Featured Publications
Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy
Molassiotis A, Cheng H, Lopez V, Au J, Chan A, Bandla A, Leung K, Li Y, Wong K, Suen L, Chan C, Yorke J, Farrell C, Sundar R. Are we mis-estimating chemotherapy-induced peripheral neuropathy? Analysis of assessment methodologies from a prospective, multinational, longitudinal cohort study of patients receiving neurotoxic chemotherapy. BMC Cancer 2019, 19: 132. PMID: 30736741, PMCID: PMC6368751, DOI: 10.1186/s12885-019-5302-4.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCohort StudiesDose-Response Relationship, DrugFemaleHumansLongitudinal StudiesMaleMiddle AgedNeoplasm StagingNeoplasmsPatient Reported Outcome MeasuresPeripheral Nervous System DiseasesPrevalenceProspective StudiesQuality of LifeSeverity of Illness IndexConceptsChemotherapy-induced peripheral neuropathyPeripheral neuropathyNeurotoxic chemotherapyPrevalence of sensory neuropathyCohort study of patientsCumulative chemotherapy dosePlatinum-based chemotherapyLongitudinal cohort study of patientsMeasuring chemotherapy-induced peripheral neuropathyStudy of patientsNerve conduction studiesAssessment of chemotherapy-induced peripheral neuropathyCIPN incidencePatient-reported outcome measuresAssociated with onsetLongitudinal cohort studyChemotherapy doseMotor neurotoxicityClinician-based scalesMotor neuropathySensory neuropathyChemotherapyNeuropathyNatural historyPatients
2024
Pushing the Frontiers of Cancer Research: Highlights from the Frontiers in Cancer Science Conference 2023.
Lee Y, Chen L, Chew V, Chow E, Deng L, Hunziker W, Lee A, Leong G, Ngeow J, Pervaiz S, Sabapathy K, Skanderup A, Sundar R, Tay Y, Virshup D, Wong S, Tergaonkar V, Tam W. Pushing the Frontiers of Cancer Research: Highlights from the Frontiers in Cancer Science Conference 2023. Cancer Research 2024, 84: 1195-1198. PMID: 38616656, DOI: 10.1158/0008-5472.can-24-0721.Commentaries, Editorials and LettersFRailty in Australian patients admitted to Intensive care unit after eLective CANCER-related SURGery: a retrospective multicentre cohort study (FRAIL-CANCER-SURG study)
Ling R, Ueno R, Alamgeer M, Sundararajan K, Sundar R, Bailey M, Pilcher D, Subramaniam A. FRailty in Australian patients admitted to Intensive care unit after eLective CANCER-related SURGery: a retrospective multicentre cohort study (FRAIL-CANCER-SURG study). British Journal Of Anaesthesia 2024, 132: 695-706. PMID: 38378383, DOI: 10.1016/j.bja.2024.01.020.Peer-Reviewed Original ResearchConceptsElective surgeryCohort studyMulticentre retrospective cohort studyRetrospective multicentre cohort studyPatients admitted to intensive care unitsAssociated with poor outcomesAssociated with similar effectsAssociated with lower survivalCancer-related surgeryMulticentre cohort studyRetrospective cohort studyLong-term outcomesIntensive care unitAssociated with mortalityPoor outcomeFollow-upICU admissionPrimary outcomeCare unitSurgeryPatientsSurvival informationCancerFrailtyICU
2023
Frailty and long-term survival among patients in Australian intensive care units with metastatic cancer (FRAIL-CANCER study): a retrospective registry-based cohort study
