Imperial College London

Professor Anand Devaraj

Faculty of MedicineNational Heart & Lung Institute

Professor of Practice (Thoracic Radiology)
 
 
 
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Contact

 

anand.devaraj Website

 
 
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Location

 

South BlockRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

278 results found

Williams P, Philip K, Buttery S, Perkins A, Chan L, Bartlett E, Devaraj A, Kemp S, Addis J, Derbyshire J, Chen M, Polkey M, Laverty AA, Hopkinson Net al., 2024, Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials, Thorax, Vol: 79, Pages: 269-273, ISSN: 0040-6376

Background: Immediate smoking cessation interventions delivered alongside targeted lung health checks (TLHC) to screen for lung cancer increase self-reported abstinence at three months. The impact on longer-term, objectively confirmed quit rates remains to established. Methods: We followed up participants from two clinical trials in people aged 55-75 years who smoked and took part in a TLHC. These randomised participants in the TLHC by day of attendance to either usual care (signposting to smoking cessation services) or an offer of immediate smoking cessation support including pharmacotherapy. In the QuLIT1 trial this was delivered face to face, in QuLIT2 it was delivered remotely. Follow up was conducted 12 months after the TLHC by telephone interview with subsequent biochemical verification of smoking cessation using exhaled CO. Results: 430 people were enrolled initially (115 in QuLIT1 315 in QuLIT2), with 4 deaths before 12 months leaving 426 [62.1±5.27 years old and 48% female] participants for analysis. At 12 months, those randomised to attend on smoking cessation support intervention days had higher quit rates compared to usual care adjusted for age, gender, deprivation, and which trial they had been in; self-reported 7-day point prevalence (20.0% vs 12.8%; AOR=1.78 95% CI, 1.04-2.89) and CO verified quits (12.1% vs 4.7%; AOR=2.97 95% CI, 1.38-6.90). Those in the intervention arm were also more likely to report having made a quit attempt (30.2% vs UC 18.5%; AOR 1.90 95% CI 1.15-3.15). Conclusion: Providing immediate smoking cessation support alongside TLHC increases long term, biochemically confirmed smoking abstinence.

Journal article

Desai SR, Sivarasan N, Johannson KA, George PM, Culver DA, Devaraj A, Lynch DA, Milne D, Renzoni E, Nunes H, Sverzellati N, Spagnolo P, Baughman RP, Yadav R, Piciucchi S, Walsh SLF, Kouranos V, Wells AU, Sarcoid Delphi Groupet al., 2023, High-resolution CT phenotypes in pulmonary sarcoidosis: a multinational Delphi consensus study., Lancet Respir Med

One view of sarcoidosis is that the term covers many different diseases. However, no classification framework exists for the future exploration of pathogenetic pathways, genetic or trigger predilections, patterns of lung function impairment, or treatment separations, or for the development of diagnostic algorithms or relevant outcome measures. We aimed to establish agreement on high-resolution CT (HRCT) phenotypic separations in sarcoidosis to anchor future CT research through a multinational two-round Delphi consensus process. Delphi participants included members of the Fleischner Society and the World Association of Sarcoidosis and other Granulomatous Disorders, as well as members' nominees. 146 individuals (98 chest physicians, 48 thoracic radiologists) from 28 countries took part, 144 of whom completed both Delphi rounds. After rating of 35 Delphi statements on a five-point Likert scale, consensus was achieved for 22 (63%) statements. There was 97% agreement on the existence of distinct HRCT phenotypes, with seven HRCT phenotypes that were categorised by participants as non-fibrotic or likely to be fibrotic. The international consensus reached in this Delphi exercise justifies the formulation of a CT classification as a basis for the possible definition of separate diseases. Further refinement of phenotypes with rapidly achievable CT studies is now needed to underpin the development of a formal classification of sarcoidosis.

Journal article

Hannah JR, Lawrence A, Martinovic J, Naqvi M, Chua F, Kouranos V, Ali SS, Stock C, Owens C, Devaraj A, Pollard L, Agarwal S, Atienza-Mateo B, González-Gay MA, Patel A, West A, Tinsley K, Robbie H, Lams B, Wells AU, Norton S, Galloway J, Renzoni EA, Gordon PAet al., 2023, Antibody predictors of mortality and lung function trends in myositis spectrum interstitial lung disease., Rheumatology (Oxford)

