Publications by authors named "Ciara Conduit"

Background: Standard of care (SOC) treatments for International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis stage II germ cell tumours (GCT) involve primary orchidectomy followed by combination chemotherapy for both seminoma and non-seminomatous germ cell tumours (NSGCT). Alternatively, external beam radiotherapy may be used for seminoma and retroperitoneal lymph node dissection (RPLND) for NSGCT. While these treatments achieve high cure rates, they are associated with significant toxicities.

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Goal: To present data from published clinical trials of treatment of patients with prostate cancer with enzalutamide described in plain language and in a dashboard format available at: https://clinical-trials.dimensions.ai/enzalutamide-clinical-review/.

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Stage II testicular seminoma is highly curable when treated using standard-of-care cisplatin-based chemotherapy or radiotherapy. However, these treatments can affect long-term quality of life because of the development long-term, or chronic, toxicities and late effects. In recent years, multiple emerging treatment strategies for stage II seminoma have been explored with the principal aim of minimizing toxicity in this young patient population.

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Testicular cancer is the most common solid malignancy in people with testicles aged 15-44 years, accounting for 1-2% of all tumours in males of all ages. Approximately 95% of testicular cancers are testicular germ cell tumours. This Seminar focuses on testicular cancer, with an emphasis on testicular germ cell tumours.

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What Is This Summary About?: This summary includes information from the ARCHES and ENZAMET . Both studies looked at enzalutamide treatment for people with metastatic hormone-sensitive prostate cancer (known as mHSPC). In ARCHES, researchers compared the medications enzalutamide + androgen deprivation therapy (known as ADT) with  + ADT.

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Background: Primary hypogonadism is a recognised complication in survivors of testicular cancer. However, secondary hypogonadism can result from other causes that suppress the hypothalamic-pituitary axis, including obesity, high dose glucocorticoids, chronic end organ failure, and diabetes. The aim of this study was to explore low total serum testosterone in Australian survivors of testicular cancer and examine associations with body mass index, age, and prior chemotherapy use.

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Objective: To assess the impact of ejaculatory dysfunction (EjD; failure of emission or retrograde ejaculation) on health-related quality of life (HRQoL) after retroperitoneal lymph node dissection (RPLND) for testicular cancer and explore the efficacy of pseudoephedrine hydrochloride as treatment.

Patients And Methods: In a single arm, phase II trial, patients at ≥6 months after RPLND were invited to complete patient-reported outcome measures (European Organisation for Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]-30-item core, EORTC QLQ-testicular cancer-26, and Brief Male Sexual Function Inventory) evaluating HRQoL and sexual function in follow-up (ACTRN12622000537752/12622000542796). If EjD was reported, post-ejaculatory urine ± semen analysis was undertaken.

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Objectives: To assess the safety of sub-urothelial injection of durvalumab and examine the impact on tissue and circulating immune cell populations.

Patients And Methods: The patients were chemotherapy and immunotherapy naïve (bacille Calmette-Guérin allowed) with non-metastatic muscle-invasive bladder cancer or non-muscle-invasive bladder cancer planned for radical cystectomy (RC). The study was a Phase Ib 3 + 3 dose-escalation design with sub-urothelial injection of durvalumab at three pre-determined doses (25, 75, 150 mg) diluted in 25 mL normal saline, injected at 25 locations (25 × 1 mL injections), at least 2 weeks before RC.

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Article Synopsis
  • The study aimed to assess the effectiveness of adding ipilimumab to nivolumab treatment in patients with advanced, non-clear-cell renal cell carcinoma who showed disease progression on nivolumab alone.
  • In a phase 2 trial, patients received nivolumab for up to 12 months, then ipilimumab if their condition worsened; the response rates were relatively low, with notable treatment-related adverse events.
  • Despite modest overall effects of nivolumab alone, some participants did respond well, and the combination treatments continued to show some promise in managing the disease.
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Background: Radiation may improve the efficacy of immune checkpoint inhibition. This study investigates the combination of pembrolizumab and chemoradiation (CRT) for muscle-invasive bladder cancer (MIBC).

Objective: To assess the feasibility and safety of pembrolizumab combined with CRT for MIBC.

