DSpace Collection: Research that acknowledges South West Healthcare as a collection site

Capability Framework for Physiotherapists delivering clinical education

2026-01-01T00:00:00Z

Journal Title: Capability Framework for Physiotherapists delivering clinical education Authors: Brommeyer, Angela; Dow, Jane; Gould, Annie; Harding, Paula; Jones, Denise; Vick, Kathryn

Resource pack to accompany the capability framework for Physiotherapists delivering clinical education.

2026-01-01T00:00:00Z

Journal Title: Resource pack to accompany the capability framework for Physiotherapists delivering clinical education.

Circulating tumor DNA-guided adjuvant therapy in locally advanced colon cancer: the randomized phase 2/3 DYNAMIC-III trial

2025-09-26T00:00:00Z

Journal Title: Circulating tumor DNA-guided adjuvant therapy in locally advanced colon cancer: the randomized phase 2/3 DYNAMIC-III trial Authors: Tie, Jeanne; Wang, Yuxuan; Loree, Jonathan M.; Cohen, Joshua D.; Wong, Rachel; Price, Timothy; Tebbutt, Niall C.; Gebski, Val; Espinoza, David; Burge, Matthew; Harris, Sam; Lynam, James; Lee, Belinda; Lee, Margaret M.; Breadner, Daniel; Debrincat, Marlyse; Foroughi, Siavash; Chantrill, Lorraine; Lim, Stephanie H.; Gill, Sharlene; O'Callaghan, Chris; Ptak, Janine; Silliman, Natalie; Dobbyn, Lisa; AGITG DYNAMIC-III Study Group Abstract: Adjuvant chemotherapy in stage III colon cancer provides uncertain benefit at the individual level. Circulating tumor DNA (ctDNA) may help refine risk-adjusted treatment selection. In this multicenter, randomized, phase 2/3 trial, patients with stage III colon cancer underwent ctDNA testing 5–6 weeks after surgery and were assigned (1:1) to ctDNA-guided or standard management. In the ctDNA-guided arm, patients negative for ctDNA received de-escalated therapy, whereas ctDNA-positive patients received escalated therapy. Clinicians prespecified the standard regimen. Primary endpoints were 3-year recurrence-free survival (RFS) for ctDNA-negative patients and 2-year RFS for ctDNA-positive patients. Secondary endpoints included treatment-related hospitalization and ctDNA clearance. Among 968 evaluable patients, 702 (72.5%) were ctDNA negative. With a median follow-up of 47 months, ctDNA-negative patients experienced significantly fewer recurrences than ctDNA-positive patients (3-year RFS 87% versus 49%; P < 0.001). In ctDNA-negative patients, de-escalation reduced oxaliplatin use (34.8% versus 88.6%) and hospitalizations (8.5% versus 13.2%) but yielded slightly lower RFS than standard management (85.3% versus 88.1%), not meeting the non-inferiority margin. In ctDNA-positive patients, higher ctDNA burden correlated with recurrence risk (3-year RFS 77% to 23% across quartiles; P < 0.001). Escalated therapy did not improve outcomes over standard management (2-year RFS 51% versus 61%). There was no unexpected toxicity. Persistent ctDNA after treatment predicted markedly worse prognosis (3-year RFS 14% versus 79%). ctDNA is validated as a strong prognostic classifier. ctDNA-guided de-escalation reduced oxaliplatin exposure and adverse events with outcomes approaching standard of care, whereas exploratory chemotherapy intensification conferred no RFS benefit, suggesting a need for novel strategies in ctDNA-positive disease. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12617001566325.

Nivolumab and ipilimumab combination treatment in advanced ovarian and endometrial clear cell cancers: A nonrandomized clinical trial.

2025-07-03T00:00:00Z

Journal Title: Nivolumab and ipilimumab combination treatment in advanced ovarian and endometrial clear cell cancers: A nonrandomized clinical trial. Authors: Gao, Bo; Carlino, Matteo S.; Michael, Michael; Underhill, Craig; Marshall, Henry; Gunjur, Ashray; So, Jane; Kee, Damien; Antill, Yoland; Lam, Wei-Sen; Chan, H.; Harrup, Rosemary; Hamilton, Anne; Grady, John; Ballinger, Mandy; Tavancheh, Elnaz; Yoon, Won-Hee; Palmer, Jodie; Thomas, David; Wilkie, Kylie; Cebon, J.; Klein, Oliver Abstract: Importance: Gynecological clear cell cancers (CCCs) are aggressive malignant neoplasms with low response rate to chemotherapy. The treatment of patients with metastatic disease remains an area of significant unmet need. Objective: To evaluate the efficacy of combined anti-programmed cell death 1 protein (PD-1)/cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) blockade using nivolumab and ipilimumab in advanced gynecological CCCs. Design, setting, and participants: The MoST-CIRCUIT prospective multicenter phase 2 nonrandomized clinical trial included patients with advanced selected rare cancers. Patients with advanced clear cell ovarian cancer (CCOC)/clear cell endometrial cancer (CCEC) with a maximum of 1 course of prior systemic therapy were enrolled from August 2021 to February 2024 across 17 Australian and New Zealand sites. Interventions: Patients received nivolumab, 3 mg/kg, and ipilimumab, 1 mg/kg, every 3 weeks for 4 doses followed by nivolumab, 480 mg, every 4 weeks for 96 weeks until disease progression or the development of unacceptable toxic effects. Main outcomes and measures: Coprimary end points were objective response rate (ORR) and 6-month progression-free survival (PFS) as assessed by RECIST version 1.1 criteria, with the secondary end points being median overall survival, PFS, and treatment-related toxic effects. Results: Of 28 included patients, the median (range) age was 55 (34-77) years. A total of 24 had CCOC and 4 had CCEC; 19 (68%) had a previous course of therapy. Overall ORR was 54% (95% CI, 35-71), with 3 (12%) with complete response and 12 (42%) with partial response; the ORR was 55% (95% CI, 35-73) in the CCOC group and 50% (95% CI, 9-91) in the CCEC group. The median duration of response has not been reached, with all responses ongoing. The 6-month PFS was 58% (95% CI, 39-74), and the median overall survival has not been reached. A total of 9 patients (35%) experienced a grade 3 or 4 immune-related adverse event, and a grade 5 myocarditis occurred in 1 patient. Conclusions and relevance: In this nonrandomized clinical trial, immunotherapy using combined anti-PD-1/CTLA-4 blockade demonstrated encouraging activity with a high rate of durable responses in patients with advanced gynecological CCCs. This regimen should be further investigated in this patient population with unmet medical need. Trial registration: ClinicalTrials.gov Identifier: NCT04969887.