Publications by authors named "Muhammad A Khattak"

Neoadjuvant immunotherapies have shown antitumor activity in melanoma. Substudy 02C of the global, rolling-arm, phase 1/2, adaptive-design KEYMAKER-U02 trial is evaluating neoadjuvant pembrolizumab (anti-PD-1) alone or in combination, followed by adjuvant pembrolizumab, for stage IIIB-D melanoma. Here we report results from the first three arms: pembrolizumab plus vibostolimab (anti-TIGIT), pembrolizumab plus gebasaxturev (coxsackievirus A21) and pembrolizumab monotherapy.

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Background: Immunotherapy has emerged as a standard treatment for deficient mismatch repair (dMMR) metastatic colorectal cancer (mCRC). Pembrolizumab became widely available as a first-line (1L) option in Australia following the Pharmaceutical Benefits Scheme (PBS) listing in August 2021. The uptake of new treatment options can be lengthy.

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Background: Recent studies have associated total neoadjuvant therapy (TNT) with better treatment adherence, decreased toxicity, improved complete clinical response and anal sphincter preservation rates in patients with locally advanced rectal cancer (LARC). However, real-world experience with TNT in the management of LARC remains limited.

Aim: This study aimed to evaluate the efficacy and safety outcomes of TNT for LARC in Western Australia.

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Introduction: Renal colic is a prevalent acute urological emergency caused by urinary stones and commonly manifests as severe loin pain. This audit assesses the management of acute renal colic at a National Health Service (NHS) Trust in the West Midlands, England, comparing practices against the National Institute for Clinical Excellence (NICE) and the British Association of Urological Surgeons (BAUS) guidelines.

Method: This retrospective audit reviewed 417 patients with suspected renal colic over a month.

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Article Synopsis
  • Laparoscopic sleeve gastrectomy (LSG) is a common weight-loss surgery, and this study examines the value of routinely sending removed stomach tissue for histopathological analysis over a five-year period.
  • The research involved a retrospective analysis of 203 patients, mostly female, to assess their demographics, preoperative procedures, and histopathological results, revealing that 81.3% had normal gastric mucosa and only a small fraction had clinically significant findings.
  • The study concludes that since most specimens showed non-significant results and no patients required further treatment, the routine practice of histopathological examination after LSG may need reevaluation.
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Objective: This study aimed to assess the quality of primary transurethral resection of bladder tumor (TURBT) procedures performed at Aga Khan University Hospital (AKUH) over nine years, focusing on proper documentation, completeness of tumor resection, quality of histopathology reports, complication rates, and adherence to European Association of Urology (EAU) guidelines.

Materials And Methods: A retrospective analysis of patients aged 25-75 who underwent primary TURBT at AKUH between 2010 and 2019 was done. Patients with incomplete records, concomitant procedures, or those who underwent emergency TURBT were excluded.

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Objective: This study aimed to investigate perineal wound healing rates following abdominoperineal resection (APR) or extralevator abdominoperineal excision (ELAPE) for rectal cancer, with a focus on identifying associated risk factors and outcomes.

Methodology: A retrospective analysis was conducted on patients undergoing APR or ELAPE for rectal cancer in a tertiary centre between 2013 and 2020. Data on demographics, comorbidities, surgical techniques, and perineal wound outcomes were collected and analyzed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp.

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This study reviews the challenges and management strategies for complex renal stones in Africa. Historically viewed as infection or struvite stones, recent studies highlight diverse compositions of staghorn stones. These complex stones pose significant risks, including recurrent urinary tract infections and renal impairment.

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JCO Pembrolizumab adjuvant therapy was shown to significantly improve recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in patients with resected stage IIB or IIC melanoma in earlier analyses of the randomized, double-blind, phase III KEYNOTE-716 study (ClinicalTrials.gov identifier: NCT03553836). We report results of the protocol-specified final analysis of DMFS for KEYNOTE-716.

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Objectives: To review the outcomes of immune checkpoint inhibitor (ICI) treatment of advanced cutaneous squamous cell carcinoma (CSCC) outside clinical trials.

Study Design: Retrospective observational study; review of patient records in fifteen Australian institutions.

Setting, Participants: All Australian adults with locally advanced or metastatic CSCC not amenable to curative surgery or radiotherapy treated with ICIs, 5 May 2017 - 23 May 2022, through a cemiplimab compassionate access scheme (Therapeutic Goods Administration Special Access Scheme) or who personally covered the cost of pembrolizumab prior to the start of the access scheme.

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Article Synopsis
  • Around 50% of uveal melanoma patients may experience metastatic disease, necessitating costly and non-specific monthly scans; ctDNA could provide a more effective monitoring solution.
  • The study used droplet-digital PCR to analyze ctDNA in three cohorts: predicting metastases in primary patients, early detection in resolved cases, and treatment response in metastatic patients.
  • Results showed ctDNA was not helpful in predicting metastases in primary patients, but it was a strong survival predictor and showed reduced levels in patients receiving effective immunotherapy.
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Article Synopsis
  • - The CheckMate 401 study aimed to evaluate the safety and effectiveness of combining nivolumab and ipilimumab, followed by nivolumab alone, in patients with advanced melanoma who historically have had poor outcomes.
  • - A total of 533 treatment-naive patients with unresectable stage III-IV melanoma were analyzed, revealing incidences of severe adverse events and varying overall survival rates across different patient subgroups.
  • - Results suggested the treatment was generally tolerable, with a 24-month overall survival rate of 63%, but efficacy was notably lower in patients with poorer performance status and specific melanoma subtypes, indicating a need for new treatment strategies.
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Purpose: To determine the feasibility, safety and preliminary efficacy of a telehealth supervised exercise programme in patients with advanced melanoma receiving checkpoint inhibitor therapy.