OBJECTIVES: The impact of autoantibody profiles on prognosis of idiopathic inflammatory myositis associated interstitial lung disease (IIM-ILD) and myositis spectrum ILD with Myositis Specific Antibodies (MSA) remains unclear. This retrospective cohort study examines whether serological profiles are associated with mortality and longitudinal lung function change. METHODS: Baseline clinical/demographic characteristics and follow-up lung function of consecutive adult patients with IIM-ILD or Interstitial Pneumonia with Autoimmune Features (IPAF) positive for MSAs were extracted from three hospitals. Univariate and multi-variate Cox-Proportional Hazards analyses were used to compare mortality between autoantibodies. Regression models were used to analyse lung function trends. RESULTS: Of 430 included patients, 81% met IIM criteria, 19% were IPAF-MSA. On univariate analysis, risk factors associated with mortality included higher age, Charlson Co-morbidity Index and CRP; and lower BMI, baseline TLCO% and FEV1%. Compared to anti-MDA5-negativity, anti-MDA5-positivity (MDA5+) was associated with high mortality in the first 3 months (HR 65.2. 95%CI 14.1, 302.0), while no significant difference was seen thereafter (HR 0.55, 95%CI 0.14, 2.28). On multi-variate analysis, combined anti-synthetase antibodies carried a reduced risk of mortality (HR 0.63), although individually, mortality was reduced in anti-Jo1 + (HR 0.61, 95%CI 0.4-0.87) and increased in anti-PL7+ patients (HR 2.07, 95%CI 1.44-2.99). Anti-MDA5+ was associated with slow improvement in %FVC over the first 3 years, while anti-PL7+ was linked with a slow decline from 12 months onwards. CONCLUSIONS: Among autoantibody profiles in myositis spectrum disorders, anti-MDA5+ and anti-PL7+ confer higher mortality risks. Survivors of an early peak of mortality in anti-MDA5+ disease appear to have a favourable prognosis.

Journal article

Hunter B, Argyros C, Inglese M, Linton-Reid K, Pulzato I, Nicholson AG, Kemp SV, L Shah P, Molyneaux PL, Mcnamara C, Burn T, Guilhem E, Mestas Nunez M, Hine J, Choraria A, Ratnakumar P, Bloch S, Jordan S, Padley S, Ridge CA, Robinson G, Robbie H, Barnett J, Silva M, Desai S, Lee RW, Aboagye EO, Devaraj Aet al., 2023, Radiomics-based decision support tool assists radiologists in small lung nodule classification and improves lung cancer early diagnosis, BRITISH JOURNAL OF CANCER, ISSN: 0007-0920

Journal article

Barnett JL, Maher TM, Quint JK, Adamson A, Wu Z, Smith DJF, Rawal B, Nair A, Walsh SLF, Desai SR, George PM, Kokosi M, Jenkins G, Kouranos V, Renzoni EA, Rice A, Nicholson AG, Chua F, Wells AU, Molyneaux PL, Devaraj Aet al., 2023, Combination of BAL and computed tomography differentiates progressive and non-progressive fibrotic lung diseases, American Journal of Respiratory and Critical Care Medicine, Vol: 208, Pages: 975-982, ISSN: 1073-449X

Rationale: Identifying patients with pulmonary fibrosis (PF) at risk of progression can guide management. Objectives: To explore the utility of combining baseline BAL and computed tomography (CT) in differentiating progressive and nonprogressive PF. Methods: The derivation cohort consisted of incident cases of PF for which BAL was performed as part of a diagnostic workup. A validation cohort was prospectively recruited with identical inclusion criteria. Baseline thoracic CT scans were scored for the extent of fibrosis and usual interstitial pneumonia (UIP) pattern. The BAL lymphocyte proportion was recorded. Annualized FVC decrease of >10% or death within 1 year was used to define disease progression. Multivariable logistic regression identified the determinants of the outcome. The optimum binary thresholds (maximal Wilcoxon rank statistic) at which the extent of fibrosis on CT and the BAL lymphocyte proportion could distinguish disease progression were identified. Measurements and Main Results: BAL lymphocyte proportion, UIP pattern, and fibrosis extent were significantly and independently associated with disease progression in the derivation cohort (n = 240). Binary thresholds for increased BAL lymphocyte proportion and extensive fibrosis were identified as 25% and 20%, respectively. An increased BAL lymphocyte proportion was rare in patients with a UIP pattern (8 of 135; 5.9%) or with extensive fibrosis (7 of 144; 4.9%). In the validation cohort (n = 290), an increased BAL lymphocyte proportion was associated with a significantly lower probability of disease progression in patients with nonextensive fibrosis or a non-UIP pattern. Conclusions: BAL lymphocytosis is rare in patients with extensive fibrosis or a UIP pattern on CT. In patients without a UIP pattern or with limited fibrosis, a BAL lymphocyte proportion of ⩾25% was associated with a lower likelihood of progression.

Journal article

Creamer AW, Horst C, Dickson JL, Tisi S, Hall H, Verghese P, Prendecki R, Bhamani A, Khaw CR, McCabe J, Limani T, Gyertson K, Hacker A-M, Teague J, Farrelly L, Dawadi S, Hackshaw A, Devaraj A, Nair A, Janes SM, SUMMIT Consortiumet al., 2023, Stage at Diagnosis Following Delay to Interval Scans for Indeterminate Nodules in Lung Cancer Screening: An Observational Study Examining the Outcomes of CHEST Expert Panel Recommendations., Chest

Journal article

O'Dowd EL, Tietzova I, Bartlett E, Devaraj A, Biederer J, Brambilla M, Brunelli A, Chorostowska J, Decaluwe H, Deruysscher D, De Wever W, Donoghue M, Fabre A, Gaga M, van Geffen W, Hardavella G, Kauczor H-U, Kerpel-Fronius A, van Meerbeeck J, Nagavci B, Nestle U, Novoa N, Prosch H, Prokop M, Putora PM, Rawlinson J, Revel M-P, Snoeckx A, Veronesi G, Vliegenthart R, Weckbach S, Blum TG, Baldwin DRet al., 2023, ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer., Eur J Cardiothorac Surg, Vol: 64

