Comparing diagnostic PET versus response PET at the 16th week induction and it’s correlation with MFC MRD: a deeper look into myeloma genomics

Background: Multiple Myeloma is a heterogenous disease. A homogenous approach to a heterogeneous disease is discouraged as more and more data evolves. Diagnostic PET is recorded for measuring the disease burden along with metabolic uptake of the burden. Minimal residual disease (MRD) measurement at the end of induction, consolidation and pre-maintenance have been looked into by multiple authors. Also, follow-up PET is done at multiple time points by multiple authors and has been correlated with molecular response. In this study, we shall correlate PET response post 16 weeks of induction and MRD assay. Methods: We have a retrospective analysis of the newly diagnosed multiple Myeloma (NDMM) with all the baseline data available at our centre and received the standard induction regimen for 16 weeks and the follow-up data was analyzed. Results: At the end of the 16th week of induction, 41 patients were in complete resolution in PET. Of them, 26 had MRD detected and 15 had no MRD detected. Ten patients had stable disease, with all of them positive for MRD. One patient with positive MRD was having a partial response. Four patients with detectable MRD had progressive disease on PET, with (p=0.058). Conclusions: MRD should be correlated with follow-up FDG PET/CT for a comprehensive evaluation of treatment response. We firmly believe that the genome of the disease drives the disease and definitely, MRD-PET correlation should be attributed to genomics

Incidence of homologous recombination deficiency among high grade serous ovarian carcinoma patients from a tertiary care center in India

Background: Ovarian cancer (OC) is the 9th most prevalent cancer overall in India and the 3rd most common among women, following breast and cervical cancers. According to GLOBOCAN 2022, there were 47,333 new OC cases and 32,978 deaths. Epithelial ovarian cancer (EOC) represents 90% of OC cases, of which 70% are high-grade serous ovarian cancer (HGSOC). Unfortunately, most patients are diagnosed at advanced stages III-IV. Homologous recombination deficiency (HRD) is a phenotype that is characterized by the inability of a cell to repair DNA double-strand breaks using the HRR pathway, leading to genomic instability and further malignant transformation. The Cancer Genome Atlas (TCGA) has reported HR deficiency in nearly 50% of HGSOC cases. Methods: This retrospective observational study evaluated 62 HGSOC patients treated at Apollo Cancer Centre Chennai from January 2021 to January 2024. Clinical data were collected from medical records. Formalin-fixed, paraffin-embedded (FFPE) tissue samples were obtained from patients undergoing surgery or biopsy and tested for HRD status. The data was analyzed and represented. Results: In the study population of 62 patients, 15 patients (24%) had HR deficiency (HRD positive).8 (13%) patients had poor quality FFPE tissue. Out of the 15 HRD-positive patients, six patients were TBRCA1, and four patients were TBRCA2. Five patients had GSS of more than 42. Conclusions: There is a significant population of HR-deficient HGSOC, comparable with the published literature. Thus, it serves as a predictive biomarker in ovarian cancers with deficiencies in DNA repair mechanisms

The profile and treatment outcomes of the older (aged 60 years and above) tuberculosis patients in Tamilnadu, South India

Background: With changing demographic patterns in the context of a high tuberculosis (TB) burden country, like India, there is very little information on the clinical and demographic factors associated with poor treatment outcome in the sub-group of older TB patients. The study aimed to assess the proportion of older TB patients (60 years of age and more), to compare the type of TB and treatment outcomes between older TB patients and other TB patients (less than 60 years of age) and to describe the demographic and clinical characteristics of older TB patients and assess any associations with TB treatment outcomes. Methods: A retrospective cohort study involving a review of records from April to June 2011 in the 12 selected districts of Tamilnadu, India. Demographic, clinical and WHO defined disease classifications and treatment outcomes of all TB patients aged 60 years and above were extracted from TB registers maintained routinely by Revised National TB Control Program (RNTCP). Results: Older TB patients accounted for 14% of all TB patients, of whom 47% were new sputum positive. They had 38% higher risk of unfavourable treatment outcomes as compared to all other TB patients (Relative risk (RR)-1.4, 95% CI 1.2–1.6). Among older TB patients, the risk for unfavourable treatment outcomes was higher for those aged 70 years and more (RR 1.5, 95% CI 1.2–1.9), males (RR 1.5, 95% CI 1.0–2.1), re-treatment patients (RR 2.5, 95% CI 1.9–3.2) and those who received community-based Direct Observed Treatment (RR 1.4, 95% CI 1.1–1.9). Conclusion: Treatment outcomes were poor in older TB patients warranting special attention to this group – including routine assessment and recording of co-morbidities, a dedicated recording, reporting and monitoring of outcomes for this age-group and collaboration with National programme of non-communicable diseases for comprehensive management of co-morbidities

Measuring tuberculosis patient perceived quality of care in public and public-private mix settings in India: an instrument development and validation study.

BACKGROUND At present, there are no validated quantitative scales available to measure patient-centred quality of care in health facilities providing services for tuberculosis (TB) patients in India and low-income and middle-income countries. METHODS Initial themes and items reflective of TB patient's perceived quality of care were developed using qualitative interviews. Content adequacy of the items were ascertained through Content validity Index (CVI) and content validity ratio (CVR). Pilot testing of the questionnaire for assessing validity and reliability was undertaken among 714 patients with TB. Sampling adequacy and sphericity were tested by Kaiser-Meyer-Olkin and Bartlett's test, respectively. Exploratory and confirmatory factor analysis was undertaken to test validity. Cronbach's α and test-retest scores were used to test reliability. RESULTS A 32-item tool measuring patient-perceived quality of TB distributed across five domains was developed initially based on a CVI and CVR cut-off score of 0.78 and cognitive interviews with patients with TB. Bartlett's test results showed a strong significance f (χ=3756 and p1 which accounted for 60.9% of the total variance of items. Correlation (z-value >1.96) between items and factors was highly significant and Cronbach's α was acceptable for the global scale (0.76) for the four factors. Intraclass correlation coefficient and the test retest scores for four factors were (<0.001) significant. CONCLUSION We validated a measurement tool for patient-perceived quality of care for TB (PPQCTB) which measured the patient's satisfaction with healthcare provider and services. PPQCTB tool could enrich quality of care evaluation frameworks for TB health services in India