Publications by authors named "Sahar B van Waalwijk van Doorn-Khosrovani"

Precision oncology has a significant role to play in delivering optimal patient care. Biomarkers are critical enablers for precision oncology across the continuum of cancer diagnosis, in defining patient prognosis, and in predicting the response to treatments and their potential toxicities, as well as delineating the risk of hereditary cancer syndromes. Biomarkers also potentiate cancer drug development, accelerating patient access to safe and effective therapies.

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In the past decade, there have been a record number of oncology therapy approvals by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Besides the EMA's conditional marketing authorisation programme and the FDA's Accelerated Approval Program, we observe a tendency towards fast approval for exploratory studies with non-randomised, uncontrolled designs and surrogate endpoints. This issue raises concerns about the robustness and effectiveness of accepted treatments, leaving patients and health-care professionals in a state of uncertainty.

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Outcome-based reimbursement models can effectively reduce the financial risk to health care payers in cases when there is important uncertainty or heterogeneity regarding the clinical value of health technologies. Still, health care payers in lower income countries rely mainly on financial based agreements to manage uncertainties associated with new therapies. We performed a survey, an exploratory literature review and an iterative brainstorming in parallel about potential barriers and solutions to outcome-based agreements in Central and Eastern Europe (CEE) and in the Middle East (ME).

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Objective: Tuberous sclerosis complex (TSC) is associated with non-malignant kidney lesions-angiomyolipomata-that may be associated with chronic kidney disease (CKD). This study investigated the relationship between renal angiomyolipomata and CKD in TSC, including the impact on healthcare resource utilization (HCRU) and costs.

Methods: This was a retrospective, longitudinal cohort study based on medical record data spanning January 1990-April 2012 for 369 TSC patients treated at a specialty center in the Netherlands.

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Article Synopsis
  • This study examined long-term outcomes in adult patients with tuberous sclerosis complex (TSC) and associated kidney tumors called angiomyolipomas over a median follow-up of 15.8 years.
  • Out of 351 TSC patients, 244 (69.5%) had angiomyolipoma, and 144 of these (59.0%) were at high risk due to severe stages, correlating older age with a higher stage of disease.
  • The study found significant kidney-related complications, including hypertension and decreased kidney function, leading to increased mortality in the TSC group, which was notably higher compared to the general population (standardized mortality ratio of 4.8).
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Maternal intake of flavonoids, known for their antioxidant properties, may affect the offspring's susceptibility to developing chronic diseases at adult age, especially those related to oxidative stress, via developmental programming. Therefore, we supplemented female mice with the flavonoids genistein and quercetin during gestation, to study their effect on the antioxidant capacity of lung and liver of adult offspring. Maternal intake of quercetin increased the expression of Nrf2 and Sod2 in fetal liver at gestational day 14.

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  • Quercetin, a flavonoid that binds to iron, can change the form of heme iron in hemoglobin and is able to pass through the placenta to the fetus, raising concerns about its long-term effects on health.
  • In a study involving mice, high maternal quercetin intake (302 mg/kg) did not affect fetal blood development but led to increased iron storage in the adult offspring, along with changes in inflammation-related gene expression.
  • The research suggests that prenatal quercetin exposure might promote iron accumulation while reducing oxidative DNA damage in the liver, possibly due to epigenetic changes in gene expression.
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  • * The study hypothesizes that a mutation in Atm, which is involved in DNA repair, could heighten the harmful effects of flavonoids, leading to more frequent MLL rearrangements in affected mice.
  • * Results showed that mice with Atm mutations exposed to high levels of flavonoids experienced significantly more MLL rearrangements and a slight increase in cancer cases, highlighting potential risks of prenatal flavonoid supplementation in those with compromised DNA repair.
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