BACKGROUND: Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation. METHODS: A multi-European society collaborative group was convened. 23 topics were identified, primarily from an ERS statement on lung cancer screening, and a systematic review of the literature was conducted according to ERS standards. Initial review of abstracts was completed and full text was provided to members of the group for each topic. Sections were edited and the final document approved by all members and the ERS Science Council. RESULTS: Nine topics considered most important and frequent were reviewed as standalone topics (interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities). Other topics considered of lower importance or infrequent were grouped into generic categories, suitable for general statements. CONCLUSIONS: This European collaborative group has produced an incidental findings statement that can be followed during lung cancer screening. It will ensure that an evidence-based approach is used for reporting and managing incidental findings, which will mean that harms are minimised and any programme is as cost-effective as possible.

Journal article

O'Dowd EL, Tietzova I, Bartlett E, Devaraj A, Biederer J, Brambilla M, Brunelli A, Chorostowska-Wynimko J, Decaluwe H, Deruysscher D, De Wever W, Donoghue M, Fabre A, Gaga M, van Geffen W, Hardavella G, Kauczor H-U, Kerpel-Fronius A, van Meerbeeck J, Nagavci B, Nestle U, Novoa N, Prosch H, Prokop M, Putora PM, Rawlinson J, Revel M-P, Snoeckx A, Veronesi G, Vliegenthart R, Weckbach S, Blum TG, Baldwin DRet al., 2023, ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer., Eur Respir J, Vol: 62

BACKGROUND: Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation. METHODS: A multi-European society collaborative group was convened. 23 topics were identified, primarily from an ERS statement on lung cancer screening, and a systematic review of the literature was conducted according to ERS standards. Initial review of abstracts was completed and full text was provided to members of the group for each topic. Sections were edited and the final document approved by all members and the ERS Science Council. RESULTS: Nine topics considered most important and frequent were reviewed as standalone topics (interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities). Other topics considered of lower importance or infrequent were grouped into generic categories, suitable for general statements. CONCLUSIONS: This European collaborative group has produced an incidental findings statement that can be followed during lung cancer screening. It will ensure that an evidence-based approach is used for reporting and managing incidental findings, which will mean that harms are minimised and any programme is as cost-effective as possible.

Journal article

Tisi S, Creamer AW, Dickson J, Horst C, Quaife S, Hall H, Verghese P, Gyertson K, Bowyer V, Levermore C, Hacker A-M, Teague J, Farrelly L, Nair A, Devaraj A, Hackhsaw A, Hurst JR, Janes Set al., 2023, Prevalence and clinical characteristics of non-malignant CT detected incidental findings in the SUMMIT lung cancer screening cohort, BMJ OPEN RESPIRATORY RESEARCH, Vol: 10

Journal article

George PM, Rennison-Jones C, Benvenuti G, Gupta G, Joly O, Gerry S, Rajan S, Jankharia B, Fernandez C, Harston G, Devaraj Aet al., 2023, The Automated E-ILD CT Algorithm Is More Prognostic Than FVC in the Serial Assessment of Patients With Non-IPF Fibrotic Interstitial Lung Disease, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

George PM, Rennison-Jones C, Benvenuti G, Gupta G, Joly O, Gerry S, Fernandez C, Harston G, Devaraj Aet al., 2023, In the Serial Assessment of Patients With Idiopathic Pulmonary Fibrosis, the Automated E-ILD CT Algorithm Outperforms Lung Function; a Validation Study, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

George PM, Rennison-Jones C, Bellot P, Joly O, Gerry S, Schwartz LA, Thiele A, Harston G, Devaraj Aet al., 2023, Performance and Reproducibility of a Deep-learning Derived Automated Algorithm to Detect, Segment and Measure Lung Cancer Lesions on Computed Tomography Scans, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Denton CP, Goh NS, Humphries SM, Maher TM, Spiera R, Devaraj A, Ho L, Stock C, Erhardt E, Alves M, Wells AU, SENSCIS trial investigatorset al., 2023, Extent of fibrosis and lung function decline in patients with systemic sclerosis and interstitial lung disease: data from the SENSCIS trial, Rheumatology, Vol: 62, Pages: 1870-1876, ISSN: 1462-0324

