Biomedical and Health Informatics Presentations (UMKC)
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Items in this collection are the scholarly output of the Department of Biomedical and Health Informatics faculty, staff, and students, either alone or as co-authors, and which may or may not have been published in an alternate format.
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Item A Study of RO5217790 (HPV Targeted Immunotherapy) in Patients With High Grade Cervical Intraepithelial Neoplasia Associated With High Risk HPV Infection(2010-03) Harper, Diane Medved; Harris, George D.; Shaffer, Todd D.; Gabriel, Michelle; Hoffmann-LaRoche; Santee, Jennifer; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)This is a randomized, double blind, placebo controlled, parallel group multicenter study in women with biopsy confirmed Grade 2 or Grade 3 cervical intraepithelial neoplasia (CIN). Two hundred patients will be enrolled and randomized in a 2: 1 ratio of RO5217790: placebo. They will be stratified on the basis of their HPV genotyping with stratum 1 consisting of those women with HPV 16 single infection and stratum 2 consisting of those with single or multiple infections with other high risk genotypes. Three injections of RO5217790 (5 x 107pfu) will be administered subcutaneously, each one week apart. Interim colposcopy, cytology and HPV assessments will be performed at Month 3. All patients will undergo conization at Month 6. The primary endpoint is histologic response at Month 6 in HPV 16 single infected patients, as assessed by central pathology review. The secondary endpoints include histologic response in all CIN2/3 patients enrolled regardless of genotype, viral clearance, safety, and immune response (cellular and humoral). After the Month 6 conization, the study will be unblinded and patients will undergo follow-up for an additional 2 years for efficacy and safety. This includes visits at Months 12, 18, 24 and 30 to assess histologic relapse/recurrence and viral re-infection as well as reporting of any serious adverse events. An interim analysis will be conducted when a minimum of 80 patients (at least 20 of whom have single infection with HPV 16 and 20 of whom have infection with HPV 16 plus HPV 16 related genotypes) have undergone conization. NCT01022346Item 3q26 Amplification is Rarely Present in Women Whose LSIL Cytology does not Represent CIN 2+ Disease(2010-03) Harper, Diane Medved; Lankachandra, K. M.; Wall, Jeffrey; Jalali, G. R.; Kershnar, E.; Harris, George D.; Bonham, Aaron James; Shaffer, Todd D.; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)Objective: 10-17% of women with LSIL cytology truly have CIN 2+ disease at colposcopically directed biopsy and 20% of the CIN 2+ lesions derive from women with LSIL cytology. No molecular marker has yet been able to triage LSIL cytology effectively. If possible, the triage would spare women the referral to colposcopy. Irreversible chromosomal damage occurs during oncogenesis. Increasing cervical dysplastic severity occurs with increasing amplification of the 3q26 chromosomal region. The purpose of this study is to evaluate the test characteristics of 3q26 amplification in women whose routine cytology is reported as LSIL with emphasis on the negative predictive value for reassurance. Methods: We conducted a retrospective study using the available SurePathâ„¢ liquid cytology LSIL archival samples from women 17-59 years old which were linked to colposcopically directed biopsy samples taken on average 36 days after cytology sampling (3-90 day range). Nuclei from the LSIL samples were hybridized with a single-copy probe for the chromosome 3q26 region and a control probe for the centromeric alpha repeat sequence of chromosome 7, using standard FISH methods. Amplification was defined as five or more signals present in at least 2 cells. Results: Of the 68 paired cytology/biopsy samples, 3q26 amplification occurred in 40% of the women with CIN 2+ disease (sensitivity 95% CI: 12, 74). There was no amplification in 91% of women with less than CIN 2 disease (specificity 95% CI: 81, 97); and the negative predictive value was 90% (79, 96). Conclusions: The lack of 3q26 amplification in women with screening cytology LSIL results offers reassurance that CIN 2+ disease has not developed. Future prospective studies are ongoing.