Methods: A 8-week non-randomised feasibility pilot trial utilising a telehealth delivered multimodal exercise programme undertaken thrice weekly with assessments at baseline and post-intervention. The study was considered feasible if there were no severe or life-threatening adverse events as a result of exercise, and three or more of the following criteria were met: the recruitment rate was >50%, completion rate was >80%, median programme attendance was >75%, median exercise compliance >75%, and average tolerance was >70%.

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Background: Gut microbiome (GM) composition and diversity have recently been studied as a biomarker of response to immune checkpoint blockade therapy (ICB) and of ICB-related colitis.

Aim: To conduct a systematic review on the role of GM composition and diversity in predicting response and colitis in patients with melanoma treated with ICB.

Methods: The review protocol was registered in PROSPERO: CRD42021228018.

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Article Synopsis
  • Patients with stage IIB or IIC melanoma had a higher chance of their cancer coming back after surgery, but using a drug called pembrolizumab helped them stay cancer-free longer than a placebo.
  • The KEYNOTE-716 trial tested this drug on patients in many hospitals around the world, focusing on those aged 12 and older with specific types of melanoma.
  • After several treatments with pembrolizumab or placebo, researchers looked at how well the drug worked and how safe it was for the patients involved.
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Background: Adjuvant pembrolizumab significantly improved recurrence-free survival (RFS) versus placebo in resected stage IIB and IIC melanoma in the phase 3 KEYNOTE-716 study. Health-related quality of life (HRQoL) results are reported.

Methods: Patients were randomly assigned 1:1 to pembrolizumab 200 mg (2 mg/kg, patients ≥12 to <18 years) Q3W or placebo for ≤17 cycles or until disease recurrence, unacceptable toxicity, or withdrawal.

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Purpose: Effective treatments are needed for melanoma that progresses on inhibitors of programmed cell death protein-1 (PD-1) or its ligand (PD-L1). We conducted the phase II LEAP-004 study to evaluate the combination of the multikinase inhibitor lenvatinib and the PD-1 inhibitor pembrolizumab in this population (ClinicalTrials.gov identifier: NCT03776136).

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Background: Pembrolizumab prolongs progression-free and overall survival among patients with advanced melanoma and recurrence-free survival in resected stage III disease. KEYNOTE-716 assessed pembrolizumab as adjuvant therapy in patients with completely resected, high-risk, stage II melanoma. We report results from the planned first and second interim analyses for recurrence-free survival.

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Shigella infection (shigellosis) is an intestinal disease caused by a shigella isolates belongs to a family Enterobacteriacea. Watery diarrhea, abdominal pain and tenesmus are the prominent symptoms of shigella infection. The present study was designed to determine period prevalence and antimicrobial susceptibility of Shigella species recovered from stool specimens obtained from diarrheal paediatric patients under 5 years of age.

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Purpose: Although exercise medicine is recommended to counter treatment-related side-effects and improve health-related outcomes of patients affected by different cancers, no specific recommendations exist for patients with melanoma. As a result, we systematically examined the current evidence regarding the effects of physical activity and exercise on objectively-measured and patient-reported outcomes among patients with melanoma.

Methods: Searches were conducted in , , , , and databases.

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Background: The validity of circulating tumour DNA (ctDNA) as an indicator of disease progression compared to medical imaging in patients with metastatic melanoma requires detailed evaluation.

Methods: Here, we carried out a retrospective ctDNA analysis of 108 plasma samples collected at the time of disease progression. We also analysed a validation cohort of 66 metastatic melanoma patients monitored prospectively after response to systemic therapy.

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Background: Chemotherapy can cause premature menopause which may result in adverse effects such as fertility loss, osteoporosis, cardiovascular disease and menopausal symptoms. It is thus very important that women are provided with accurate information regarding their risk of premature menopause as a consequence of proposed chemotherapy. Unfortunately, at present there are no reliable tools which can be applied in clinical practice to estimate the risk of premature menopause in women undergoing chemotherapy, beyond age of the patient and form of chemotherapy utilized.

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In this study, we evaluated the predictive value of circulating tumour DNA (ctDNA) to inform therapeutic outcomes in metastatic melanoma patients receiving systemic therapies. We analysed 142 plasma samples from metastatic melanoma patients prior to commencement of systemic therapy: 70 were treated with BRAF/MEK inhibitors and 72 with immunotherapies. Patient-specific droplet digital polymerase chain reaction assays were designed for ctDNA detection.

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Background: We aimed to assess the impact of genomic human leukocyte antigen (HLA)-I/II homozygosity on the survival benefit of patients with unresectable locally advanced, metastatic non-small lung cancer treated by single-agent programmed cell death protein-1/programmed death ligand 1 (PD1/PDL1) inhibitors.

Methods: We collected blood from 170 patients with advanced lung cancer treated with immunotherapy at two major oncology centers in Western Australia. Genomic DNA was extracted from white blood cells and used for HLA-I/II high-resolution typing.

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