OBJECTIVE: To assess associations between the extent of fibrotic interstitial lung disease (ILD) and forced vital capacity (FVC) at baseline and change in FVC over 52 weeks in patients with systemic sclerosis-associated ILD (SSc-ILD) in the SENSCIS trial. METHODS: We used generalised additive models, which involve few assumptions and allow for interaction between non-linear effects, to assess associations between the extent of fibrotic ILD on high-resolution computed tomography (HRCT), and the interplay of extent of fibrotic ILD on HRCT and FVC % predicted, at baseline and FVC decline over 52 weeks. RESULTS: In the placebo group (n = 288), there was weak evidence of a modest association between a greater extent of fibrotic ILD at baseline and a greater decline in FVC % predicted at week 52 (r: -0.09 [95% CI -0.2, 0.03]). Higher values of both the extent of fibrotic ILD and FVC % predicted at baseline tended to be associated with greater decline in FVC % predicted at week 52. In the nintedanib group (n = 288), there was no evidence of an association between the extent of fibrotic ILD at baseline and decline in FVC % predicted at week 52 (r: 0.01 [95% CI: -0.11, 0.12]) or between the interplay of extent of fibrotic ILD and FVC % predicted at baseline and decline in FVC % predicted at week 52. CONCLUSION: Data from the SENSCIS trial suggest that patients with SSc-ILD are at risk of ILD progression and benefit from nintedanib largely irrespective of their extent of fibrotic ILD at baseline. TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT02597933.

Journal article

O'Dowd EL, Lee RW, Akram AR, Bartlett EC, Bradley SH, Brain K, Callister MEJ, Chen Y, Devaraj A, Eccles SR, Field JK, Fox J, Grundy S, Janes SM, Ledson M, MacKean M, Mackie A, McManus KG, Murray RL, Nair A, Quaife SL, Rintoul R, Stevenson A, Summers Y, Wilkinson LS, Booton R, Baldwint DR, Crosbie Pet al., 2023, Defining the road map to a UK national lung cancer screening programme, LANCET ONCOLOGY, Vol: 24, Pages: E207-E218, ISSN: 1470-2045

Journal article

Ng K, Boumelha J, Enfield KSS, Almagro JL, Cha HM, Pich O, Karasaki T, Moore D, Salgado R, Sivakumar M, Young G, Molina-Arcas ML, de Carne Trecesson S, Anastasiou P, Fendler AC, Au L, Shepherd STC, Martinez-Ruiz C, Puttick C, Black JRM, Watkins TBK, Kim H, Shim S, Faulkner N, Attig JA, Veeriah S, Magno NJ, Ward ST, Frankell A, Al Bakir M, Lim E, Hill M, Wilson G, Cook D, Birkbak N, Behrens A, Yousaf N, Popat S, Hackshaw A, TRACERx C, CAPTURE C, Hiley CT, Litchfield K, McGranahan N, Jamal-Hanjani M, Larkin J, Lee S-H, Turajlic S, Swanton C, Downward J, Kassiotis Get al., 2023, Antibodies against endogenous retroviruses promote lung cancer immunotherapy, NATURE, Vol: 616, Pages: 563-+, ISSN: 0028-0836

Journal article

Frankell AM, Dietzen M, Al Bakir M, Lim EL, Karasaki T, Ward S, Veeriah S, Colliver E, Huebner A, Bunkum A, Hill MS, Grigoriadis K, Moore DA, Black JRM, Liu WK, Thol K, Pich O, Watkins TBK, Naceur-Lombardelli C, Cook DE, Salgado R, Wilson GA, Bailey C, Angelova M, Bentham R, Martinez-Ruiz C, Abbosh C, Nicholson AG, Le Quesne J, Biswas D, Rosenthal R, Puttick C, Hessey S, Lee C, Prymas P, Toncheva A, Smith J, Xing W, Nicod J, Price G, Kerr KM, Naidu B, Middleton G, Blyth KG, Fennell DA, Forster MD, Lee SM, Falzon M, Hewish M, Shackcloth MJ, Lim E, Benafif S, Russell P, Boleti E, Krebs MG, Lester JF, Papadatos-Pastos D, Ahmad T, Thakrar RM, Lawrence D, Navani N, Janes SM, Dive C, Blackhall FH, Summers Y, Cave J, Marafioti T, Herrero J, Quezada SA, Peggs KS, Schwarz RF, Van Loo P, Miedema DM, Birkbak NJ, Hiley CT, Hackshaw A, Zaccaria S, Jamal-Hanjani M, McGranahan N, Swanton C, Bajaj A, Nakas A, Sodha-Ramdeen A, Ang K, Tufail M, Chowdhry MF, Scotland M, Boyles R, Rathinam S, Wilson C, Marrone D, Dulloo S, Matharu G, Shaw JA, Riley J, Primrose L, Cheyne H, Khalil M, Richardson S, Cruickshank T, Gilbert K, Patel AJ, Osman A, Lacson C, Langman G, Shackleford H, Djearaman M, Kadiri S, Leek A, Hodgkinson JD, Totten N, Montero A, Smith E, Fontaine E, Granato F, Doran H, Novasio J, Rammohan K, Joseph L, Bishop P, Shah R, Moss S, Joshi V, Crosbie P, Gomes F, Brown K, Carter M, Chaturvedi A, Priest L, Oliveira P, Lindsay CR, Clipson A, Tugwood J, Kerr A, Rothwell DG, Kilgour E, Aerts HJWL, Kaufmann TL, Szallasi Z, Kisistok J, Sokac M, Diossy M, Demeulemeester J, Stewart A, Magness A, Rowan A, Karamani A, Chain B, Campbell BB, Castignani C, Weeden CE, Richard C, Pearce DR, Karagianni D, Levi D, Hoxha E, Larose Cadieux E, Nye E, Gronroos E, Galvez-Cancino F, Athanasopoulou F, Gimeno-Valiente F, Kassiotis G, Stavrou G, Mastrokalos G, Zhai HL, Lowe HL, Matos I, Goldman J, Reading JL, Rane JK, Lam JM, Hartley JA, Enfield KSS, Selvaraju K, Litchfield K, Ng KW, Chen K, Dijkstra K, Thet al., 2023, The evolution of lung cancer and impact of subclonal selection in TRACERx, NATURE, Vol: 616, Pages: 525-+, ISSN: 0028-0836

