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Evolving treatment landscape for early and advanced pancreatic cancer

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World Journal of Gastrointestinal Oncology 2017年第7期9卷 281-292页

作者： Sally C Lau winson y cheung Division of Medical Oncology University of British Columbia British Columbia Cancer Agency Department of Oncology University of Calgary Tom Baker Cancer Center

Pancreatic ductal adenocarcinoma is an infrequent cancer with a high disease related mortality rate, even in the context of early stage disease. Until recently, the rate of death from pancreatic cancer has remained largely similar whereby gemcitabine monotherapy was the mainstay of systemic treatment for most stages of disease. With the discovery of active multiagent chemotherapy regimens, namely FOLFIRINOX and gemcitabine plus nab-paclitaxel, the treatment landscape of pancreatic cancer is slowly evolving. FOLFIRINOX and gemcitabine plus nab-paclitaxel are now considered standard first line treatment options in metastatic pancreatic cancer. Studies are ongoing to investigate the utility of these same regimens in the adjuvant setting. The potential of these treatments to downstage disease is also being actively examined in the locally advanced context since neoadjuvant approaches may improve resection rates and surgical outcomes. As more emerging data become available, the management of pancreatic cancer is anticipated to change significantly in the coming years.

关键词： Cancer Neoplasm Pancreas Adjuvant treatment Systemic treatment Gemcitabine FOLFIRINOX Nab-paclitaxel

Real-world evidence on adjuvant chemotherapy in older adults with stage II/III colon cancer

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World Journal of Gastrointestinal Oncology 2020年第6期12卷 604-618页

作者： Atul Batra Rodrigo Rigo Dropen Sheka winson y cheung Department of Medicine Tom Baker Cancer CentreCalgaryAlberta T2N 1N4Canada Department of Oncology University of CalgaryCalgaryAlberta T 2N 4N2Canada

Colon cancer represents one of the most common cancers diagnosed in older adults *** standard of care in resected stage II and stage III colon cancer continues to *** there is unequivocal evidence to suggest both disease free and overall survival benefits with the use of combination chemotherapy in patients with stage III colon cancer,data regarding its use in patients with stage II colon cancer are less ***,although colon cancer is a disease that affects older adults,there is considerable debate on the value of adjuvant chemotherapy in the aging *** particular,many older patients are undertreated when compared to their younger *** this review,we will describe the clinical trials that contributed to the current adjuvant chemotherapy approach in colon cancer,discuss representation of older adults in trials and the specific challenges associated with the management of this subpopulation,and highlight the role of comprehensive geriatric *** will also review how real-world evidence complements the data gaps from clinical trials of early stage colon cancer.

关键词： Colon cancer Older adults Adjuvant chemotherapy Real-world evidence

Leveraging the power of pooled data for cancer outcomes research

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Chinese Journal of Cancer 2016年第8期35卷 388-390页

作者： Kiara Hugh-yeun winson y.cheung Division of Medical Oncology British Columbia Cancer Agency

Background:Clinical trials continue to be the gold standard for determining the efficacy of novel cancer treatments,but they may also expose participants to the potential risks of unpredictable or severe *** development of validated tools that better inform patients of the benefits and risks associated with clinical trial participation can facilitate the informed consent *** design and validation of such instruments are strengthened when we leverage the power of pooled data analysis for cancer outcomes *** body:In a recent study published in the Journal of Clinical Oncology entitled "Determinants of early mortality among 37,568 patients with colon cancer who participated in 25 clinical trials from the adjuvant colon cancer endpoints database," using a large pooled analysis of over 30,000 study participants who were enrolled in clinical trials of adjuvant therapy for early-stage colon cancer,we developed and validated a nomogram depicting the predictors of early cancer *** database of pooled individual-level data allowed for a comprehensive analysis of poor prognostic factors associated with early death;furthermore,it enabled the creation of a nomogram that was able to reliably capture and quantify the benefit-to-risk profile for patients who are considering clinical trial *** toolcan facilitate treatment decision-making ***:As China and other Asian countries continue to conduct oncology clinical trials,efforts to collate patient-level information from these studies into a large data repository should be strongly considered since pooled data can increase future capacity for cancer outcomes research,which,in turn,can enhance patient-physician discussions and optimize clinical care.

