Publications by authors named "L Bharwani"

Importance: Despite patients with cancer being at risk of poor outcomes from COVID-19, there are few published studies for vaccine efficacy in this group, with suboptimal immunogenicity and waning vaccine efficacy described in small studies being a concern.

Objective: To assess the incidence rate of severe COVID-19 disease outcomes associated with the number of vaccine doses received and the waning of protection over time.

Design, Setting, And Participants: A prospective multicenter observational cohort study was carried out over 2 time periods (September 15, 2021, to December 20, 2021 [delta wave], and January 20, 2022, to November 11, 2022 [omicron wave]) predominated by SARS-CoV-2 delta and omicron variants, respectively.

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Article Synopsis
  • The study investigated factors that predict primary resistance to immune checkpoint inhibitors (ICIs) in patients with advanced non-small-cell lung cancer (NSCLC), defining resistance as disease progression within 6 months of treatment.
  • Out of 108 patients, over half (54.6%) exhibited primary resistance, with notable demographics including a majority being male, smokers, and predominantly Chinese with adenocarcinoma.
  • Key predictive factors for resistance included being female, having a neutrophil-to-lymphocyte ratio (NLR) of 3 or higher at 6 weeks, and receiving immunotherapy as a later treatment line (≥2 lines).
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Background: Oestrogen receptor positive, human epidermal growth factor receptor-2 (HER2) negative breast cancer (BC) is the most frequently diagnosed BC subtype. Combinations of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with anti-oestrogen therapy have led to improved survival compared with anti-oestrogen therapy alone for advanced/metastatic BC. The evaluation of CDK4/6i in the real-world facilitates treatment planning, insights into the incidence of drug toxicities, dose modifications including dose delays (DDs) and dose reductions (DRs) and improves prognostic accuracy in subgroups, for example geriatric patients, who are under-represented in clinical trials.

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Background: There are concerns that tamoxifen is less effective in Asian women because of the high prevalence of impaired function cytochrome P450 2D6 () polymor-phisms.

Aim: To evaluate how knowledge of genotype impacted the choice of hormonal agent and how genotype and agent were associated with clinical outcomes.

Methods: Eighty-two women were recruited.

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Cytokine release syndrome (CRS) is a phenomenon of immune hyperactivation described in the setting of immunotherapy. Unlike other immune-related adverse events, CRS triggered by immune checkpoint inhibitors (ICIs) is not well described. The clinical characteristics and course of 25 patients with ICI-induced CRS from 2 tertiary hospitals were abstracted retrospectively from the medical records and analyzed.

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