Journal article

Martinez-Ruiz C, Black JRM, Puttick C, Hill M, Demeulemeester J, Cadieux EL, Thol K, Jones T, Veeriah S, Naceur-Lombardelli C, Toncheva A, Prymas P, Rowan A, Ward S, Cubitt L, Athanasopoulou F, Pich O, Karasaki T, Moore D, Salgado R, Colliver E, Castignani CI, Dietzen M, Huebner A, Al Bakir M, Tanic MG, Watkins TBK, Lim E, Al-Rashed A, Lang D, Clements J, Cook DJ, Rosenthal R, Wilson G, Frankell AG, Trecesson SDC, East P, Kanu N, Litchfield K, Birkbak N, Hackshaw A, Beck S, Van Loo P, Jamal-Hanjani M, Swanton C, McGranahan Net al., 2023, Genomic-transcriptomic evolution in lung cancer and metastasis, NATURE, Vol: 616, Pages: 543-+, ISSN: 0028-0836

Journal article

Al Bakir M, Huebner A, Martinez-Ruiz C, Grigoriadis K, Watkins TBK, Pich O, Moore DA, Veeriah S, Ward S, Laycock J, Johnson D, Rowan A, Razaq M, Akther M, Naceur-Lombardelli C, Prymas P, Toncheva A, Hessey S, Dietzen M, Colliver E, Frankell A, Bunkum A, Lim EL, Karasaki T, Abbosh C, Hiley CT, Hill MS, Cook DE, Wilson GA, Salgado R, Nye E, Stone RK, Fennell DA, Price G, Kerr KM, Naidu B, Middleton G, Summers Y, Lindsay CR, Blackhall FH, Cave J, Blyth KG, Nair A, Ahmed A, Taylor MN, Procter AJ, Falzon M, Lawrence D, Navani N, Thakrar RM, Janes SM, Papadatos-Pastos D, Forster MD, Lee SM, Ahmad T, Quezada S, Peggs KS, Van Loo P, Dive C, Hackshaw A, Birkbak NJ, Zaccaria S, Jamal-Hanjani M, McGranahan N, Swanton C, Lester JF, Bajaj A, Nakas A, Sodha-Ramdeen A, Ang K, Tufail M, Chowdhry MF, Scotland M, Boyles R, Rathinam S, Wilson C, Marrone D, Dulloo S, Matharu G, Shaw JA, Riley J, Primrose L, Boleti E, Cheyne H, Khalil M, Richardson S, Cruickshank T, Benafif S, Gilbert K, Patel AJ, Osman A, Lacson C, Langman G, Shackleford H, Djearaman M, Kadiri S, Leek A, Hodgkinson JD, Totten N, Montero A, Smith E, Fontaine E, Granato F, Doran H, Novasio J, Rammohan K, Joseph L, Bishop P, Shah R, Moss S, Joshi V, Crosbie P, Gomes F, Brown K, Carter M, Chaturvedi A, Priest L, Oliveira P, Krebs MG, Clipson A, Tugwood J, Kerr A, Rothwell DG, Kilgour E, Aerts HJWL, Schwarz RF, Kaufmann TL, Rosenthal R, Szallasi Z, Kisistok J, Sokac M, Diossy M, Demeulemeester J, Stewart A, Magness A, Karamani A, Chain B, Campbell BB, Castignani C, Bailey C, Puttick C, Weeden CE, Lee C, Richard C, Pearce DR, Karagianni D, Biswas D, Levi D, Hoxha E, Larose Cadieux E, Gronroos E, Galvez-Cancino F, Athanasopoulou F, Gimeno-Valiente F, Kassiotis G, Stavrou G, Mastrokalos G, Zhai H, Lowe HL, Matos I, Goldman J, Reading JL, Black JRM, Herrero J, Rane JK, Nicod J, Lam JM, Hartley JA, Enfield KSS, Selvaraju K, Thol K, Litchfield K, Ng KW, Chen K, Dijkstra K, Thakkar K, Ensell L, Shah M, Vasquez M, Litovchenko M, Weet al., 2023, The evolution of non-small cell lung cancer metastases in TRACERx, NATURE, Vol: 616, Pages: 534-+, ISSN: 0028-0836