关键词： Colon cancer Informed consent Risk assessment Clinical outcomes

Colorectal cancer screening: Opportunities to improve uptake, outcomes, and disparities

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 733-740页

作者： Neal Shahidi winson y cheung Division of Gastroenterology Department of Medicine University of British Columbia Vancouver BC V6Z 2K5 Canada Division of Medical Oncology Department of Medicine University of British Columbia Vancouver BC V5Z 4E6 Canada British Columbia Cancer Agency VancouverBC V5Z 4E6 Canada

Colorectal cancer screening has become a standard of care in industrialized nations for those 50 to 75 years of age,along with selected high-risk *** colorectal cancer screening has been shown to reduce both the incidence and mortality of colorectal cancer,it is a complex multi-disciplinary process with a number of important steps that require optimization before tangible improvements in outcomes are *** both opportunistic and programmatic colorectal cancer screening,poor participant uptake remains an ongoing ***,current screening modalities(such as the guaiac based fecal occult blood test,fecal immunochemical test and colonoscopy) may be used or performed suboptimally,which can lead to missed neoplastic lesions and unnecessary endoscopic *** latter poses the risk of adverse events,such as perforation and post-polypectomy bleeding,as well as financial impacts to the healthcare ***,ongoing disparities in colorectal cancer screening persist among marginalized populations,including specific ethnic minorities(African Americans,Hispanics,Asians,Indigenous groups),immigrants,and those who are economically *** this context,we aimed to review the current literature on these important areas pertaining to colorectal cancer screening,particularly focusing on the guaiac based fecal occult blood test,the fecal immunochemical test and colonoscopy.

关键词： Fecal occult blood test Fecal immunochemical test Colonoscopy Neoplasia Polyp

After the Treatment Phase of Colorectal Cancer Care: Survivorship and Follow-Up

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Journal of Cancer Therapy 2012年第6期3卷 977-984页

作者： Maria y. Ho winson y. cheung Division of Medical Oncology British Columbia Cancer Agency University of British Columbia Vancouver Canada.

The number of long-term colorectal cancer (CRC) survivors has increased substantially over the past three decades due to both ongoing advances in early detection and improvements in cancer therapies. Adult survivors of CRC experience chronic health conditions due to normal issues associated with aging, which is further compounded by the long-term adverse effects of having had cancer and anti-cancer therapies. In addition, they are at a higher risk for CRC recurrences, new primary cancers, and other co-morbidities. This article will provide an overview of the clinical care of adult survivors of CRC. Epidemiologic data will be presented followed by a discussion of the approach to the care of long-term adult survivors of CRC, including surveillance of recurrences and new primary cancers, interventions to manage both physical and psychological consequences of cancer and its treatments, and strategies to address concerns related to unemployment and disability. Finally, we will explore the challenges of healthcare delivery, especially with respect to the coordination of follow-up between cancer specialists and primary care physicians, so as to ensure that all of the survivor’s health needs are met promptly and appropriately.

关键词： Colorectal Cancer Survivorship Care Surveillance of CRC

Real-world evidence on first-and second-line palliative chemotherapy in advanced pancreatic cancer

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World Journal of Clinical Oncology 2021年第9期12卷 787-799页

作者： Hakon Blomstrand Atul Batra winson y cheung Nils Oskar Elander Department of Biomedical and Clinical Sciences Linköping UniversityLinköping 58185Sweden Department of Medical Oncology All India Institute of Medical SciencesNew Delhi 110029India Department of Oncology University of CalgaryCalgary T2N 4N1Canada

In spite of recent diagnostic and therapeutic advances,the prognosis of pancreatic ductal adenocarcinoma(PDAC)remains very *** most patients are not amenable to curative intent treatments,optimized palliative management is highly *** key question is to what extent promising results produced by randomized controlled trials(RCTs)correspond to clinically meaningful outcomes in patients treated outside the strict frames of a clinical *** answer such questions,real-world evidence is *** present paper reviews and discusses the current literature on first-and second-line palliative chemotherapy in ***,a growing number of studies report that the outcomes of the two predominant first-line multidrug regimens,*** plus nabpaclitaxel(GnP)and folfirinox(FFX),is similar in RCTs and real-life *** of second-line therapy following failure of first-line regimens are still dismal,and considerable uncertainty of the optimal management *** RCTs and real-world evidence studies focusing on the optimal treatment sequence,such as FFX followed by GnP or vice versa,are urgently ***,the review highlights the need for prognostic and predictive biomarkers to inform clinical decision making and enable personalized management in advanced PDAC.

