads. This may provide greater flexibility for urologists in terms of referral patterns, reducing healthcare system costs and improving efficiencies in prostate cancer diagnosis.