Journal article

Abbosh C, Frankell AM, Harrison T, Kisistok J, Garnett A, Johnson L, Veeriah S, Moreau M, Chesh A, Chaunzwa TL, Weiss J, Schroeder MR, Ward S, Grigoriadis K, Shahpurwalla A, Litchfield K, Puttick C, Biswas D, Karasaki T, Black JRM, Martínez-Ruiz C, Bakir MA, Pich O, Watkins TBK, Lim EL, Huebner A, Moore DA, Godin-Heymann N, L'Hernault A, Bye H, Odell A, Roberts P, Gomes F, Patel AJ, Manzano E, Hiley CT, Carey N, Riley J, Cook DE, Hodgson D, Stetson D, Barrett JC, Kortlever RM, Evan GI, Hackshaw A, Daber RD, Shaw JA, Aerts HJWL, Licon A, Stahl J, Jamal-Hanjani M, TRACERx Consortium, Birkbak NJ, McGranahan N, Swanton Cet al., 2023, Tracking early lung cancer metastatic dissemination in TRACERx using ctDNA, Nature, Vol: 616, Pages: 553-562, ISSN: 0028-0836

Circulating tumour DNA (ctDNA) can be used to detect and profile residual tumour cells persisting after curative intent therapy1. The study of large patient cohorts incorporating longitudinal plasma sampling and extended follow-up is required to determine the role of ctDNA as a phylogenetic biomarker of relapse in early-stage non-small-cell lung cancer (NSCLC). Here we developed ctDNA methods tracking a median of 200 mutations identified in resected NSCLC tissue across 1,069 plasma samples collected from 197 patients enrolled in the TRACERx study2. A lack of preoperative ctDNA detection distinguished biologically indolent lung adenocarcinoma with good clinical outcome. Postoperative plasma analyses were interpreted within the context of standard-of-care radiological surveillance and administration of cytotoxic adjuvant therapy. Landmark analyses of plasma samples collected within 120 days after surgery revealed ctDNA detection in 25% of patients, including 49% of all patients who experienced clinical relapse; 3 to 6 monthly ctDNA surveillance identified impending disease relapse in an additional 20% of landmark-negative patients. We developed a bioinformatic tool (ECLIPSE) for non-invasive tracking of subclonal architecture at low ctDNA levels. ECLIPSE identified patients with polyclonal metastatic dissemination, which was associated with a poor clinical outcome. By measuring subclone cancer cell fractions in preoperative plasma, we found that subclones seeding future metastases were significantly more expanded compared with non-metastatic subclones. Our findings will support (neo)adjuvant trial advances and provide insights into the process of metastatic dissemination using low-ctDNA-level liquid biopsy.

Journal article

Karasaki T, Moore DA, Veeriah S, Naceur-Lombardelli C, Toncheva A, Magno N, Ward S, Al Bakir M, Watkins TBK, Grigoriadis K, Huebner A, Hill MS, Frankell AM, Abbosh C, Puttick C, Zhai H, Gimeno-Valiente F, Saghafinia S, Kanu N, Dietzen M, Pich O, Lim EL, Martinez-Ruiz C, Black JRM, Biswas D, Campbell BB, Lee C, Colliver E, Enfield KSS, Hessey S, Hiley CT, Zaccaria S, Litchfield K, Birkbak NJ, Cadieux EL, Demeulemeester J, Van Loo P, Adusumilli PR, Tan KS, Cheema W, Sanchez-Vega F, Jones DR, Rekhtman N, Travis WD, Hackshaw A, Marafioti T, Salgado R, Le Quesne J, Nicholson AG, McGranahan N, Swanton C, Jamal-Hanjani M, Lester JF, Bajaj A, Nakas A, Sodha-Ramdeen A, Ang K, Tufail M, Chowdhry MF, Scotland M, Boyles R, Rathinam S, Wilson C, Marrone D, Dulloo S, Fennell DA, Matharu G, Shaw JA, Riley J, Primrose L, Boleti E, Cheyne H, Khalil M, Richardson S, Cruickshank T, Price G, Kerr KM, Benafif S, Gilbert K, Naidu B, Patel AJ, Osman A, Lacson C, Langman G, Shackleford H, Djearaman M, Kadiri S, Middleton G, Leek A, Hodgkinson JD, Totten N, Montero A, Smith E, Fontaine E, Granato F, Doran H, Novasio J, Rammohan K, Joseph L, Bishop P, Shah R, Moss S, Joshi V, Crosbie P, Gomes F, Brown K, Carter M, Chaturvedi A, Priest L, Oliveira P, Lindsay CR, Blackhall FH, Krebs MG, Summers Y, Clipson A, Tugwood J, Kerr A, Rothwell DG, Kilgour E, Dive C, Aerts HJWL, Schwarz RF, Kaufmann TL, Wilson GA, Rosenthal R, Szallasi Z, Kisistok J, Sokac M, Diossy M, Bunkum A, Stewart A, Magness A, Rowan A, Karamani A, Chain B, Castignani C, Bailey C, Weeden CE, Richard C, Pearce DR, Karagianni D, Levi D, Hoxha E, Nye E, Gronroos E, Galvez-Cancino F, Athanasopoulou F, Kassiotis G, Stavrou G, Mastrokalos G, Lowe HL, Matos IG, Goldman J, Reading JL, Herrero J, Rane JK, Nicod J, Lam JM, Hartley JA, Peggs KS, Selvaraju K, Thol K, Ng KW, Chen K, Dijkstra K, Thakkar K, Ensell L, Shah M, Duran MV, Litovchenko M, Sunderland MW, Leung M, Escudero M, Angelova M, Tanic M, Sivakumar M, Chervova O, Lucas O, Al-Saet al., 2023, Evolutionary characterization of lung adenocarcinoma morphology in TRACERx, NATURE MEDICINE, ISSN: 1078-8956

