Publications by authors named "Keegan P"
Safety and Efficacy of Toripalimab in Patients with Cholangiocarcinoma: An Open-Label, Phase 1 Study.
J Immunother Precis Oncol
February 2025
Introduction: This was the first phase 1 study conducted in the United States. It consisted of dose-escalation (part A) and multiple indication-specific cohort expansion (part B), investigating the safety and preliminary efficacy of toripalimab (anti-programmed cell death-1 inhibitor) in patients with advanced malignancies.
Methods: Patients with advanced malignancies that progressed after treatment with at least one prior line of standard systemic therapy, including the patients with advanced/recurrent cholangiocarcinoma (CCA), received toripalimab 240 mg every 3 weeks in part B.
Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM.
View Article and Find Full Text PDFBackground: Next-day discharge (NDD) outcomes following uncomplicated self-expanding transcatheter aortic valve replacement have not been studied. Here, we compare readmission rates and clinical outcomes in NDD versus non-NDD transcatheter aortic valve replacement with Evolut.
Methods And Results: Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry patients (n=29 597) undergoing elective transcatheter aortic valve replacement with self-expanding supra-annular valves (Evolut R, PRO, and PRO+) from July 2019 to June 2021 were stratified by postprocedure length of stay: ≤1 day (NDD) versus >1 day (non-NDD).
Article Synopsis
- Over the last decade, FDA-approved immune checkpoint inhibitors, particularly targeting PD-1, have shown promising clinical benefits, especially for patients with PD-L1 expressing tumors, with toripalimab specifically approved for treating nasopharyngeal carcinoma alongside chemotherapy.
- In phase 3 studies, toripalimab demonstrated improved overall survival across various cancers, including nasopharyngeal carcinoma and advanced lung and esophageal cancers, regardless of PD-L1 status.
- Research indicates that toripalimab has a significantly higher affinity for PD-1 compared to pembrolizumab, enhances immune responses, and shows unique activation patterns in tumor environments, highlighting its potential as a powerful anti-cancer treatment.
Article Synopsis
- Adjuvant and neoadjuvant immunotherapy has been shown to enhance outcomes for patients with early-stage non-small cell lung cancer (NSCLC), but the best combination with chemotherapy is still unclear.!
- The study's aim was to evaluate if adding toripalimab, an immunotherapy drug, to standard platinum-based chemotherapy improves event-free survival and major pathological responses in patients with stage II or III resectable NSCLC compared to chemotherapy alone.!
- Conducted across 50 hospitals in China, the trial involved 501 patients, mostly with stage III NSCLC, and assessed outcomes like event-free survival and response rates over an interim analysis period ending November 2022.
Article Synopsis
- The TORCHLIGHT trial tested the combination of the immune-checkpoint inhibitor toripalimab and nab-paclitaxel (nab-P) against a placebo with nab-P in patients with advanced triple-negative breast cancer (TNBC).
- Results showed that the toripalimab group had a significantly longer progression-free survival (PFS) of 8.4 months compared to 5.6 months for the placebo group, particularly in PD-L1-positive patients.
- The overall survival was also better for the toripalimab group (32.8 months vs. 19.5 months), and the safety profile was similar between groups, suggesting that toripalimab is a promising treatment for this cancer type.
Article Synopsis
- There are currently no FDA-approved therapies for nasopharyngeal carcinoma (NPC), with gemcitabine-cisplatin being the standard first-line treatment for recurrent or metastatic NPC (RM-NPC).
- The JUPITER-02 study aimed to evaluate whether the addition of toripalimab to gemcitabine-cisplatin could improve progression-free and overall survival compared to gemcitabine-cisplatin alone.
- Results showed that patients receiving toripalimab had significantly longer progression-free survival (21.4 months) and overall survival compared to those on placebo (8.2 months), indicating that toripalimab may enhance treatment outcomes for RM-NPC.
Objective: The purpose of this study is to analyze the voice used in kapa haka, a contemporary indigenous vocal performance from New Zealand, which includes the well-known haka. This is the first study of its kind and is a preliminary investigation into the vocal and acoustic description of kapa haka. A significant goal of this study is to contribute ideas and potential definitions of vocal qualities to the community of kapa haka trainers that were specific to the genre.
View Article and Find Full Text PDFThe intestinal epithelium comprises diverse cell types and executes many specialized functions as the primary interface between luminal contents and internal organs. A key function provided by the epithelium is maintenance of a barrier that protects the individual from pathogens, irritating luminal contents, and the microbiota. Disruption of this barrier can lead to inflammatory disease within the intestinal mucosa, and, in more severe cases, to sepsis.
View Article and Find Full Text PDFFlat dose regimen of toripalimab based on model-informed drug development approach.
Front Pharmacol
January 2023
Article Synopsis
- A flat dosing regimen of 240 mg Q3W for the PD-1 inhibitor toripalimab was analyzed for its efficacy and safety compared to the existing 3 mg/kg Q2W dosage.
- A pharmacokinetic model was created using data from over 1,000 patients, showing that the new dosing schedule provided similar drug exposure levels as the current approved regimen with no increased risk of adverse events.
- Results indicated that the 240 mg Q3W dose is effective and safe, making it a preferred treatment option for patients receiving toripalimab.
Article Synopsis
- Cardiovascular multidisciplinary heart teams (MDHTs) have greatly changed over the past decade, becoming essential in treating various heart diseases across multiple specialties.
