Publications by authors named "Elizabeth Robilotti"

Oncolytic viral immunotherapies are agents which can directly kill tumor cells and activate an immune response. Oncolytic viruses (OVs) range from native/unmodified viruses to genetically modified, attenuated viruses with the capacity to preferentially replicate in and kill tumors, leaving normal tissue unharmed. Talimogene laherparepvec (T-VEC) is the only OV approved for patient use in the United States; however, during the last 20 years, there have been a substantial number of clinical trials using OV immunotherapies across a broad range of cancers.

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  • - AZD7442 is a combination therapy of two monoclonal antibodies designed to prevent COVID-19 in high-risk patients, particularly those with hematologic cancers who may not respond well to vaccines.
  • - A study involving 892 high-risk patients at Memorial Sloan Kettering Cancer Center found that 10.9% experienced breakthrough infections, but most were treated outpatient and had low hospitalization rates.
  • - Patients receiving updated dosing regimens of AZD7442 had a lower likelihood of breakthrough infections, but no clear predictors for infection risk were identified, suggesting the treatment's effectiveness regardless of individual risk factors.
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  • A study examined outcomes of cancer patients who got COVID-19, focusing on those with and without existing cardiovascular disease (CVD) or risk factors (CVRF).
  • The research found that over half of the 10,876 patients had CVD/CVRF, which linked to more severe COVID-19 symptoms and complications.
  • Notably, patients without recent cancer treatment experienced worse COVID-19 severity related to CVD/CVRF compared to those under active treatment.
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A disrupted "dysbiotic" gut microbiome engenders susceptibility to the diarrheal pathogen Clostridioides difficile by impacting the metabolic milieu of the gut. Diet, in particular the microbiota-accessible carbohydrates (MACs) found in dietary fiber, is one of the most powerful ways to affect the composition and metabolic output of the gut microbiome. As such, diet is a powerful tool for understanding the biology of C.

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  • - Sotrovimab is a monoclonal antibody aimed at preventing severe COVID-19 cases in high-risk patients, including those with hematologic cancers, although limited research has been done on its effect in this specific group.
  • - In a study of 156 cancer patients treated with sotrovimab, 11% were hospitalized due to COVID-19, with significant factors for hospitalization being anti-CD20 therapy and having relapse or refractory disease.
  • - The findings suggest that while sotrovimab can reduce COVID-19 severity, patients on anti-CD20 therapy face higher risks, indicating a need to investigate combination treatments to improve outcomes.
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  • The Alpha and Omicron variants of COVID-19 share specific mutations in their spike gene that cause certain tests to fail in detecting them.
  • The study analyzed over 2,300 positive samples using the TaqPath RT-PCR test and found that the S gene target failure (SGTF) is a reliable indicator for identifying these variants.
  • The SGTF showed high sensitivity and specificity rates (over 99%) for both variants, demonstrating its effectiveness as a quick and accurate method for variant identification in labs.
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Objective: To describe effectiveness of mRNA vaccines by comparing 2-dose (2D) and 3-dose (3D) healthcare worker (HCW) recipients in the setting of Omicron variant dominance. Performance of 2D and 3D vaccine series against SARS-CoV-2 variants and the clinical outcomes of HCWs may inform return-to-work guidance.

Methods: In a retrospective study from December 15, 2020 to January 15, 2022, SARS-CoV-2 infections among HCWs at a large tertiary cancer centre in New York City were examined to estimate infection rates (aggregated positive tests / person-days) and 95% CIs over the Omicron period in 3D and 2D mRNA vaccinated HCWs and were compared using rate ratios.

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We used a self-reporting system to compare symptom frequency of hospital personnel with coronavirus disease 2019 before and after the emergence of the Omicron variant. Omicron was more likely to result in asymptomatic carriage (7% vs 12%; = .009), and fewer symptoms were observed in those with booster vaccination.

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  • The study investigates the frequency and outcomes of coinfections in cancer patients who also have COVID-19, a group at high risk for such infections.
  • Among 8,765 patients analyzed, 16.6% developed coinfections, predominantly bacterial, with specific risk factors identified such as age, sex, and existing health conditions.
  • Co-occurrence of bacterial and fungal infections significantly increased the 30-day mortality rates, highlighting the severe impact of these coinfections in this vulnerable population.
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Background: Vaccine-induced clinical protection against severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) variants is an evolving target. There are limited genomic level data on SARS CoV-2 breakthrough infections and vaccine effectiveness (VE) since the global spread of the B.1.

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Cefiderocol is a novel injectable siderophore cephalosporin that hijacks the bacterial iron transport machinery to facilitate cell entry and achieve high periplasmic concentrations. It has broad in vitro activity against gram-negative bacteria, including multidrug-resistant (MDR) organisms such as carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and Acinetobacter baumannii. It was approved by the US Food and Drug Administration for the treatment of complicated urinary tract infections and nosocomial pneumonia based on clinical trials that demonstrated noninferiority to comparators.

