• c-kit receptors in ovarian tumors and the response of ovarian carcinoma cell lines ro recombinant human stem cell factor

      Wrigley, E; McGown, Alan T; Ward, Timothy H; Ewen, C; Crowther, Derek; Department of Medical Oncology, Christie Hospital; (1996)
    • C-kit receptors in ovarian tumors and the response of ovarian carcinoma cell lines to recombinant human stem cell factor.

      Wrigley, E; McGown, Alan T; Ward, Timothy H; Ewen, C; Crowther, Derek; Christie Hospital, Wilmslow Road, Manchester, M20 4BX (1996)
    • Caecal metastases from cervical cancer--a rare presentation.

      Ansari, H A K; Manoharan, Prakash; Department of Diagnostic Radiology, Christie Hospital, Manchester, UK. doctorkhan75@yahoo.co.uk (2008-08)
    • Caelyx (stealth liposomal doxorubicin) in the treatment of advanced breast cancer.

      Ranson, Malcolm R; Cheeseman, Sue; White, Shane C; Margison, Jennifer M; Department of Medical Oncology, Cancer Research Campaign, Christie Hospital NHS Trust, Wilmslow Road, Manchester, M204BX, UK. malcolm.ransom@man.ac.uk (2001-02)
      Anthracyclines are amongst the most active drugs in the treatment of breast cancer. Stealth liposomal doxorubicin (Caelyx, Doxil, Alza Pharmaceuticals Inc.) is a promising new agent under investigation for the treatment of breast cancer and other solid tumours. The liposomal encapsulation alters drug pharmacokinetics and leads to a marked change in toxicity profile compared to non-liposomal doxorubicin. The results of recently completed and ongoing clinical trials in breast cancer are reviewed.
    • Calcitonin in the treatment of intractable pain from advanced malignancy.

      Allan, Ernest; Christie Hospital, Manchester (1983)
      Clinical details are given of 8 patients who complained of severe pain from metastatic bone disease or from multiple myeloma. Four of the patients were included in a double-blind pilot trial designed to compare the effectiveness of salmon calcitonin (200 i.u. intramuscularly) and placebo given twice daily for 4 days. Two of these patients experienced pain relief and were found to have been given salmon calcitonin; the other 2 had no pain relief and had been given placebo. The other 4 of the 8 patients were treated with salmon calcitonin and also had relief of their pain. It would appear, therefore, that salmon calcitonin may be dramatically effective in the treatment of intractable pain from advanced malignancy and its use warrants further study.
    • The calculation of dosage and an additional distribution rule for cylindrical “volume” implantations with radium

      Meredith, W Jack; Stephenson, S K; Christie Hospital and Holt Radium Institute, Manchester (1945-02)
    • Calibration of pre-cut iridium-192 wires for low dose rate interstitial brachytherapy using a Farmer-type ionization chamber.

      Vollans, S E; Wilkinson, James M; North Western Medical Physics, Christie Hospital, Manchester, UK. (2000-02)
      A technique, originally developed for calibrating small low activity caesium sources, which uses a Farmer-type ionization chamber, has been further developed for use with iridium wires. Correction factors have been generated to account for the finite source and detector sizes, and attenuation in the source carriers. The air kerma calibration factor for heavily filtered 280 kV X-rays was used for reference back to the National Standard. The results of this calibration method have been compared with the calibration figures given by the manufacturers over a 5 year period for the emissions from 50 batches of wires of varying strengths. Agreement to within +/- 3.2% was achieved in all cases, establishing that the method is satisfactory for acceptance testing purposes. The mean agreement was good to within 0.2%, but the possibility of a systematic error of between 1% and 3% existing both in this method and in the method used by the manufacturer is discussed.
    • A call for standardized reporting of adverse events

      Fankhauser, Christian D; Wettstein, M. S.; Pedregal, M.; Clarke, Noel W; Sweeney, C. J.; Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; (2020)
    • A call to action on chemotherapy services.

      Davis, Carole; The Christie Hospital NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, U.K. (2009)
    • CAM and cancer care: champions for integration.

