Publications by authors named "Mohini Varughese"
Article Synopsis
- Metformin, an anti-diabetic drug, is being studied for its potential anticancer effects, particularly in metastatic hormone-sensitive prostate cancer, where it may also help counteract issues related to androgen-deprivation therapy (ADT).
- The STAMPEDE trial involved patients with high-risk prostate cancer across the UK and Switzerland, comparing standard treatment with and without metformin for non-diabetic patients who were in good health.
- Patients were randomly assigned to receive either standard care or standard care plus metformin, with the main goal of assessing overall survival in those treated with the additional medication.
Objective: To review the efficacy and safety of low-dose versus standard-dose enzalutamide, apalutamide or darolutamide treatment for metastatic prostate cancer.
Methods And Analysis: Keyword searches in MEDLINE and EMBASE up to 1 June 2023, with forward and backward citation searches of potentially relevant studies. Studies were included if primary outcome data were reported for patients with metastatic prostate cancer who had received reduced doses of enzalutamide, apalutamide or darolutamide.
Background And Objective: Delivering radiotherapy to the bladder is challenging as it is a mobile, deformable structure. Dose-escalated adaptive image-guided radiotherapy could improve outcomes. RAIDER aimed to demonstrate the safety of such a schedule.
View Article and Find Full Text PDFBackground And Objective: Cytoreductive treatments for patients diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) confer incremental survival benefits over systemic therapy, but these may lead to added toxicity and morbidity. Our objective was to determine patients' preferences for, and trade-offs between, additional cytoreductive prostate and metastasis-directed interventions.
Methods: A prospective multicentre discrete choice experiment trial was conducted at 30 hospitals in the UK between December 3, 2020 and January 25, 2023 (NCT04590976).
Objectives: To report the long-term outcomes from a longitudinal psychosocial study that forms part of the 'Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted Screening in men at higher genetic risk and controls' (IMPACT) study. The IMPACT study is a multi-national study of targeted prostate cancer (PrCa) screening in individuals with a known germline pathogenic variant (GPV) in either the BReast CAncer gene 1 (BRCA1) or the BReast CAncer gene 2 (BRCA2).
Subjects And Methods: Participants enrolled in the IMPACT study were invited to complete a psychosocial questionnaire prior to each annual screening visit for a minimum of 5 years.
Bladder Preservation for Muscle-Invasive Bladder Cancer With Variant Histology.
Semin Radiat Oncol
January 2023
A growing body of evidence has shown bladder-preservation with chemo-radiotherapy achieves comparable survival to Radical Cystectomy (5-year OS 50%-70%) and superior quality of life outcomes for patients with muscle-invasive urothelial carcinoma of the bladder (UC). However, up to 55% of patients harbor variant histology and in this review we aim to clarify the role of bladder-preservation for this group. We first draw the distinction between urothelial carcinoma with divergent differentiation (UCDD) and non-urothelial carcinoma (NUC).
View Article and Find Full Text PDFBackground: Little is known about health-related quality of life (HRQOL) following treatment for bladder cancer (BC).
Objective: To determine this, we undertook a cross-sectional survey covering 10% of the English population.
Design, Setting, And Participants: Participants 1-10 yr from diagnosis were identified through national cancer registration data.
Background: UK Bladder cancer survival remains low. Nonmetastatic muscle-invasive bladder cancer (MIBC) is potentially curable. It is unclear how many patients receive nonradical treatment owing to advanced age, comorbidities, or alternative factors.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the genomic differences between primary prostate cancer and metastatic castration-resistant prostate cancer (mCRPC), analyzing biopsies from patients who developed mCRPC.
- Researchers examined 470 treatment-naive prostate cancer biopsies and 61 matched mCRPC biopsies, utilizing targeted and low-pass whole-genome sequencing to identify common mutations and copy number variations.
- Key findings include higher than previously reported mutations in TP53, BRCA2, and CDK12, and the discovery that RB1 loss in primary tumors correlates with poorer patient prognosis, indicating significant genomic differences between early-stage and more advanced cancer.
Background: Metastatic castration-resistant prostate cancer is enriched in DNA damage response (DDR) gene aberrations. The TOPARP-B trial aims to prospectively validate the association between DDR gene aberrations and response to olaparib in metastatic castration-resistant prostate cancer.
Methods: In this open-label, investigator-initiated, randomised phase 2 trial following a selection (or pick-the-winner) design, we recruited participants from 17 UK hospitals.
Background: International guidelines, including NICE, recommend using the 21-gene Recurrence Score assay for guiding adjuvant treatment decisions in ER+, HER2-negative early breast cancer (BC). We investigated the impact of adding this assay to standard pathological tests on clinicians'/patients' treatment decisions and on patients' decisional conflict in the United Kingdom.
Methods: In this prospective multicentre study, eligibility criteria included: ER+ HER2-negative BC (N0/Nmic for patients ⩽50 years; ⩽3 positive lymph nodes for patients >50 years) and being fit for chemotherapy.
Objective: To describe the outcome of primary chemotherapy for women with advanced-stage epithelial ovarian or primary peritoneal cancer and delayed surgery when optimal debulking surgery cannot be achieved at diagnosis.
Methods: Between 1998 and 2006, we retrospectively reviewed the overall survival and examined prognostic markers in consecutive patients who were not suitable for initial radical surgery because of the extent of disease and/or poor performance status. They were treated with a policy of primary platinum-based chemotherapy, followed whenever possible in responding patients by debulking surgery.
Thrombotic microangiopathy is a rare haematological emergency which encompasses the conditions of haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). It is an unusual but recognised complication of chemotherapy. It has not previously been described in conjunction with docetaxel or trastuzumab therapy.
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