Alamgeer M, Ling R, Ueno R, Sundararajan K, Sundar R, Pilcher D, Subramaniam A. Frailty and long-term survival among patients in Australian intensive care units with metastatic cancer (FRAIL-CANCER study): a retrospective registry-based cohort study. The Lancet Healthy Longevity 2023, 4: e675-e684. PMID: 38042160, DOI: 10.1016/s2666-7568(23)00209-x.Peer-Reviewed Original ResearchConceptsIntensive care unitRegistry-based cohort studyLong-term survivalAustralian intensive care unitsRetrospective registry-based cohort studyMetastatic cancerAssociated with shorter survival timeEffect of frailtyClinical Frailty ScaleShorter survival timeSurvival timeCohort studyAssociated with poor long-term survivalCare unitPoor long-term survivalIntensive care unit admissionTime-limited trialsCandidacy of patientsCox proportional hazards regression modelsRobust sandwich variance estimatorProportion of patientsProportional hazards regression modelsHazards regression modelsImpact of frailtyOverall survivalCOVID-19 Severity and Waning Immunity After up to 4 mRNA Vaccine Doses in 73 608 Patients With Cancer and 621 475 Matched Controls in Singapore
Tan W, Tan J, Lim J, Tan R, Bin Lee A, Leong F, Lee S, Chai L, Tan T, Bin Abdul Malek M, Ong B, Lye D, Chiew C, Chng W, Lim S, Bharwani L, Tan I, Sundar R, Tan K. COVID-19 Severity and Waning Immunity After up to 4 mRNA Vaccine Doses in 73 608 Patients With Cancer and 621 475 Matched Controls in Singapore. JAMA Oncology 2023, 9: 1221-1229. PMID: 37440245, PMCID: PMC10346511, DOI: 10.1001/jamaoncol.2023.2271.Peer-Reviewed Original ResearchConceptsIncidence rate ratiosCancer survivorsVaccine doseSevere diseaseCohort studyTreated patientsProspective multicenter observational cohort studyCompeting-risk regression analysisMulticenter observational cohort studyMatched controlsVaccine efficacyVaccine effectivenessRisk of poor outcomesWaning of vaccine effectivenessSevere COVID-19 disease outcomesMRNA vaccine doseRisk of deathObservational cohort studyMRNA-based vaccinesSocioeconomic statusSARS-CoV-2 DeltaRate ratiosCOVID-19 hospitalizationIncidence rateOmicron waveA Phase I, First-in-Human Study of PRL3-zumab in Advanced, Refractory Solid Tumors and Hematological Malignancies
Chee C, Ooi M, Lee S, Sundar R, Heong V, Yong W, Ng C, Wong A, Lim J, Tan D, Soo R, Tan J, Yang S, Thura M, Al-Aidaroos A, Chng W, Zeng Q, Goh B. A Phase I, First-in-Human Study of PRL3-zumab in Advanced, Refractory Solid Tumors and Hematological Malignancies. Targeted Oncology 2023, 18: 391-402. PMID: 37060431, PMCID: PMC10192144, DOI: 10.1007/s11523-023-00962-w.Peer-Reviewed Original ResearchConceptsAcute myeloid leukemiaAdvanced solid tumorsFirst-in-human studyEuropean Leukemia NetworkSolid tumorsHematologic malignanciesTreatment-emergent adverse eventsHuman antibodiesDose-escalation cohortsDose-limiting toxicityGrade 2 vomitingPRL-3Refractory solid tumorsResponse Evaluation CriteriaSolid tumor patientsDose-expansion cohortReduced tumor growthFirst-in-humanPhase IStable diseaseStoma outputEvaluation CriteriaMyeloid leukemiaPharmacodynamic relationshipsAdverse eventsClinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients.