      Mackereth, Peter A; Stringer, Jacqui; Clinical Leads, Complementary Therapy Service, Rehabilitation Unit, Christie Hospital, Manchester, UK. peter.a.mackereth@virgin.net (2005-02)
      The paper reviews challenges and developments in the integration of complementary therapies in cancer care. These issues are examined by reflecting on papers published in CTNM in the last 10 years by champions of CAM in cancer care. Given the aim of the journal to encourage an inclusive readership, multidisciplinary and user perspectives are included. The paper argues for better information, improved service provision and CAM choices in public healthcare, leadership support, funded research and audit, and user and non-users views.
    • The CamGFR model for renal function in patients with cancer: validation and extension for use with data from isotope mass dilution spectrometry creatinine assays

      Williams, E; Whitley, C; Weaver, Jamie M; Connell, C; Geisler, S; Giglio, D; Tavare, S; Jodrell, D; Janowitz, T; Liver Unit, Barcelona Clinic Liver Cancer group, Hospital Clinic Barcelona (2018)
    • CamGFR v2: a new model for estimating the glomerular filtration rate from standardized or non-standardized creatinine in patients with cancer

      Williams, E. H.; Flint, T. R.; Connell, C. M.; Giglio, D.; Lee, H.; Ha, T.; Gablenz, E.; Bird, N. J.; Weaver, Jamie M; Potts, H.; et al. (2020)
      Purpose: Management of patients with cancer, specifically carboplatin dosing, requires accurate knowledge of glomerular filtration rate (GFR). Direct measurement of GFR is resource-limited. Available models for estimated GFR (eGFR) are optimized for patients without cancer and either isotope dilution mass spectrometry (IDMS)- or non-IDMS-standardized creatinine measurements. We present an eGFR model for patients with cancer compatible with both creatinine measurement methods. Methods: GFR measurements, biometrics, and IDMS- or non-IDMS-standardized creatinine values were collected for adult patients from three cancer centers. Using statistical modelling, an IDMS- and non-IDMS creatinine compatible eGFR model (CamGFR v2) was developed. Its performance was compared to that of the existing models CKD-EPI, MDRD, FAS, Lund-Malmo Revised and CamGFR v1 using statistics for bias, precision, accuracy, and clinical robustness. Results: 3,083 IDMS- and 4,612 non-IDMS-standardized creatinine measurements were obtained from 7,240 patients. IDMS-standardized creatinine values were lower than non-IDMS-standardized values in within-centercomparisons (13.8% lower in Cambridge, p<0.0001; 19.3% lower in Manchester, p <0.0001), and more consistent between centers. CamGFR v2 was the most accurate (root-mean-squared error for IDMS = 14.97ml/min[95% CI 13.84,16.13]; non-IDMS = 15.74ml/min[14.86,16.63]), most clinically robust (proportion with >20% error of calculated carboplatin dose for IDMS = 0.12[0.09, 0.14]; non-IDMS = 0.17[0.15, 0.2]) and least biased (median residual for IDMS = 0.73ml/min[-0.68,2.2]; non-IDMS = -0.43ml/min[-1.48,0.91]) eGFR model, particularly when eGFR was larger than 60ml/min. Conclusions: CamGFR v2 can utilize IDMS- and non-IDMS-standardized creatinine measurements and outperforms previous models. CamGFR v2 should be examined prospectively as a practice-changing standard of care for eGFR-based carboplatin dosing.
    • Camidanlumab tesirine in patients with relapsed or refractory lymphoma: a phase 1, open-label, multicentre, dose-escalation, dose-expansion study

      Hamadani, M.; Collins, G. P.; Caimi, P. F.; Samaniego, F.; Spira, A.; Davies, A.; Radford, John A; Menne, T.; Karnad, A.; Zain, J. M.; et al. (2021)
      Background: Novel approaches are required to improve outcomes in relapsed or refractory classical Hodgkin lymphoma and non-Hodgkin lymphoma. We aimed to evaluate camidanlumab tesirine, an anti-CD25 antibody-drug conjugate, in this patient population. Methods: This was a phase 1, dose-escalation (part 1), dose-expansion (part 2), multicentre trial done in 12 hospital sites (seven in the USA and five in the UK). Adults (≥18 years old) with pathologically confirmed relapsed or refractory classical Hodgkin lymphoma or non-Hodgkin lymphoma, an Eastern Cooperative Oncology Group performance status 0-2, who had no therapies available to them with established clinical benefit for their disease stage were enrolled. Camidanlumab tesirine was administered intravenously (3-150 μg/kg) once every 3 weeks. Primary objectives were to assess dose-limiting toxicity, determine maximum tolerated dose and recommended expansion dose(s), and assess safety of camidanlumab tesirine. Safety was assessed in all treated patients; antitumour activity was assessed in patients with one or more valid baseline and post-baseline disease assessment and in those who had disease progression or died after first study-drug dose. This trial was registered with ClinicalTrials.gov, NCT02432235. Findings: Between Oct 5, 2015, and Jun 30, 2019, 133 patients were enrolled (77 [58%] had classical Hodgkin lymphoma and 56 (42%) had non-Hodgkin lymphoma). Median follow-up was 9·2 months (IQR 4·2-14·3). Eight dose-limiting toxicities were reported in five (6%) of 86 patients who were evaluable; the maximum tolerated dose was not reached. The recommended doses for expansion were 30 μg/kg and 45 μg/kg for patients with classical Hodgkin lymphoma and 80 μg/kg for patients with T-cell non-Hodgkin lymphomas. No recommended doses for expansion were defined for B-cell non-Hodgkin lymphomas. Grade 3 or worse treatment-emergent adverse events (reported by ≥10% of the 133 patients) included increased γ-glutamyltransferase (20 [15%] patients), maculopapular rash (16 [12%]), and anaemia (15 [11%]); 74 (56%) patients had serious treatment-emergent adverse events, most commonly pyrexia (16 [12%]). One (1%) fatal treatment-emergent adverse event and two (2%) deaths outside the reporting period were considered at least possibly study-drug related. Antitumoural activity was seen in classical Hodgkin and non-Hodgkin lymphomas; notably in all patients with classical Hodgkin lymphoma, the overall response was 71% (95% CI 60-81). Interpretation: These results warrant evaluation of camidanlumab tesirine as a potential treatment option for relapsed or refractory lymphoma, particularly in patients with classical Hodgkin lymphoma
    • CAMPATH-1H monoclonal antibody in therapy for previously treated low-grade non-Hodgkin's lymphomas: a phase II multicenter study. European Study Group of CAMPATH-1H Treatment in Low-Grade Non-Hodgkin's Lymphoma.