关键词： Pancreatic cancer Palliative therapy Cancer chemotherapy Gemcitabine Paclitaxel,nano albumin-bound Folfirinox

Neuroendocrine tumor metastatic to the orbit treated with radiotherapy

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World Journal of Gastrointestinal Oncology 2013年第8期5卷 177-180页

作者： Renata D'Alpino Peixoto Howard John Lim winson y cheung Department of Medical Oncology BC Cancer Agency

Neuroendocrine tumors are rare neoplasms that infrequently metastasize to the *** that patients with these tumors may have prolonged survival despite dissemination,maintaining quality of life by providing early diagnosis and effective treatment to preserve vision and comfort is a fundamental *** report the case of a79-year old woman who presented with well-differentiated metastatic neuroendocrine tumor to the liver with no carcinoid syndrome and was started on intramuscular long-acting octreotide with disease *** years later she developed right-sided diplopia associated with mild eye discomfort,proptosis and *** magnetic resonance imaging showed a 2.1 cm mass in the right orbit and further biopsy confirmed a neuroendocrine tumor *** patient was treated with a four-week course of stereotactic radiotherapy to the right orbital metastasis(4000 cGy in 20 fractions)with minor conjunctivitis as the only side *** months later,she remains well with no visual loss.

关键词： Neuroendocrine tumor Carcinoid tumor Orbital metastases Diplopia Radiotherapy

Repeatability,interocular correlation and agreement of optic nerve head vessel density in healthy eyes:a sweptsource optical coherence tomographic angiography study

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 896-903页

作者： Dan-Qi Fang Da-Wei yang Xiao-Ting Mai Carol y cheung Hao-yu Chen Joint Shantou International Eye Center Shantou University&the Chinese University of Hong KongShantou 515041Guangdong ProvinceChina Department of Ophthalmology and Visual Sciences Chinese University of Hong KongHong Kong 999077China

AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy ***:Thir ty-three healthy subjects were *** ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm×3 mm scanning *** of the radial peripapillary capillary were analyzed by a customized Matlab program,and the vessel density,fractal dimension,and vessel diameter index were *** repeatability of the four scans was determined by the intraclass correlation coefficient(ICC).The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient,ICC and Bland-Altman ***:All swept-source-OCTA ONH parameters exhibited certain repeatability,with ICC>0.760 and coefficient of variation(CoV)≤7.301%.The obvious interocular correlation was observed for papillary vessel density(ICC=0.857),vessel diameter index(ICC=0.857)and fractal dimension(ICC=0.906),while circumpapillary vessel density exhibited moderate interocular correlation(ICC=0.687).Bland-Altman plots revealed an agreement range of-5.26%to 6.21%for circumpapillary vessel ***:OCTA ONH parameters demonstrate good repeatability in healthy *** interocular correlations of papillary vessel density,fractal dimension and vessel diameter index are high,but the correlation for circumpapillary vessel density is moderate.

关键词： interocular correlation repeatability optic nerve head optical coherence tomography angiography vessel density

Mindfulness Facets and Psychological Well-Being among Meditators:Serenity as a Mediating Process

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International Journal of Mental Health Promotion 2024年第3期26卷 177-187页

作者： Rebecca y.M.cheung Iris yili Wang Elsa Ngar-Sze Lau School of Psychology and Clinical Language Sciences University of ReadingReadingUK Department of Special Education and Counselling The Education University of Hong KongHong KongChina Department of Educational Administration and Policy The Chinese University of Hong KongHong KongChina

Guided by the theoretical processes of mindfulness and psychological well-being,this study examined serenity as a mediator between mindfulness facets and psychological well-being,as indexed by depressive symptoms and life *** were 133 mindfulness practitioners who took part in a 3-day transnational meditation event in Hong *** informed consent,participants completed a self-report *** findings from structural equation modeling showed that serenity mediated the relation between two facets of mindfulness,including describing and nonreacting to inner experience,and life *** also mediated the relation between the mindfulness facet of describing and depressive *** associations were indicated between two mindfulness facets,including observing and nonjudging of inner experience,and depressive *** together,the findings revealed mindfulness facets as major correlates of serenity and psychological outcomes among Chinese meditation *** foster psychological well-being,researchers,educators,and practitioners should pay attention to the role of serenity,describing,and nonreacting to inner experience in mental health.

关键词： Depressive symptoms mindfulness mindfulness practitioners satisfaction with life serenity