Lee M, Peng S, Lee A, Wong S, Tay R, Li J, Tariq A, Goh C, Tan Y, Tan B, Teo C, Chan E, Ooi M, Chng W, Chee C, Ho C, Walsh R, Wong M, Su Y, Alexander L, Sethi S, Tan S, Chan Y, Tan K, Lee S, Chai L, Sundar R. Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients. Annals, Academy Of Medicine, Singapore 2023, 52: 8-16. PMID: 36730801, DOI: 10.47102/annals-acadmedsg.2022302.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 mRNA vaccinesDoses of SARS-CoV-2 mRNA vaccinesMRNA vaccinesCancer patientsThird doseHaematological malignanciesLong-term immunogenicityCompared to patientsRisk of severe diseaseAnti-neoplastic treatmentActive cancer therapyVirus neutralisation assaySARS-CoV-2 infectionSystemic chemotherapyNo patientEarly administrationSeroconversion ratesVaccine immunogenicitySolid tumorsClinical efficacyClinical outcomesSevere infectionsCancer therapyHumoral responseActive treatment
2022
Resistance to systemic immune checkpoint inhibition in the peritoneal niche
Chia D, Gwee Y, Sundar R. Resistance to systemic immune checkpoint inhibition in the peritoneal niche. Journal For ImmunoTherapy Of Cancer 2022, 10: e004749. PMID: 35728873, PMCID: PMC9214396, DOI: 10.1136/jitc-2022-004749.Commentaries, Editorials and LettersMeSH KeywordsAscitesHumansImmune Checkpoint InhibitorsImmunotherapyNeoplasmsPeritoneumTumor MicroenvironmentConceptsImmune checkpoint inhibitionResistance to immune checkpoint inhibitionPeritoneal metastasisCheckpoint inhibitionMetastatic nicheResponse to ICIImmune checkpoint inhibition therapySensitive to immune checkpoint inhibitionIntrinsic tumor factorsPresence of ascitesDeficient mismatch repairPeritoneal microenvironmentTumor factorsMalignant ascitesPrimary resistanceClinical entityTherapeutic optionsMicrosatellite instable tumorsPeritoneal cavityGastrointestinal cancerParacrine factorsAscitesConcurrent ascitesPatientsInstable tumorsBooster doses of COVID-19 vaccines for patients with haematological and solid cancer: a systematic review and individual patient data meta-analysis
Mai A, Lee A, Tay R, Shapiro L, Thakkar A, Halmos B, Grinshpun A, Herishanu Y, Benjamini O, Tadmor T, Shroff R, LaFleur B, Bhattacharya D, Peng S, Tey J, Lee S, Chai L, Soon Y, Sundar R, Lee M. Booster doses of COVID-19 vaccines for patients with haematological and solid cancer: a systematic review and individual patient data meta-analysis. European Journal Of Cancer 2022, 172: 65-75. PMID: 35753213, PMCID: PMC9163022, DOI: 10.1016/j.ejca.2022.05.029.Peer-Reviewed Original ResearchConceptsIndividual patient data meta-analysisPatient data meta-analysisSolid cancersBooster doseNon-respondersData meta-analysisHaematological cancersMeta-analysisAntibody titresBooster dose of COVID-19 vaccineAssociated with increased durationIncreased risk of severe diseaseResponse to booster vaccinationAge of patientsRisk of severe diseaseVaccine non-respondersDose of COVID-19 vaccineSystematic reviewJoanna Briggs Institute Critical Appraisal ChecklistGastrointestinal cancer patientsCOVID-19 vaccine booster doseReduced vaccine immunogenicityVaccine booster doseImproved seroconversionCritical Appraisal ChecklistAssociation of obstructive sleep apnea and nocturnal hypoxemia with all-cancer incidence and mortality: a systematic review and meta-analysis.
