Publications by authors named "Liam C"

We hypothesized that persistent lifetime (PLT) images could represent tumor imaging traits, locations, and persistent contrasts of topological components (connected and hole components) corresponding to gene mutations such as epidermal growth factor receptor (EGFR) mutant signs. We aimed to develop a topological radiogenomic approach using PLT images to identify EGFR mutation-positive patients with non-small cell lung cancer (NSCLC). The PLT image was newly proposed to visualize the locations and persistent contrasts of the topological components for a sequence of binary images with consecutive thresholding of an original computed tomography (CT) image.

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  • Autologous hematopoietic cell transplantation (AHCT) is an effective treatment for multiple myeloma, with real-world data collected from 61,725 patients revealing median overall survival of 90.2 months and median progression-free survival of 36.5 months.* -
  • Cumulative relapse incidence and non-relapse mortality rates at 24 months were found to be 33% and 2.5% respectively, with better outcomes linked to factors like younger age, certain disease subtypes, and high performance status.* -
  • Global variations were observed in patient outcomes based on registry data, influenced by differences in patient characteristics, use of maintenance treatments, and macroeconomic factors, highlighting the safety and effectiveness of AH
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  • This study examined the effectiveness and safety of lower doses of osimertinib (20 mg and 40 mg daily) for patients with advanced NSCLC who had previously failed other treatments, compared to the standard 80 mg daily dose.
  • Researchers analyzed data from 22 patients who had the EGFR T790M mutation and found that lower doses resulted in a notable overall response rate of 77.3%, with median progression-free survival of 10 months and overall survival of 13 months.
  • The findings suggest that even patients with poor performance status (ECOG 3 or 4) experienced decent survival outcomes, emphasizing that lower doses of osimertinib could be a viable treatment
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Background: Patients with EGFR-mutated non-small-cell lung cancer (NSCLC) and MET amplification as a mechanism of resistance to first-line osimertinib have few treatment options. Here, we report the primary analysis of the phase 2 INSIGHT 2 study evaluating tepotinib, a highly selective MET inhibitor, combined with osimertinib in this population.

Methods: This open-label, phase 2 study was conducted at 179 academic centres and community clinics in 17 countries.

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Understanding the prevalence of abnormal lung function and its associated factors among patients recovering from COVID-19 is crucial for enhancing post-COVID care strategies. This study primarily aimed to determine the prevalence and types of spirometry abnormalities among post-COVID-19 patients in Malaysia, with a secondary objective of identifying its associated factors. Conducted at the COVID-19 Research Clinic, Faculty of Medicine, University Technology MARA, from March 2021 to December 2022, this study included patients at least three months post-discharge from hospitals following moderate-to-critical COVID-19.

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Inherited thrombocytopenia is a rare phenomenon. MYH9-related disorder (MYH9-RD) is one such pathology characterized by thrombocytopenia and giant platelets with the presence of cytoplasmic inclusion bodies in the granulocytes. The condition is often misdiagnosed as immune thrombocytopenia (ITP) due to its similarities in clinical phenotype and often no associated secondary causes.

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  • Afatinib can be safely started at doses lower than the standard 40 mg/day for treating non-small cell lung cancer (NSCLC) with EGFR mutations, but its effectiveness in real-world settings needed examination.
  • A study involving 133 NSCLC patients in Malaysia found that lower doses (below 40 mg) had a higher objective response rate (72.3%) compared to the standard dose (54.0%).
  • Although patients on lower doses were more likely to respond to treatment, the overall median survival was similar, indicating potential benefits without compromising safety.
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An increasing number of reports have described the pathogenic nature of several non-classical spp. Among them, and have been implicated in a myriad of respiratory-associated infections in humans and animals. We report the isolation of a genetically close relative of and from the sputum of a woman in her early 60s with extensive bronchiectasis who presented with fever and brown colored sputum.

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Objective: Irreversible organ damage is common in patients with systemic lupus erythematosus (SLE). Despite evidence of increased prevalence and severity of SLE in Asia Pacific, organ damage is less well studied in this region. This systematic review aims to identify predictors of organ damage in SLE in the Asia Pacific region.

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  • * The patient population primarily consisted of older males with significant smoking histories and various complications, including a high rate of respiratory infections and a notable need for mechanical ventilation.
  • * Key risk factors for readmission included a higher mMRC grade and previous exacerbations requiring hospitalization, suggesting that better symptom management and integrated care strategies could help reduce readmission rates.
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Background: In non-small cell lung cancer (NSCLC), there may be a relationship between programmed death-ligand 1 (PD-L1) expression, driver mutations and cigarette smoking.

Methods: In this single-center retrospective study, the relationship between common driver mutations (EGFR mutation and ALK rearrangement) and PD-L1 expression in advanced NSCLC according to the patients' smoking history was examined. Light, moderate and heavy smokers had smoked < 20, 20-39, and ≥ 40 pack-years, respectively.

