Real-World Data Validation of NAPOLI-1 Nomogram for the Prediction of Overall Survival in Metastatic Pancreatic Cancer

Su, Yung‐Yeh; Chiang, Nai‐Jung; Yang, Yi‐Hsin; Yen, Chia‐Jui; Bai, Li‐Yuan; Chiu, Chang‐Fang; Chuang, Shih‐Chang; Chou, Wen‐Chi; Chen, Jen‐Shi; Chiu, Tai‐Jan; Chen, Yen‐Yang; Chan, De-Chuan; Peng, Cheng-Ming; Chiu, Sz-Chi; Li, Chung Pin; Shan, Yan–Shen; Chen, Li-Tzong

doi:10.3390/cancers15041008

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…Consequently, the inclusion criteria in the trial closely resembled those of our standard approach in daily patient care, which was reflected by the lack of a significant difference in survival between patients enrolled and not enrolled in the clinical trial. Both the GOFL and SLOG regimens were incorporated into daily practice in our hospitals prior to the reimbursement of nab-paclitaxel and FOLFORINOX [ 58 – 62 ]. Patients treated with gemcitabine monotherapy (n = 21), usually prescribed for fragile patients as recommended in the majority of treatment guidelines, were excluded in the present study to prevent selection bias when comparing survival between patients treated with platinum-based and platinum-free chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan

Cheng,

Su,

Chiang

et al. 2024

J Biomed Sci

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Background Cancer susceptibility germline mutations are associated with pancreatic ductal adenocarcinoma (PDAC). However, the hereditary status of PDAC and its impact on survival is largely unknown in the Asian population. Methods Exome sequencing was performed on 527 blood samples from PDAC individuals and analyzed for mutations in 80 oncogenic genes. Pathogenic and likely pathogenic (P/LP) germline variants were diagnosed according to the ACMG variant classification categories. The association between germline homologous recombination gene mutations (gHRmut, including BAP1, BRCA1, BRCA2, PALB2, ATM, BLM, BRIP1, CHEK2, NBN, MUTYH, FANCA and FANCC) and the treatment outcomes was explored in patients with stage III/IV diseases treated with first-line (1L) platinum-based versus platinum-free chemotherapy. Results Overall, 104 of 527 (19.7%) patients carried germline P/LP variants. The most common mutated genes were BRCA2 (3.60%), followed by ATR (2.66%) and ATM (1.9%). After a median follow-up duration of 38.3-months (95% confidence interval, 95% CI 35.0–43.7), the median overall survival (OS) was not significantly different among patients with gHRmut, non-HR germline mutations, or no mutation (P = 0.43). Among the 320 patients with stage III/IV disease who received 1L combination chemotherapy, 32 (10%) had gHRmut. Of them, patients receiving 1L platinum-based chemotherapy exhibited a significantly longer median OS compared to those with platinum-free chemotherapy, 26.1 months (95% CI 12.7–33.7) versus 9.6 months (95% CI 5.9–17.6), P = 0.001. However, the median OS of patients without gHRmut was 14.5 months (95% CI 13.2–16.9) and 12.6 months (95% CI 10.8–14.7) for patients receiving 1L platinum-based and platinum-free chemotherapy, respectively (P = 0.22). These results were consistent after adjusting for potential confounding factors including age, tumor stage, performance status, and baseline CA 19.9 in the multivariate Cox regression analysis. Conclusions Our study showed that nearly 20% of Taiwanese PDAC patients carried germline P/LP variants. The longer survival observed in gHRmut patients treated with 1L platinum-based chemotherapy highlights the importance of germline testing for all patients with advanced PDAC at diagnosis.

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Section: Discussionmentioning

confidence: 99%

Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan

Cheng,

Su,

Chiang

et al. 2024

J Biomed Sci

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“…There are many reports on predictors of treatment-response by nal-IRI-based therapy. In particular, CAR, NLR, GPS, total bilirubin, carcinomatosis, and previous treatment with irinotecan have been significantly associated with overall survival (3)(4)(5)(6)(7)(8). However, no study has reported the risk factors for the adverse events during nal-IRI/FL treatment based on the analysis of factors other than the UGT1A1 polymorphism in clinical settings.…”