Tan B, Teo Y, Tan N, Yap D, Sundar R, Lee C, See A, Toh S. Association of obstructive sleep apnea and nocturnal hypoxemia with all-cancer incidence and mortality: a systematic review and meta-analysis. Journal Of Clinical Sleep Medicine 2022, 18: 1427-1440. PMID: 34755597, PMCID: PMC9059590, DOI: 10.5664/jcsm.9772.Peer-Reviewed Original ResearchConceptsAssociation of obstructive sleep apneaObstructive sleep apneaAll-cancer riskAll-cancer incidenceSevere nocturnal hypoxemiaNocturnal hypoxemiaSleep apneaAll-cancer mortalityModerate obstructive sleep apneaNo/mild OSASevere obstructive sleep apneaObstructive sleep apnea diagnosisObstructive sleep apnea treatmentOxygen desaturation indexMeta-analysisNewcastle-Ottawa ScaleSystematic reviewRandom-effects meta-analysesQuality of evidenceArousal indexDesaturation indexNormoxemic patientsRandomized studyHypoxemiaEvaluated study bias
2020
A randomized phase II trial evaluating the addition of low dose, short course sunitinib to docetaxel in advanced solid tumours
Ang Y, Ho G, Soo R, Sundar R, Tan S, Yong W, Ow S, Lim J, Chong W, Soe P, Tai B, Wang L, Goh B, Lee S. A randomized phase II trial evaluating the addition of low dose, short course sunitinib to docetaxel in advanced solid tumours. BMC Cancer 2020, 20: 1118. PMID: 33203399, PMCID: PMC7672922, DOI: 10.1186/s12885-020-07616-4.Peer-Reviewed Original ResearchConceptsProgression-free-survivalAdvanced solid tumorsBreast cancer patientsSolid tumorsCancer patientsMedian progression-free-survivalRandomized phase II trialMetastatic breast cancer patientsClinical-benefit rateProphylactic G-CSFNon-haematological toxicityPrimary tumor siteAdministration of sunitinibPhase II trialAdvanced solid cancersMedian OSHaematological toxicityDoxorubicin-cyclophosphamideTrial registrationThe studyII trialNeutrophil nadirPrimary endpointSecondary endpointsG-CSFIntermittent administrationPsychometric testing of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group—Neurotoxicity (FACT/GOG-Ntx) subscale in a longitudinal study of cancer patients treated with chemotherapy
Cheng H, Lopez V, Lam S, Leung A, Li Y, Wong K, Au J, Sundar R, Chan A, De Ng T, Suen L, Chan C, Yorke J, Molassiotis A. Psychometric testing of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group—Neurotoxicity (FACT/GOG-Ntx) subscale in a longitudinal study of cancer patients treated with chemotherapy. Health And Quality Of Life Outcomes 2020, 18: 246. PMID: 32703223, PMCID: PMC7376939, DOI: 10.1186/s12955-020-01493-y.Peer-Reviewed Original ResearchConceptsFunctional Assessment of Cancer Therapy/Gynecologic Oncology Group-NeurotoxicityFACT/GOG-Ntx subscalePatients treated with chemotherapyCancer patients treated with chemotherapyFACT/GOG-NtxAssessment pointsFunctional assessmentNational Cancer Institute Common Terminology CriteriaInternal consistency reliabilityPeripheral Neuropathy ScaleEORTC QLQ-CIPN20Longitudinal studyEuropean Organization for ResearchResultsCronbach’s alpha coefficientCommon Terminology CriteriaLight touch testMotor itemsLow-to-moderateConsistency reliabilityAlpha coefficientEvaluate CIPNQLQ-CIPN20Four-factor structurePsychometric analysisMonofilament test
2019
Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy
Bandla A, Tan S, Kumarakulasinghe N, Huang Y, Ang S, Magarajah G, Hairom Z, Lim J, Wong A, Chan G, Ngoi N, Ang E, Lee Y, Chan A, Lee S, Thakor N, Wilder-Smith E, Sundar R. Safety and tolerability of cryocompression as a method of enhanced limb hypothermia to reduce taxane-induced peripheral neuropathy. Supportive Care In Cancer 2019, 28: 3691-3699. PMID: 31811482, PMCID: PMC7316694, DOI: 10.1007/s00520-019-05177-2.Peer-Reviewed Original ResearchConceptsNerve conduction studiesTotal Neuropathy ScoreFrozen glovesTaxane chemotherapyNeuropathy scorePeripheral neuropathyDose-limiting toxicityConcomitant with chemotherapyTaxane-induced peripheral neuropathySeverity of neuropathySensory nerve amplitudesPrevention of neurotoxicitySkin temperature reductionLimb hypothermiaMonths post-chemotherapyPaclitaxel chemotherapyNerve amplitudeMotor amplitudeSevere neuropathyPost-chemotherapyUndesired side effectsChemotherapyCancer patientsNeuropathySide effectsRedefining chemotherapy-induced peripheral neuropathy through symptom cluster analysis and patient-reported outcome data over time
Wang M, Cheng H, Lopez V, Sundar R, Yorke J, Molassiotis A. Redefining chemotherapy-induced peripheral neuropathy through symptom cluster analysis and patient-reported outcome data over time. BMC Cancer 2019, 19: 1151. PMID: 31775665, PMCID: PMC6882224, DOI: 10.1186/s12885-019-6352-3.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCluster AnalysisFemaleHumansLongitudinal StudiesMaleMiddle AgedNeoplasm StagingNeoplasmsPatient Reported Outcome MeasuresPeripheral Nervous System DiseasesPublic Health SurveillanceQuality of LifeSurveys and QuestionnairesSymptom AssessmentConceptsSymptom clustersCancer Quality of Life Questionnaire CoreTreatment of Cancer Quality of Life Questionnaire CoreQuality of Life Questionnaire CoreImprove symptom managementPatient-reported outcome dataBackgroundChemotherapy-induced peripheral neuropathySymptom management strategiesMethodsA secondary analysisSymptom cluster analysisNeurotoxic chemotherapy agentsEuropean Organization for the ResearchSymptom managementChemotherapy-induced peripheral neuropathySecondary analysisResultsSample sizeCancer diagnosisAssessment pointsPeripheral neuropathyOutcome dataCIPNClinical practiceThe ResearchFollow-upSecondary symptomsMinimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy
Yeo F, Ng C, Loh K, Molassiotis A, Cheng H, Au J, Leung K, Li Y, Wong K, Suen L, Chan C, Yorke J, Farrell C, Bandla A, Ang E, Lopez V, Sundar R, Chan A. Minimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy. Supportive Care In Cancer 2019, 27: 4753-4762. PMID: 30972646, DOI: 10.1007/s00520-019-04771-8.Peer-Reviewed Original ResearchConceptsMinimal clinically important differenceEORTC QLQ-CIPN20QLQ-CIPN20Clinically important differenceDistribution-based approachMotor subscaleNtx subscaleConclusionThe MCIDChange scoresSensory subscaleFunctional Assessment of Cancer Therapy/Gynecologic Oncology Group-NeurotoxicityImportant differenceStandard error of measurementFACT/GOG-NtxNeurotoxic chemotherapyExperience of symptomsAnchor-based approachError of measurementEuropean Organisation of ResearchDistribution-based methodsPeripheral neuropathyChemotherapy-induced peripheral neuropathyMethodsCancer patientsCycles of chemotherapyWorsening peripheral neuropathy
2018
A study of 1088 consecutive cases of electrolyte abnormalities in oncology phase I trials
Garces A, Ang J, Ameratunga M, Chénard-Poirier M, Dolling D, Diamantis N, Seeramreddi S, Sundar R, de Bono J, Lopez J, Banerji U. A study of 1088 consecutive cases of electrolyte abnormalities in oncology phase I trials. European Journal Of Cancer 2018, 104: 32-38. PMID: 30316017, PMCID: PMC6259582, DOI: 10.1016/j.ejca.2018.08.019.Peer-Reviewed Original ResearchConceptsPhase I clinical trialElectrolyte abnormalitiesBaseline hypoalbuminaemiaOverall survivalClinical significanceDose-limiting toxicity windowPrognostic factors of OSOncology phase I trialsInferior median OSFactors of OSPhase I patientsPhase I trialRetrospective chart reviewSerum albumin levelAssociated with hypomagnesaemiaRoyal Marsden HospitalCox regression analysisPhase I populationDrug Development UnitMedian OSPrognostic factorsPrognostic significanceI patientsI trialAlbumin levelsClinical outcomes of adolescents and young adults with advanced solid tumours participating in phase I trials