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  • Lung cancer incidence and mortality rates are notably higher in Asia, particularly East Asia, necessitating improved early detection and treatment strategies compared to Western countries.
  • A virtual meeting of 19 healthcare advisors from 11 Asian countries led to the recommendation of annual low-dose computed tomography screening for those at high risk, along with tailored reassessment intervals based on individual risk factors.
  • Challenges such as economic constraints and insufficient government programs hinder the implementation of effective lung cancer screening in Asia, prompting the need for strategic solutions.
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Neoadjuvant chemotherapy is a therapeutic option for potentially resectable non-small cell lung cancer (NSCLC). The role of neoadjuvant targeted therapy (NTT) remains less explored. This case highlights the use of neoadjuvant osimertinib in a case of advanced NSCLC.

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Objectives: To elucidate a novel radiogenomics approach using three-dimensional (3D) topologically invariant Betti numbers (BNs) for topological characterization of epidermal growth factor receptor (EGFR) Del19 and L858R mutation subtypes.

Methods: In total, 154 patients (wild-type EGFR, 72 patients; Del19 mutation, 45 patients; and L858R mutation, 37 patients) were retrospectively enrolled and randomly divided into 92 training and 62 test cases. Two support vector machine (SVM) models to distinguish between wild-type and mutant EGFR (mutation [M] classification) as well as between the Del19 and L858R subtypes (subtype [S] classification) were trained using 3DBN features.

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  • This study investigated how forced expiratory volume (FEV), exacerbations, and patient-reported outcomes (PROs) relate to each other in individuals with stable chronic obstructive pulmonary disease (COPD).
  • The analysis included data from 374 COPD patients, revealing that those with a lower FEV (less than 30%) experienced more exacerbations compared to those with higher FEV levels.
  • Although correlations were found between lower FEV and increased exacerbations, the severity of airflow limitation did not significantly increase PRO scores, suggesting that different aspects of COPD management need to be considered.
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Purpose: The final analyses of the INSIGHT phase II study evaluating tepotinib (a selective MET inhibitor) plus gefitinib versus chemotherapy in patients with MET-altered EGFR-mutant NSCLC (data cut-off: September 3, 2021).

Patients And Methods: Adults with advanced/metastatic EGFR-mutant NSCLC, acquired resistance to first-/second-generation EGFR inhibitors, and MET gene copy number (GCN) ≥5, MET:CEP7 ≥2, or MET IHC 2+/3+ were randomized to tepotinib 500 mg (450 mg active moiety) plus gefitinib 250 mg once daily, or chemotherapy. Primary endpoint was investigator-assessed progression-free survival (PFS).

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Background: The PLASMIC score is a convenient tool for predicting ADAMTS13 activity of <10%. Lactate dehydrogenase (LDH) is widely used as a marker of haemolysis in thrombotic thrombocytopenic purpura (TTP) monitoring, and could be used as a replacement marker for lysis. We aimed to validate the PLASMIC score in a multi-centre Asia Pacific region, and to explore whether LDH could be used as a replacement marker for lysis.

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Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare disease which is highly malignant with a poor prognosis. PSC is highly resistant to chemotherapy and radiotherapy and is prone to recurrence even after surgery. Most of what is known about PSC comes from limited single-center, retrospective studies.

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Non-small cell lung cancer (NSCLC) is a heterogeneous disease, with many oncogenic driver mutations, including de novo mutations in the Mesenchymal Epithelial Transition (MET) gene (specifically in Exon 14 [ex14]), that lead to tumourigenesis. Acquired alterations in the MET gene, specifically MET amplification is also associated with the development of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) resistance in patients with EGFR-mutant NSCLC. Although MET has become an actionable biomarker with the availability of MET-specific inhibitors in selected countries, there is differential accessibility to diagnostic platforms and targeted therapies across countries in Asia-Pacific (APAC).

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Metastatic pulmonary calcification (MPC) is characterized by deposition of calcium in the normal lung parenchyma secondary to elevation of serum calcium. Most patients are asymptomatic and routine chest radiograph is not sensitive to make the diagnosis. Further imaging is needed such as computed tomography (CT) which typically shows small centrilobular nodules in the upper lobes.

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Background: Although first- and second-generation EGFR TKIs are considered first-line treatment in EGFRm+ NSCLC, most patients develop resistance and progress, commonly, EGFR mutation. The third-generation EGFR-TKI has demonstrated efficacy in patients with progressive disease harboring the mutation and in the first-line setting, bypassing this mode of resistance. The primary objectives of this study are to describe the proportion of m+ NSCLC patients treated with first-, second- and third-generation EGFR TKIs, and cytotoxic chemotherapy in the first-line setting, and the time on treatment for each category.

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Introduction: Immune checkpoint inhibitor (ICI) therapy is an established treatment for advanced non-small-cell lung cancer (NSCLC) and programmed death ligand-1 (PD-L1) expression is a recognized biomarker to determine response to therapy. We retrospectively analyzed NSCLC patients in the Malaysia Lung Cancer Registry (MLCR) and report on the clinical characteristics associated with PD-L1 expression and ICI use in Malaysia, a low- to middle-income country.

Methods: All 901 NSCLC patients in the MLCR who were diagnosed from January 1, 2017 to December 31, 2020 from 14 hospitals across the country were analyzed.

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