ORCID Profile
0000-0001-7357-2024
Current Organisation
Peter MacCallum Cancer Centre
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Publisher: Wiley
Date: 24-06-2019
DOI: 10.1111/BJH.16064
Abstract: De novo diffuse large B-cell lymphoma (DLBCL) presenting with synchronous central nervous system (CNS) and systemic disease (synDLBCL) is not well described and is excluded from clinical trials. We performed a retrospective analysis of 80 synDLBCL patients treated across 10 Australian and UK centres. Of these patients, 96% had extranodal systemic disease. CNS-directed treatment with combination intravenous cytarabine and high-dose methotrexate ("CNS-intensive") (n = 38) was associated with favourable survival outcomes compared with "CNS-conservative" strategies such as intravenous high-dose methotrexate monotherapy, intrathecal therapy and/or radiotherapy (2-year progression-free survival [PFS] 50% vs. 31%, P = 0·006 2-year overall survival [OS] 54% vs. 44%, P = 0·037). Outcomes were primarily dictated by the ability to control the CNS disease, with 2-year cumulative CNS relapse incidence of 42% and non-CNS relapse 21%. Two-year OS for CNS-relapse patients was 13% vs. 36% for non-CNS relapses (P = 0·02). Autologous stem cell transplantation as consolidation (n = 14) was not observed to improve survival in those patients who received CNS-intensive induction when matched for induction outcomes (2-year PFS 69% vs. 56%, P = 0·99 2-year OS 66% vs. 56%, P = 0·98). Hyperfractionated or infusional systemic treatment did not improve survival compared to R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) (2-year OS 49% for both groups). Our study suggests that adequate control of the CNS disease is paramount and is best achieved by intensive CNS-directed induction.
Publisher: Wiley
Date: 30-10-2023
DOI: 10.1111/BJH.19179
Publisher: American Society of Hematology
Date: 26-10-2023
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.RESUSCITATION.2016.06.019
Abstract: In a recent high-quality randomised controlled trial (RCT), strict therapeutic normothermia (STN) following cardiac arrest with coma resulted in similar outcomes to therapeutic hypothermia (TH). We aimed to test the feasibility, reproducibility, and safety of the STN protocol outside of its RCT context. In two teaching hospital ICUs, we performed a before-and-after study comparing the previously International Liaison Committee on Resuscitation (ILCOR)-endorsed TH protocol to the recently studied STN protocol. The primary feasibility end point was the percentage of temperature recordings in the prescribed range in the first 24h of treatment. Secondary end points included pharmacological management and complications. We studied 69 similar patients in each group. We found no difference in feasibility as shown by the proportion of within range temperatures. However, the median doses of midazolam (37mg vs. 9mg, p=0.02), fentanyl (883μg vs. 310μg, p=0.01) and the use of muscle relaxants (84.1% vs. 59.4%, p=0.001) was greater with the TH protocol. Furthermore, shivering (52.2% vs. 18.8%, p<0.001), a composite of other pre-defined complications (66.7% vs. 47.8%, p<0.03) and fever in the first 96h (55.1% vs. 33.3%, p=0.01) were also more common with the TH protocol. The STN protocol was successfully reproduced outside of an RCT and appeared associated with fewer complications than the TH protocol. Our findings imply that the STN protocol may offer clinical advantages over the TH protocol.