      Lundin, J; Osterborg, Anders; Brittinger, G; Crowther, Derek; Dombret, Herve; Engert, Andreas; Epenetos, A; Gisselbrecht, Christian; Huhn, D; Jaeger, U; et al. (1998-10)
      PURPOSE: CAMPATH-1H is a human immunoglobulin G1 (IgG1) anti-CD52 monoclonal antibody (MAb) that binds to nearly all B-cell and T-cell lymphomas. We report here the results of a multicenter phase II trial of CAMPATH-1H in patients with advanced, low-grade non-Hodgkin's lymphoma (NHL) who were previously treated with chemotherapy. PATIENTS AND METHODS: Fifty patients who had relapsed (n=25) after or were resistant (n = 25) to chemotherapy were treated with CAMPATH-1H 30 mg administered as a 2-hour intravenous (i.v.) infusion three times weekly for a maximum period of 12 weeks. RESULTS: Six patients (14%) with B-cell lymphomas achieved a partial remission (PR). Patients with mycosis fungoides appeared to respond more frequently (50%; four of eight patients, which included two complete remissions [CRs]). Lymphoma cells were rapidly eliminated from blood in 16 of 17 patients (94%). CR in the bone marrow was obtained in 32% of the patients. Lymphoma skin lesions disappeared completely in four of 10 patients and partial regression was obtained in three patients. Lymphadenopathy and splenomegaly were normalized in only 5% and 15% of patients, respectively. Lymphopenia (< 0.5 x 10(9)/L) occurred in all patients. World Health Organization (WHO) grade IV neutropenia occurred in 14 patients (28%). Opportunistic infections were diagnosed in seven patients and nine patients had bacterial septicemia. Death related to infectious complications occurred in three patients. CONCLUSION: CAMPATH-1H had a significant but limited activity in patients with advanced, heavily pretreated NHL. The most pronounced effects were noted in the blood and bone marrow and in patients with mycosis fungoides. The risk for serious infectious complications needs to be considered for severely ill patients who are evaluated for CAMPATH-1H treatment.
    • Campto effective and flexible chemotherapy for advanced colorectal cancer.

      Ferns, Helen; Christie Hospital NHS Trust, Manchester M20 4BX, UK. (2003-07)
      The use of chemotherapy with patients with advanced colorectal cancer is increasing. There is a growing appreciation of the potential of traditional and newer treatments to improve quality of life, and of their value in the palliation of symptoms, in addition to providing modest gains in overall survival. Possible benefits have to be weighed up against the risk of side effects and patients need to be supported in making difficult decisions. This article provides a brief overview of chemotherapy agents for advanced colorectal cancer and focuses on one new agent, Campto. The evidence supporting its use, common side effects and management recommendations are discussed. The role of the oncology team and the implications for nurses are outlined.
    • Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial.