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In this retrospective study of 105 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-infected cancer patients with longitudinal nasopharyngeal sampling, the duration of viral shedding and time to attain cycle threshold >30 was longer in patients with hematologic malignancy than in those with solid tumors. These findings have important public health implications.

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  • Limited data exists on the risk of hospital-acquired COVID-19 among high-risk patients in nonoutbreak settings, especially after exposure to infected individuals or healthcare workers (HCWs).
  • A study at a cancer center in NYC from March 2020 to February 2021 found that out of over 11,000 patients tested, only 112 tested positive after admission (0.98%), with a notable attack rate of 18.9% among those in semiprivate rooms.
  • While the risk of acquiring COVID-19 in the hospital is generally low for cancer patients, sharing a room with an infected person significantly increases the risk of transmission, especially during aerosol-generating procedures.
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Background: The global struggle against antibiotic resistance requires antimicrobial stewardship (AMS). Massive open online courses (MOOCs) offer health professionals unprecedented access to high-quality instructional material on AMS; the question is how apprehensible it is to non-native English speakers. Furthermore, to better understand how education interventions promote change towards rational antibiotic prescribing, leading institutions call for studies integrating behavioural science.

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  • A study investigated the impact of convalescent plasma treatment on 30-day mortality rates among hospitalized patients with hematologic cancers and COVID-19, as this group is known to have poor outcomes.
  • The research utilized a retrospective cohort design, analyzing data from the COVID-19 and Cancer Consortium registry, focusing on patients admitted between March 2020 and January 2021.
  • Results indicated that convalescent plasma treatment significantly improved 30-day mortality (HR, 0.60), with the benefit persisting even after accounting for potential confounding factors (HR, 0.52).
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An evidence-based triage plan for cellular therapy distribution is critical in the face of emerging constraints on healthcare resources. We evaluated the impact of treatment delays related to COVID-19 on patients scheduled to undergo hematopoietic cell transplantation (HCT) or chimeric antigen receptor T-cell (CAR-T) therapy at our center. Data were collected in real time between March 19 and May 11, 2020, for patients who were delayed to cellular therapy.

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  • A study evaluated the effectiveness of using oral rinses and saliva samples instead of traditional swabs for detecting SARS-CoV-2 RNA in healthcare workers, showing promising results for saliva.
  • The sensitivity and agreement of saliva samples with oropharyngeal and nasopharyngeal swabs were high (around 93-97%), indicating they can reliably detect the virus.
  • Oral rinses were less effective due to dilution issues, but overall, posterior oropharyngeal saliva emerged as a good alternative sample for accurate SARS-CoV-2 detection.
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Background: New York City (NYC) experienced a surge of coronavirus disease 2019 (COVID-19) cases in March and April 2020. Since then, universal polymerase chain reaction (PCR)-based surveillance testing and personal protective equipment (PPE) measures are in wide use in procedural settings. There is limited published experience on the utility and sustainability of PCR-based surveillance testing in areas with receding and consistently low community COVID-19 rates.

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  • As of April 10, 2020, New York State reported 180,458 cases of COVID-19, with 9,385 deaths, of which 8.4% were cancer patients.
  • Studies from China and Italy indicate cancer patients may have a higher death rate from COVID-19, leading to concerns about balancing safety in cancer treatment and reducing virus exposure.
  • At Memorial Sloan Kettering Cancer Center, 423 cancer patients tested positive for COVID-19, with 40% hospitalized and factors like age over 65 and treatment with immune checkpoint inhibitors linked to worse outcomes.
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  • - As of April 10, 2020, New York reported over 180,000 COVID-19 cases and nearly 9,400 deaths, with cancer patients making up 8.4% of the fatalities.
  • - Studies indicated that cancer patients face higher COVID-19 death rates, yet the specific risks linked to cancer and its treatments need more investigation to ensure safe cancer care amidst the pandemic.
  • - At Memorial Sloan Kettering Cancer Center, 40% of hospitalized cancer patients tested positive for COVID-19, with factors like age over 65 and recent immune checkpoint inhibitor treatment increasing the risk of severe illness.
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Clostridioides difficile infection (CDI) is prevalent in pediatric oncology patients, but the transmission risk to peers is unknown. In 224 children with CDI, multilocus sequence typing (MLST) identified only 7 alleged transmission events (18%) originating from children <3 years old. None of these events were corroborated by WGS.

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Oncolytic viral immunotherapy is an emerging treatment modality for cancer that exploits in vivo replication and other viral properties to enhance immune killing of malignant cells. The potential for horizontal transmission of native or engineered oncolytic viruses creates several unique infection control challenges. In 2015, talimogene laherparepvec (TVEC) became the first agent in this class to gain FDA approval for treatment of melanoma, and several others are being developed.

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  • Antibiotics can make the good bacteria in our gut disappear, which might lead to more infections, especially after a medical procedure called allo-HSCT.
  • During this procedure, doctors use antibiotics to help, but they can harm the variety of helpful gut bacteria we have.
  • A study showed that giving patients a special treatment using their own poop (called auto-FMT) helped bring back the good bacteria and made their gut healthier again after the antibiotics.
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