Journal article

Al-Sawaf O, Weiss J, Skrzypski M, Lam JM, Karasaki T, Zambrana F, Kidd AC, Frankell AM, Watkins TBK, Martinez-Ruiz C, Puttick C, Black JRM, Huebner A, Al Bakir M, Sokac M, Collins S, Veeriah S, Magno N, Naceur-Lombardelli C, Prymas P, Toncheva A, Ward S, Jayanth N, Salgado R, Bridge CP, Christiani DC, Mak RH, Bay C, Rosenthal M, Sattar N, Welsh P, Liu Y, Perrimon N, Popuri K, Beg MF, McGranahan N, Hackshaw A, Breen DM, O'Rahilly S, Birkbak NJ, Aerts HJWL, Jamal-Hanjani M, Swanton C, Lester JF, Bajaj A, Nakas A, Sodha-Ramdeen A, Ang K, Tufail M, Chowdhry MF, Scotland M, Boyles R, Rathinam S, Wilson C, Marrone D, Dulloo S, Fennell DA, Matharu G, Shaw JA, Riley J, Primrose L, Boleti E, Cheyne H, Khalil M, Richardson S, Cruickshank T, Price G, Kerr KM, Benafif S, Gilbert K, Naidu B, Patel AJ, Osman A, Lacson C, Langman G, Shackleford H, Djearaman M, Kadiri S, Middleton G, Leek A, Hodgkinson JD, Totten N, Montero A, Smith E, Fontaine E, Granato F, Doran H, Novasio J, Rammohan K, Joseph L, Bishop P, Shah R, Moss S, Joshi V, Crosbie P, Gomes F, Brown K, Carter M, Chaturvedi A, Priest L, Oliveira P, Lindsay CR, Blackhall FH, Krebs MG, Summers Y, Clipson A, Tugwood J, Kerr A, Rothwell DG, Kilgour E, Dive C, Schwarz RF, Kaufmann TL, Wilson GA, Rosenthal R, Van Loo P, Szallasi Z, Kisistok J, Sokac M, Diossy M, Demeulemeester J, Bunkum A, Stewart A, Magness A, Rowan A, Karamani A, Chain B, Campbell BB, Castignani C, Bailey C, Abbosh C, Weeden CE, Lee C, Richard C, Hiley CT, Moore DA, Pearce DR, Karagianni D, Biswas D, Levi D, Hoxha E, Cadieux EL, Lim EL, Colliver E, Nye E, Gronroos E, Galvez-Cancino F, Athanasopoulou F, Gimeno-Valiente F, Kassiotis G, Stavrou G, Mastrokalos G, Zhai H, Lowe HL, Matos IG, Goldman J, Reading JL, Herrero J, Rane JK, Nicod J, Hartley JA, Peggs KS, Enfield KSS, Selvaraju K, Thol K, Litchfield K, Ng KW, Chen K, Dijkstra K, Grigoriadis K, Thakkar K, Ensell L, Shah M, Duran MV, Litovchenko M, Sunderland MW, Hill MS, Dietzen M, Leung M, Escudero M, Angelet al., 2023, Body composition and lung cancer-associated cachexia in TRACERx, NATURE MEDICINE, ISSN: 1078-8956

Journal article

Ratnakumar R, Sabarwal K, Derbyshire J, Stephenson C, Rhodes A, Morris K, Burchill J, Devaraj A, Orhan O, Sheard S, Mayer E, Quint J, Bloch Set al., 2023, Developing a regional hub- and-spoke model for volumetric assessment of indeterminate pulmonary nodules supports efficient and effective management of pulmonary nodule pathways, Publisher: ELSEVIER IRELAND LTD, Pages: S6-S7, ISSN: 0169-5002

Conference paper

Hill W, Lim EL, Weeden CE, Lee C, Augustine M, Chen K, Kuan F-C, Marongiu F, Evans EJ, Moore DA, Rodrigues FS, Pich O, Bakker B, Cha H, Myers R, van Maldegem F, Boumelha J, Veeriah S, Rowan A, Naceur-Lombardelli C, Karasaki T, Sivakumar M, De S, Caswell DR, Nagano A, Black JRM, Martínez-Ruiz C, Ryu MH, Huff RD, Li S, Favé M-J, Magness A, Suárez-Bonnet A, Priestnall SL, Lüchtenborg M, Lavelle K, Pethick J, Hardy S, McRonald FE, Lin M-H, Troccoli CI, Ghosh M, Miller YE, Merrick DT, Keith RL, Al Bakir M, Bailey C, Hill MS, Saal LH, Chen Y, George AM, Abbosh C, Kanu N, Lee S-H, McGranahan N, Berg CD, Sasieni P, Houlston R, Turnbull C, Lam S, Awadalla P, Grönroos E, Downward J, Jacks T, Carlsten C, Malanchi I, Hackshaw A, Litchfield K, TRACERx Consortium, DeGregori J, Jamal-Hanjani M, Swanton Cet al., 2023, Lung adenocarcinoma promotion by air pollutants., Nature, Vol: 616, Pages: 159-167

