ORCID Profile
0000-0002-0043-8374
Current Organisation
Peter MacCallum Cancer Centre
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Publisher: Wiley
Date: 06-09-2017
DOI: 10.1111/AJD.12388
Abstract: To assess the sun-protection practices of undergraduates at the Australian National University. We sent emails with links to the questionnaire on the use of five sun-protection practices in the last fortnight of the summer to 3341 randomly selected students aged 18-24 years in this cross-sectional study. The response rate was 19% and 507 students met the inclusion criteria. The s le consisted of 338 female and 169 male students with a mean age of 20.5 years (SD ± 1.9). Any method of sun protection was used always or often by 32% of respondents. The commonest method used was shade (58%) while the least common was wearing a hat (8%). Domestic students (44%) used sunglasses more than the international students (23%, P < 0.05) and female students used sunscreen (48%) and sunglasses (37%) more than male students (33% and 23% respectively) (P < 0.05). In the 22-24-year-old age group non-medical students (54%) used sunglasses more than the medical students (36%, P < 0.05). Only a third of the s le practiced any method of sun protection and there were significant differences in the practices between subgroups, suggesting they were at an increased risk of sun damage.
Publisher: Wiley
Date: 19-02-2022
DOI: 10.1111/AJCO.13552
Abstract: Colorectal cancer remains the third most common malignancy in Australia with the peritoneum being the second most common metastatic site. Colorectal peritoneal carcinomatosis (CPC) can be treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy but this is only limited to a small subset of patients. Those with inoperable disease have a particularly poor prognosis. While the ideal systemic regimen has not been defined, 5-fluorouracil-based chemotherapy regimens appear to provide overall and progression free survival benefits. The role of targeted agents such as bevacizumab (vascular endothelial growth factor inhibitor) or cetuximab (epidermal growth factor inhibitor) in the setting of CPC is still evolving. Currently, retrospective analyses have shown promising results for the use of bevacizumab in addition to systemic chemotherapy but similar results have not been seen with cetuximab or panitumumab. However, there is significant heterogeneity in the trial data, lack of prospective randomized controlled trials and demonstrated treatment variability based on age and tumour characteristics. This review summarises the current literature in regard to treatment in the unresectable CPC setting as well as discussing issues with the current data and highlighting the need for further trials.
Publisher: Wiley
Date: 23-09-2013
DOI: 10.1111/JEP.12081
Abstract: It is uncertain whether survival increases from melanoma recorded by some population registries include a treatment effect. The US Surveillance, Epidemiology and End Results (SEER) programme has good data quality control, large numbers of cases enabling high statistical precision and summary stage plus thickness, which we consider to be a best-case population registry scenario to investigate potential for a treatment effect. We have investigated SEER data to indicate whether survivals increases are fully attributable to earlier diagnosis and other non-treatment factors. Through relative survival regression, the effects of diagnostic period on 5-year excess mortality were investigated, adjusting for socio-demographic factors, lesion sub-site, histology, thickness and stage at diagnosis in 1990-2009 (n = 99 690 cases). The reduction in excess mortality (95% confidence interval) between 1990-1999 and 2000-2009 was 31 (20-41)% for localised melanoma, 18 (12-22)% for regional melanoma and 3 (-5-10)% for melanomas with distant spread. Younger age was predictive of a greater percentage reduction. Treatment benefits are inferred from the higher survivals in 2000-2009 but uncertainty remains due to incomplete data to adjust for non-treatment factors and a lack of treatment data. Registries should use new information systems to collect more complete data on stage, other prognostic indicators, co-morbidities and treatment, to provide more definitive and detailed information on population effects of cancer control.
Publisher: Wiley
Date: 28-02-2023
DOI: 10.1111/AJCO.13940
Abstract: Consolidation durvalumab after concurrent chemoradiation is the standard of care for unresectable stage III non‐small cell lung cancer (NSCLC) based on the PACIFIC trial. However, there have been reports in the literature suggesting the efficacy of the treatment differs in patients whose tumors harbor epidermal growth factor receptor ( EGFR ) mutations and in those with low programed death ligand‐1 (PD‐L1) expression. This study describes the survival outcomes for patients with unresectable stage III NSCLC treated with chemoradiation followed by durvalumab with a specific focus on EGFR mutation status and PD‐L1 expression. This retrospective observational study was conducted across six sites in Greater Sydney, Australia. It included all patients diagnosed with unresectable stage III NSCLC treated with chemoradiation and who received at least one cycle of durvalumab between January 2018 and September 2021. Patients were stratified according to EGFR mutation status and PD‐L1 tumor proportion score (TPS) of 1%. Of the 145 patients included in the analysis, 15/145 (10%) patients harbored an EGFR mutation and 61/145 (42%) patients had PD‐L1 TPS of %. At a median follow‐up of 15.1 months from the start of durvalumab, median progression‐free survival (PFS) in EGFR mutant versus wild‐type patients was 7.5 and 33.9 months, respectively (hazard ratio [HR]: 2.7 95% confidence intervals [95% CI] 1.2–5.7 p = .01). Overall survival (OS) was not different between EGFR mutant and wild‐type patients. There was no statistically significant difference in PFS (HR .7, 95% CI .4–1.7, p = .43) or OS (HR .5, 95% CI .4–4.7, p = .16) between patients with PD‐L1 TPS of % versus PD‐L1 TPS of ≥1%. Our data adds to the growing evidence that suggests consolidation durvalumab after definitive chemoradiation may not be as efficacious in patients with EGFR ‐mutant tumors compared with EGFR wild‐type NSCLC.