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Background: Salvage radiation therapy (SRT) and surveillance for low-risk prostate-specific antigen (PSA) recurrence have competing risks and benefits. The efficacy of early SRT to the prostate bed with or without pelvic lymph nodes compared to surveillance in patients with PSA recurrence after radical prostatectomy and no identifiable recurrent disease evident on prostate specific membrane antigen-positron emission tomography/computer tomography (PSMA-PET/CT) is unknown.

Study Design: The Dedicated Imaging Post-Prostatectomy for Enhanced Radiotherapy outcomes (DIPPER) is an open-label, multicentre, randomised Phase II trial.

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Prostate cancer remains the commonest cancer diagnosed in males and a leading cause of cancer-related death. Men with metastatic castration-resistant prostate cancer (mCRPC) who have progressed on chemotherapy and androgen receptor pathway inhibitors (ARPI) have limited treatment options, significant morbidity, and poor outcomes. Prostate-specific membrane antigen (PSMA)-directed radionuclide therapy (RNT) is emerging as an efficacious and well-tolerated therapy; however, disease progression is universal.

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Purpose: International guidelines advocate for active surveillance as the preferred treatment strategy for patients with stage 1 testicular cancer after orchidectomy although a personalized discussion is required.

Materials And Methods: We conducted an analysis of individuals registered in iTestis, Australia's testicular cancer registry, to describe the patterns of relapse and outcomes of patients treated in Australia where the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations are widely adopted.

Results: A total of 650 individuals diagnosed between 2000 and 2020 were included, 63% (411 of 650) seminoma and 37% (239 of 650) nonseminoma.

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International Germ Cell Cancer Collaborative Group good-risk metastatic seminoma has cure rates of >95%. Within this risk group, patients with stage II disease exhibit the best oncological outcomes with the standard-of-care treatment strategies of radiotherapy or combination chemotherapy. However, these treatments can be associated with substantial early and late toxic effects.

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Background: Distress is common immediately after diagnosis of testicular cancer. It has historically been difficult to engage people in care models to alleviate distress because of complex factors, including differential coping strategies and influences of social gender norms. Existing support specifically focuses on long-term survivors of testicular cancer, leaving an unmet need for age-appropriate and sex-sensitized support for individuals with distress shortly after diagnosis.

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Article Synopsis
  • Some people who survive testicular cancer can have health problems later on, and doctors want to find better ways to tell who needs more treatment.
  • Researchers looked at special scans (FDG-PET/CT) from a hospital to see how good they are at finding active cancer or knowing when it’s not there in patients with different stages of testicular seminoma.
  • The results showed that the scans were very good at predicting cancer in some situations, with high success rates for both finding it when it's there and confirming it's not there in the patients they studied.
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Purpose: Post-chemotherapy retroperitoneal lymph node dissection (pcRPLND) for residual nodal masses is a critical component of care in metastatic testicular germ cell tumour (GCT). However, the procedure is not of therapeutic value in up to 50% of individuals in whom histopathology demonstrates post-treatment necrosis or fibrosis alone. Improved diagnostic tools and clinicopathologic features are needed to separate individuals who benefit from pcRPLND and avoid surgery in those who do not.

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Purpose Of Review: Testicular germ cell tumours (TGCTs) are the most common solid malignant cancer diagnosed in young males and the incidence is increasing. Understanding the genetic basis of this disease will help us to navigate the challenges of early detection, diagnosis, treatment, surveillance, and long-term outcomes for patients.

Recent Findings: TGCTs are highly heritable.

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Article Synopsis
  • The study aims to assess the effectiveness and safety of intermittent docetaxel chemotherapy guided by plasma levels of methylated glutathione S-transferase Pi-1 in men with metastatic castration-resistant prostate cancer (CRPC).
  • It involves a randomized phase-2 trial with 120 patients across six Australian centers, where participants will be pre-screened based on their methylated levels before and during treatment.
  • The primary outcome is radiographic progression-free survival, while secondary outcomes include patient safety, overall survival, and treatment costs, with results expected to provide insights on using the biomarker for treatment decisions.
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Without preventive interventions, women with germline pathogenic variants in or have high lifetime risks for breast cancer and tubo-ovarian cancer. The increased risk for breast cancer starts at a considerably younger age than that for tubo-ovarian cancer. Risk-reducing bilateral salpingo-oophorectomy (rrBSO) is effective in reducing tubo-ovarian cancer risk for and mutation carriers, but whether it reduces breast cancer risk is less clear.

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