Sundar R, McVeigh T, Dolling D, Petruckevitch A, Diamantis N, Ang J, Chenard-Poiriér M, Collins D, Lim J, Ameratunga M, Khan K, Kaye S, Banerji U, Lopez J, George A, de Bono J, van der Graaf W. Clinical outcomes of adolescents and young adults with advanced solid tumours participating in phase I trials. European Journal Of Cancer 2018, 101: 55-61. PMID: 30025230, DOI: 10.1016/j.ejca.2018.06.003.Peer-Reviewed Original ResearchConceptsPhase I trialPhase I clinical trialAdvanced solid tumorsI trialOverall survivalAYA patientsSolid tumorsCancer syndromesCohort of AYA patientsMolecular characterisation of tumoursOutcomes of AYA patientsClinical benefit rateMedian overall survivalOutcomes of AYAsSomatic genetic aberrationsSignificant family historyRoyal Marsden HospitalHereditary cancer syndromesCharacterisation of tumoursTherapeutic treatment optionsClinical outcomes of adolescentsClinical trial dataDrug Development UnitYoung adultsGenetic aberrationsBiomarkers for Homologous Recombination Deficiency in Cancer
Hoppe M, Sundar R, Tan D, Jeyasekharan A. Biomarkers for Homologous Recombination Deficiency in Cancer. Journal Of The National Cancer Institute 2018, 110: 704-713. PMID: 29788099, DOI: 10.1093/jnci/djy085.Peer-Reviewed Educational MaterialsConceptsPoly-ADP-ribose polymeraseArray-based comparative genomic hybridizationSingle nucleotide polymorphismsHomologous recombination deficiencyPoly-ADP ribose polymerase inhibitorsComparative genomic hybridizationHomologous recombination genesNext-generation sequencingDNA repair pathwaysRecombination deficiencyClinical trialsGenomic hybridizationGermline BRCA1/2 mutation statusClinical development of PARP inhibitorsDefective DNA repairGenomic scarsResponse to platinum-based therapyHomologous recombinationDevelopment of PARP inhibitorsRecombinant genesNucleotide polymorphismsPlatinum-based therapyRibose polymeraseBRCA1/2 mutation statusDNA repairThe role of genomic profiling in adolescents and young adults (AYAs) with advanced cancer participating in phase I clinical trials
McVeigh T, Sundar R, Diamantis N, Kaye S, Banerji U, Lopez J, de Bono J, van der Graaf W, George A. The role of genomic profiling in adolescents and young adults (AYAs) with advanced cancer participating in phase I clinical trials. European Journal Of Cancer 2018, 95: 20-29. PMID: 29614442, PMCID: PMC6296443, DOI: 10.1016/j.ejca.2018.02.028.Peer-Reviewed Original ResearchConceptsDrug Development UnitGermline testingAdvanced cancerPhase I clinical trialTumor testingPersonal history of cancerAdvanced solid tumorsProportion of AYAsRoyal Marsden HospitalHistory of cancerAt-risk relativesCommon cancer typesYoung adultsDepartmental databaseClinicopathological featuresSolid tumorsChart reviewFamily risk factorsGermline mutationsPathogenic variantsStudy cohortCancer predispositionGenomic profilingPatient managementGenetic testingResisting resistance to cancer immunotherapy
Lam W, Wang L, Roudi R, Yong W, Syn N, Sundar R. Resisting resistance to cancer immunotherapy. Thoracic Cancer 2018, 9: 507-508. PMID: 29512891, PMCID: PMC5928381, DOI: 10.1111/1759-7714.12614.Commentaries, Editorials and Letters