Section: Discussionmentioning

confidence: 99%

“…Based on this trial result, the regulatory agency in Japan has approved the nal-IRI plus 5-FU and L-leucovorin (nal-IRI/FL) combination therapy. Particularly interesting studies focused on predictors of treatment-response by nal-IRI-based therapy in patients with pancreatic cancer have indicated that C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), Glasgow prognostic score (GPS), total bilirubin, carcinomatosis, and previous irinotecan treatment are significantly associated with overall survival (3)(4)(5)(6)(7)(8).…”

mentioning

confidence: 99%

Risk Factors for Adverse Events of Nanoliposomal Irinotecan Plus 5-Fluorouracil and L-leucovorin

ITO,

SUNO,

EGAWA

et al. 2024

CDP

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Background/Aim: The regimen with nanoliposomal irinotecan plus 5-fluorouracil and L-leucovorin (nal-IRI/FL) is used for metastatic pancreatic cancer. A clinical study has indicated that the uridine diphosphate-glucuronosyltransferase (UGT) 1A1 polymorphism is associated with neutropenia during nal-IRI/FL treatment; however, no studies have reported risk factors for the occurrence of adverse events in the clinical setting. This study aimed to explore the risk factors for adverse events of nal-IRI/FL. Patients and Methods: This study included patients with metastatic pancreatic cancer who started nal-IRI/FL treatment. Patient information, including laboratory data before nal-IRI/FL initiation and adverse events during nal-IRI/FL treatment, was retrospectively obtained from medical records. Results: This study consisted of 36 patients, including 16, 16, and 4 with UGT1A1*6 or *28 wild-type (–/–), heterozygous (+/–), and homozygous (+/+), respectively. Patients with UGT1A1*6 or *28 (+/+) exhibited significantly lower nadir counts of white blood cells (p=0.033) and neutrophils (p=0.043). Multiple regression analyses revealed that the decreased white blood cell count was significantly associated with the genotype of UGT1A1*6 or *28 (+/+) (p=0.009), high aspartate aminotransferase (AST) value before the therapy (p=0.019), and pancreatic head cancer (p=0.030). Also, the decreased neutrophil count was significantly related to the genotype of UGT1A1*6 or *28 (+/+) (p=0.017). Conclusion: Patients with UGT1A1*6 or *28 (+/+) should be especially concerned about neutropenia and leukopenia during nal-IRI/FL treatment. Additionally, high AST value and pancreatic head cancer may be risk factors for leukopenia during nal-IRI/FL treatment.

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“…To keep up with the rising demand for Brain-Computer Interface (BCI) systems, it will be necessary to implement strategies that reduce user anxiety and make the necessary adjustments to BCI systems [26]. The current concept places an emphasis on using data collected in real-world settings to verify the efficiency of detection mechanisms.…”

Section: Literature Reviewmentioning

confidence: 99%

Driver Drowsy and Yawn System Alert Using Deep Cascade Convolution Neural Network DCCNN

ABBOOD,

Yonan

2023

ijcsm

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Driver fatigue and lethargy are widely acknowledged as significant contributors to the occurrence of vehicular accidents. During the preceding decade, there were a total of 66,000 motor vehicle accidents, resulting in 22,952 fatalities and 79,545 injuries. It is of the utmost importance to implement measures designed to notify drivers in order to prevent accidents and save lives. The purpose of this research was to develop and implement a Driving Drowsiness Detection System (DDDS) in order to increase road safety. The system employs eye and mouth movements as indicators in order to detect fatigue and reduce the likelihood of accidents. Using a high-resolution camera and Deep Cascaded Convolutional Neural Networks (DCCNN) to accomplish accurate drowsiness detection was the objective of this research. This study's methodology entails the analysis of driver behavior, with a particular emphasis on eye movements captured by a high-resolution camera. The facial region was identified using landmarks extracted from the Dlib toolset, and the "Eyes Aspect Ratio" metric was developed to quantify the level of fatigue. Deep Convolutional Neural Network (DCCNN) output triggers an alarm on the dashboard of the graphical user interface (GUI). The study utilized an image with 450x320 pixels and a frame rate of 60 frames per second. In ideal lighting conditions, drowsy detection accuracy exceeded 99.9%, while in less than ideal lighting conditions, it surpassed 99.8%. Compared to previous research, the present study demonstrated a higher level of accuracy in detecting drowsiness.

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Real-World Data Validation of NAPOLI-1 Nomogram for the Prediction of Overall Survival in Metastatic Pancreatic Cancer

Cited by 5 publications

References 31 publications

Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan

Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan

Risk Factors for Adverse Events of Nanoliposomal Irinotecan Plus 5-Fluorouracil and L-leucovorin

Driver Drowsy and Yawn System Alert Using Deep Cascade Convolution Neural Network DCCNN

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