Publisher: Wiley
Date: 16-09-2022
Abstract: Sustained elevation in neutrophil‐to‐lymphocyte ratio (NLR) after initial chemoradiotherapy (CRT) has been shown to correlate with worse prognosis in a number of solid organ malignancies. Here, we conducted a retrospective observational cohort study involving six sites across Sydney, Australia, including all patients with unresectable stage III NSCLC treated with CRT and consolidation durvalumab between January 2018 and September 2021. Patients had NLR collected prior to CRT and prior to cycle one of durvalumab. We used an NLR value of 3 to stratify patients into high and low groups. Patients with sustained NLR were defined as those with values ≥3 at both timepoints. A total of 145 patients were included in the study. The median age of patients was 66 years with median follow‐up of 15.1 months. The median PFS was 17.6 months in the pre‐CRT NLR high cohort and not reached (NR) in the pre‐CRT NLR low cohort (HR 1.99 p = 0.01). The median OS was 35.5 months in the high pre‐CRT NLR cohort compared with 42.0 months in the low pre‐CRT NLR cohort (HR 2.62 95% CI: 1.23–5.56, p 0.01). Median PFS for sustained NLR elevation was 17.1 months versus NR (HR 1.5 p 0.01). Pre‐CRT NLR and sustained NLR remained independently prognostic for PFS on multivariate analysis ( p = 0.04, p = 0.01) respectively. Pre‐CRT NLR and sustained NLR is associated with worse PFS outcomes in unresectable stage III NSCLC treated with CRT and durvalumab. Pre‐CRT NLR is also associated with worse OS.
Publisher: AME Publishing Company
Date: 04-2023
DOI: 10.21037/JGO-22-886
Publisher: AME Publishing Company
Date: 03-2022
DOI: 10.21037/TLCR-21-938
Publisher: China Anti-cancer Association
Date: 2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-06-2020
Publisher: MDPI AG
Date: 07-06-2022
DOI: 10.3390/CURRONCOL29060331
Abstract: Growing teratoma syndrome (GTS) is rare and can mimic disease recurrence in patients with a history of immature teratoma. Benign hypermetabolic lymphadenopathy found on staging and surveillance computed tomography (CT) and positron emission tomography (PET) may lead to the presumption of metastatic malignancy. We report a case of a 38 year old with mixed mature and immature teratomas who developed new peritoneal masses after adjuvant chemotherapy despite a normalization of tumor markers. In addition to low FDG uptake observed in these peritoneal masses, a PET scan showed hypermetabolic lymphadenopathy and pulmonary and spleen lesions suggesting widespread metastases. Subsequent surgical resection confirmed a mixed pathology with GTS and sarcoidosis. We reviewed the current literature evidence of GTS and sarcoidosis as a benign cause of lymphadenopathy in cancer patients. We emphasize the importance of a tissue diagnosis before instituting therapy for presumed cancer recurrence to avoid potentially fatal diagnostic traps and management errors. A multiple disciplinary team approach is imperative in managing patients with suspected recurrent immature teratomas.
Publisher: Future Medicine Ltd
Date: 10-2016
Abstract: Aims: Oxaliplatin-based chemotherapy for colorectal cancer demonstrates interin idual variability in response, and polymorphisms of ERCC1, ERCC2, XRCC1, GSTP1 and GSTM1 genes may be contributing factors. Additionally, the effect of these genotypes may differ between ethnic groups. Material & Methods: A meta-analysis of the association between these genotypes and response, progression-free survival and overall survival (OS) for patients with colorectal cancer treated with oxaliplatin-based therapy is reported. Results: ERCC1 C118T (TT vs CC OS [hazard ratio (HR): 2.59 p = 0.001]), ERCC2 A2251C (CC or AC vs AA OS [HR: 1.53 p = 0.04]) and GSTP1 A313G (GG vs AA OS, [HR: 0.47 p 0.001]) polymorphisms were associated with survival. The effect size may be larger for ERCC1 C118T and XRCC1 G1196A in Asian compared with Caucasian populations. No association was apparent for the GSTM1 genotype. Conclusion: ERCC1 C118T, ERCC2 A2251C and GSTP1 A313G polymorphisms were associated with clinical outcomes
Publisher: Oxford University Press (OUP)
Date: 04-08-2023
DOI: 10.1093/JNCI/DJAD152
Abstract: Overall survival (OS) is the optimal marker of efficacy of treatments in randomized clinical trials (RCTs) but can take a considerable amount of time to mature. Progression free survival (PFS) has served as an early surrogate of OS however is imperfect. Time to deterioration (TTD) in quality of life (QoL) measures could be an alternative surrogate of OS. Phase 3 RCTs in solid malignancies that reported OS, PFS and TTD in QoL or physical function (PF) published between 1st of January 2010 and 30th of June 2022 were evaluated. Weighted regression analysis was utilised to assess the relationship between PFS, TTD QoL and TTD PF with OS. The coefficient of determination (R2) was used to quantify surrogacy. 138 phase 3 RCT were included. 47 trials evaluated immune checkpoint inhibitors (ICIs) and 91 investigated non-ICI agents. TTD QoL (137 RCTs) and TTD PF (75 RCTs) performed similarly to PFS as surrogates of OS (R2 0.18 vs 0.19 and R2 0.10 vs 0.09, respectively). For ICI studies, TTD PF had a higher association with OS compared to PFS (R2 0.38 vs 0.19) and PFS and TTD PF were not correlated with each other (R2=0). When used together, the coefficient of determination increased (R2 = 0.57). TTD of PF appears to be a OS surrogate measure of particular importance for ICI treatment efficacy. The combination of TTD PF with PFS may enable better prediction of OS treatment benefit in ICI RCTs than either PFS or TTD PF alone.
Publisher: Elsevier BV
Date: 06-2022
No related grants have been discovered for Adel Shahnam.