      Pitceathly, Carolyn; Maguire, Peter; Fletcher, I; Parle, Michael; Tomenson, B; Creed, Francis; CRUK Psychological Medicine Group, Stanley House, Christie Hospital, Manchester. (2009-01-06)
      BACKGROUND: We tested whether a brief psychological intervention could prevent anxiety or depressive disorders among newly diagnosed cancer patients. PATIENTS AND METHODS: Patients free of anxiety or depressive disorder were randomised to receive immediate intervention (start of cancer treatment), delayed intervention (8 weeks after starting treatment) or usual care. They were stratified according to risk of developing anxiety or depressive disorders. Primary outcome was measured using a standardised psychiatric interview to detect any anxiety or depressive disorder at 6 and 12 months following the cancer diagnosis. Analyses used conditional odds logistic regression models adjusting for age, gender, concerns and past history to compare outcome of all intervention patients with usual care. RESULTS: A total of 465 patients were recruited. In all, 313 (79%) of the 397 well enough to be interviewed completed the study. At 12 months, there was no difference between the groups receiving the intervention and usual care [odds ratio (OR) = 0.69, 95% confidence interval (CI) 0.41-1.17, P = 0.17]. In high-risk patients, those who received the intervention were less likely to develop an anxiety or depressive disorder compared with those who received usual care (OR = 0.54, 95% CI 0.29-1.00, P = 0.050). In low-risk patients, there was no difference (OR = 1.50, 95% CI 0.51-4.43, P = 0.47). CONCLUSION: A brief intervention, delivered by nonspecialists, promoted adjustment among newly diagnosed cancer patients at high risk of developing anxiety or depressive disorders.
    • Can a dual isocentre technique enable cervix treatments on the MR-Linac?

      Chuter, Robert; Cree, Anthea; Whitehurst, Philip; Hales, Rosie; McWilliam, Alan; The Christie NHS Foundation Trust, Christie Medical Physics and Engineering, Manchester, (2020)
      Purpose or Objective Cervix patients can exhibit large inter and intra-fraction anatomical changes due to variation in bladder and rectum filling. The MR-Linac (MRL), which combines a 7MV linear accelerator with a 1.5T MR scanner can image these patients prior to and during treatment and enables daily adaptation due to improved image contrast compared to CBCT. The MR-Linac has a limited treatment field in the Sup/Inf direction of 22 cm at isocentre which can restrict the treatment of patients where nodal disease extends outside this limit. Here we investigate the feasibility of a dual isocentre technique to enable cervix patients with large nodal volumes to be treated, exploring potential adaptive workflows. Material and Methods Four cervix cancer patients were retrospectively planned with a dual isocentre technique delivering 45Gy in 25 fractions. Research Monaco v5.19.02 (Elekta AB Stockholm, Sweden) with an MR-Linac specific beam model and 1% statistical uncertainty was utilised. A 1 cm overlap region between PTV1 (primary) and PTV2 (elective nodal volume) was created, positioned entirely in PTV2 (Figure 1). The plan consisted of 14 step-and-shoot IMRT beams, 7 beams per isocentre. The plans met dose constraints for the EMBRACE II study. To test robustness to small movements between treatments of each plan, PTV1 isocentre was shifted superiorly and inferiorly by 3mm and 6mm. The plan was recalculated and dosimetric changes evaluated. A potential treatment workflow was simulated, with the plan to the nodal region delivered first as the interfraction movement is likely to be less. The plan for the primary disease was then re-optimised (post PTV1 isocentre shift 3mm or 6mm) onto the nodal region plan using the bias dose. Plan dosimetry was evaluated compared against the initial reference plan. Results For the four patients included, combined PTV lengths of 18.6–21.6 cm were required. Therefore to ensure coverage three patients would not have been suitable for the MRL. Using a dual isocentre technique resulted in two fields ranging from 10.8–15.3 cm for PTV1 isocentre and 6.3–10.5 cm for PTV2 isocentre. Shifting PTV1 isocentre and recalculating 6 mm sup increased the maximum dose to 1cc of CTV1 by 17.2% on average over the four patients. Similarly, shifting the PTV1 isocentre 6 mm inf decreased the minimum dose to 1cc of CTV1 by 17.8% averaged over four patients. The results of re-optimising onto the nodal dose with shifted PTV1 regions is shown in Figure 2. This shows that reoptimising the plan rather than just recalculating maintains plan quality. However, this method does struggle to maintain dose coverage to PTV2 for large shifts in the junction region. Conclusion The dual isocentre technique for cervix and nodal treatments can feasibly give good quality plans whilst ensuring that the treatment fields can be treated on the MR-Linac. This preliminary work has investigated the effect of potential intra-fraction motion and possible plan adaptation workflows.
    • Can communication skills be taught?

      Maguire, Peter; Christie Hospital, Manchester. (1990-03)
      Basic interviewing skills can be learned at undergraduate and postgraduate level, providing effective methods are used. These include demonstration of key skills, practice under controlled conditions, and audiotape or videotape feedback of performance by a tutor within small groups. More complex skills can also be learned but may not be used or maintained without ongoing training and supervision.