Publisher: Frontiers Media SA
Date: 15-03-2018
Publisher: Elsevier BV
Date: 02-2023
Publisher: Wiley
Date: 13-03-2019
DOI: 10.1111/BJH.15186
Publisher: Elsevier BV
Date: 04-2021
Publisher: American Society of Hematology
Date: 03-04-2019
DOI: 10.1182/BLOODADVANCES.2018028035
Abstract: Although second-generation tyrosine kinase inhibitors (TKIs) show superiority in achieving deep molecular responses in chronic myeloid leukemia in chronic phase (CML-CP) compared with imatinib, the differing adverse effect (AE) profiles need consideration when deciding the best drug for in idual patients. Long-term data from randomized trials of nilotinib demonstrate an increased risk of vascular AEs (VAEs) compared with other TKIs, although the natural history of these events in response to dose modifications or cessation has not been fully characterized. We retrospectively reviewed the incidence of nilotinib-associated AEs in 220 patients with CML-CP at 17 Australian institutions. Overall, AEs of any grade were reported in 95 patients (43%) and prompted nilotinib cessation in 46 (21%). VAEs occurred in 26 patients (12%), with an incidence of 4.1 events per 100 patient-years. Multivariate analysis identified age (P = .022) and dyslipidemia (P = .007) as independent variables for their development. There was 1 fatal first VAE, whereas the remaining patients either continued nilotinib (14 patients) or stopped it immediately (11 patients). Recurrent VAEs were associated with ongoing therapy in 7 of 14 who continued (with 2 fatal VAEs) vs 1 of 11 who discontinued (P = .04). Nineteen of the 23 evaluable patients surviving a VAE ultimately stopped nilotinib, of whom 14 received an alternative TKI. Dose reduction or cessation because of VAEs did not adversely affect maintenance of major molecular response. These findings demonstrate that in contrast to other AEs, VAEs are ideally managed with nilotinib cessation because of the increased risk of additional events with its ongoing use.
Publisher: Informa UK Limited
Date: 15-07-2021
DOI: 10.1080/10428194.2021.1953016
Abstract: Bispecific T-cell recruiting antibodies are emerging as a potent immunotherapeutic class in the treatment of B-cell malignancies and act by simultaneously targeting antigens on T-cells and malignant cells to effect tumor cell death. Glofitamab is a novel full-length IgG-like CD20-CD3 bispecific with a unique 2:1 configuration that provides an extended half-life and superior CD20 binding. Phase 1 monotherapy and combination data demonstrate clear activity in heavily treated aggressive and indolent B-cell lymphoma, including >50% complete responses at the recommended phase 2 dose. In this review, we provide an overview of the structure, mechanism of action and pharmacokinetics of glofitamab. Available efficacy and safety data from ongoing clinical trials are also presented. Glofitamab appears to be a welcome addition to the treatment possibilities for patients with B-cell lymphomas who otherwise have limited therapeutic options. The current data are sufficient to evaluate its role in combination and in earlier lines of therapy.
Publisher: MDPI AG
Date: 03-2022
Abstract: Targeted therapies continue to change the landscape of lymphoma treatment, resulting in improved therapy options and patient outcomes. Numerous agents are now approved for use in the indolent lymphomas and many others under development demonstrate significant promise. In this article, we review the landscape of targeted agents that apply to the indolent lymphomas, predominantly follicular lymphoma, lymphoplasmacytic lymphoma/Waldenstrom macroglobulinaemia and marginal zone lymphoma. The review covers small molecule inhibitors, immunomodulators and targeted immunotherapies, as well as presenting emerging and promising combination therapies.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 05-10-2023
DOI: 10.1200/JCO.23.00365
Publisher: Informa UK Limited
Date: 10-06-2023
Publisher: Informa UK Limited
Date: 09-06-2021
Publisher: Informa UK Limited
Date: 17-12-2021
DOI: 10.1080/10428194.2021.2015345
Abstract: Salvage chemotherapy and autologous stem cell transplant remain a standard of care in the management of diffuse large B cell lymphoma (DLBCL) at first relapse. However, this paradigm is increasingly being challenged by novel immunotherapies, such as chimeric antigen receptor T-cells (CART-cells). Traditional positron emission tomography-based (PET) prognostication takes place after salvage and before autologous stem cell transplant (ASCT), and while useful, for many patients this information comes too late and at the expense of unnecessary toxicity. In this edition of Leukemia & Lymphoma, two groups present their findings on the use of early quantitative PET markers and the correlation with outcomes in patients embarking on second line salvage chemotherapy. These approaches have the potential to better identify patients who are destined for treatment failure and help guide appropriate sequencing of alternative therapies or the development of PET-adapted clinical trials.
Publisher: Informa UK Limited
Date: 14-08-2021
No related grants have been discovered for Adrian Minson.