- The structure and function of these teams have adapted to better address patient needs, but there is still a lack of established best practices for their effectiveness compared to cancer care teams.
- This expert panel review examines the history, current roles, and challenges of cardiovascular MDHTs, while highlighting the need for more evidence on their effectiveness and operational strategies.
Article Synopsis
- The CHOICE-01 study evaluated the effectiveness and safety of toripalimab combined with chemotherapy as a first-line treatment for advanced non-small-cell lung cancer (NSCLC).
- A total of 465 patients were enrolled, with the toripalimab group showing a median progression-free survival (PFS) of 8.4 months compared to 5.6 months in the placebo group, and a better overall survival (OS) at interim analysis.
- The study found that patients with a high tumor mutational burden and specific mutations had significantly improved outcomes with toripalimab, while adverse events were similar between both treatment groups, indicating a manageable safety profile.
Penile cancer is a rare but debilitating condition, which often requires aggressive treatment. Partial penectomy is considered as a treatment option when a sufficient portion of the penile shaft can be maintained to preserve functionality. This systematic review, which followed the PRIMSA guidelines, aimed to evaluate the effects of partial penectomy for penile cancer on sexual function-the maintenance of which is often a priority in patient groups-and to identify potential factors which may moderate these effects.
View Article and Find Full Text PDFTranscatheter Aortic Valve Replacement Patient Care Improvements; It Takes a Team.
Crit Care Nurs Clin North Am
June 2022
Team-based care has been recommended by numerous cardiovascular organizations involving the treatment of valvular heart disease. Utilization of the cardiovascular team (CVT) in valvular programs has been discussed but there is a paucity of data involving team roles, backgrounds, or expectations. This article will describe a single health system and the roles of the CVT involved in the transcatheter aortic valve replacement (TAVR) program.
View Article and Find Full Text PDFBackground: Long-term follow-up is necessary to understand the impact of perinatal interventions. Exploring parents' motives and experiences in consenting to their children taking part in longitudinal studies and understanding what outcomes are important to families may enhance participation and mitigate the loss to follow-up. As existing evidence is largely based on investigators' perspectives using Western samples, the present pilot study explored parents' perspectives in a multicultural New Zealand context.
View Article and Find Full Text PDFThe COVID19 pandemic brought unprecedented disruption to healthcare. Staggering morbidity, mortality, and economic losses prompted the review and refinement of care for structural heart disease (SHD). To mitigate negative impacts in the face of crisis or capacity constraints, this paper offers best practice recommendations for Planning Efficient and Resource Leveraging Systems (PEARLS) in structural heart programs.
View Article and Find Full Text PDFObjectives: The aim of this study was to determine the safety and efficacy of same-day discharge (SDD) after transcatheter aortic valve replacement (TAVR) during the COVID-19 pandemic.
Background: The COVID-19 pandemic has placed significant stress on health care systems worldwide. SDD in highly selected TAVR patients can facilitate the provision of essential cardiovascular care while managing competing COVID-19 resource demands.
Article Synopsis
- Neonatal hypoglycemia, which occurs when a newborn's blood sugar drops too low, may lead to concerns about Executive and visual-motor skills later in life, specifically regarding educational outcomes.
- A study involving 614 infants at risk of hypoglycemia showed that those who experienced hypoglycemic episodes were evaluated at 9-10 years old to determine their academic performance.
- Results indicated that there was no significant difference in educational achievement between children who experienced neonatal hypoglycemia and those who did not, suggesting that the impact of early hypoglycemia on later learning might not be as pronounced as previously thought.
Article Synopsis
- Platinum-based chemotherapy, specifically toripalimab combined with paclitaxel and cisplatin, was tested against a placebo in a phase 3 trial for patients with advanced esophageal squamous cell carcinoma (ESCC).
- The results showed that those treated with toripalimab experienced significantly better progression-free survival (PFS) and overall survival (OS) compared to the placebo group.
- Both treatment groups had similar rates of serious side effects, indicating that the toripalimab plus chemotherapy regimen is effective and has a manageable safety profile.
Article Synopsis
- Immunotherapy with toripalimab serves as a second-line treatment option for patients with metastatic urothelial carcinoma (mUC) who have not responded to traditional therapies, focusing on the evaluation of safety, efficacy, and relevant biomarkers.
- In the study involving 151 patients, 85% experienced treatment-related adverse events, with an objective response rate (ORR) of 26% and a disease control rate (DCR) of 45%, while the median overall survival was 14.4 months.
- Results indicate that patients with high levels of PD-L1 and tumor mutational burden (TMB) had significantly better response rates and overall survival than those with lower levels, highlighting the importance of these biomarkers in predicting treatment response
Article Synopsis
- - Gemcitabine-cisplatin chemotherapy is the standard treatment for recurrent or metastatic nasopharyngeal carcinoma; a phase 3 trial tested toripalimab (a PD-1 antibody) combined with this chemotherapy against a placebo.
- - The trial involved 289 patients and showed that those receiving toripalimab had a significantly better progression-free survival (PFS) of 11.7 months compared to 8.0 months for the placebo group.
- - The addition of toripalimab also reduced the risk of death by 40%, though some immune-related side effects were more common; overall, the treatment had an acceptable safety profile.
Background: To review and summarize all U.S. Food and Drug Administration (FDA) approvals of programmed death (PD)-1 and PD-ligand 1 blocking antibodies (collectively referred to as PD-[L]1 inhibitors) over a 6-year period and corresponding companion/complementary diagnostic assays.
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