A complete understanding of how exposure to environmental substances promotes cancer formation is lacking. More than 70 years ago, tumorigenesis was proposed to occur in a two-step process: an initiating step that induces mutations in healthy cells, followed by a promoter step that triggers cancer development1. Here we propose that environmental particulate matter measuring ≤2.5 μm (PM2.5), known to be associated with lung cancer risk, promotes lung cancer by acting on cells that harbour pre-existing oncogenic mutations in healthy lung tissue. Focusing on EGFR-driven lung cancer, which is more common in never-smokers or light smokers, we found a significant association between PM2.5 levels and the incidence of lung cancer for 32,957 EGFR-driven lung cancer cases in four within-country cohorts. Functional mouse models revealed that air pollutants cause an influx of macrophages into the lung and release of interleukin-1β. This process results in a progenitor-like cell state within EGFR mutant lung alveolar type II epithelial cells that fuels tumorigenesis. Ultradeep mutational profiling of histologically normal lung tissue from 295 individuals across 3 clinical cohorts revealed oncogenic EGFR and KRAS driver mutations in 18% and 53% of healthy tissue samples, respectively. These findings collectively support a tumour-promoting role for  PM2.5 air pollutants  and provide impetus for public health policy initiatives to address air pollution to reduce disease burden.

Journal article

Zhang YZ, Sherlock S, MacMahon S, Brambilla C, Rice A, Robertus JL, Wassilew K, Lim E, Begum S, Buderi S, Jordan S, Anikin V, Finch J, Asadi N, Beddow E, Garner JL, Morjaria J, Lee R, McDonald F, Antoniou G, Ridge C, Padley S, Dalal P, Morris-Rosendahl D, Valganon-Petrizan M, Shah PL, Devaraj A, Popat S, Nicholson AGet al., 2023, Prediction of next generation sequencing test failure in lung adenocarcinoma in a genomic laboratory hub setting, Publisher: ELSEVIER IRELAND LTD, Pages: S1-S2, ISSN: 0169-5002

Conference paper

Dintakurti SH, Kamath S, Mahon C, Singh S, Rawal B, Padley S, Devaraj A, Price L, Desai S, Semple T, Ridge Cet al., 2023, Pulmonary hypertension: the hallmark of acute COVID-19 microvascular angiopathy?, ERJ Open Research, Vol: 9, Pages: 1-4, ISSN: 2312-0541

Journal article

Williams PJ, Philip KEJ, Gill NK, Flannery D, Buttery S, Bartlett EC, Devaraj A, Kemp SV, Addis J, Derbyshire J, Chen M, Morris K, Laverty AA, Hopkinson NSet al., 2023, Immediate, remote smoking cessation intervention in participants undergoing a targeted lung health check: quit smoking lung health intervention trial, a randomized controlled trial, Chest, Vol: 163, Pages: 455-463, ISSN: 0012-3692

BACKGROUND: Lung cancer screening programs provide an opportunity to support people who smoke to quit, but the most appropriate model for delivery remains to be determined. Immediate face-to-face smoking cessation support for people undergoing screening can increase quit rates, but it is not known whether remote delivery of immediate smoking cessation counselling and pharmacotherapy in this context also is effective. RESEARCH QUESTION: Does an immediate telephone smoking cessation intervention increase quit rates compared with usual care among a population enrolled in a targeted lung health check (TLHC)? STUDY DESIGN AND METHODS: In a single-masked randomized controlled trial, people 55 to 75 years of age who smoke and attended a TLHC were allocated by day of attendance to receive either immediate telephone smoking cessation intervention (TSI) support (starting immediately and lasting for 6 weeks) with appropriate pharmacotherapy or usual care (UC; very brief advice to quit and signposting to smoking cessation services). The primary outcome was self-reported 7-day point prevalence smoking abstinence at 3 months. Differences between groups were assessed using logistic regression. RESULTS: Three hundred fifteen people taking part in the screening program who reported current smoking with a mean ± SD age of 63 ± 5.4 years, 48% of whom were women, were randomized to TSI (n = 152) or UC (n = 163). The two groups were well matched at baseline. Self-reported quit rates were higher in the intervention arm, 21.1% vs 8.9% (OR, 2.83; 95% CI, 1.44-5.61; P = .002). Controlling for participant demographics, neither baseline smoking characteristics nor the discovery of abnormalities on low-dose CT imaging modified the effect of the intervention. INTERPRETATION: Immediate provision of an intensive telephone-based smoking cessation intervention, delivered within a targeted lung screening context, is associated with incr

Journal article

Bhamani A, Horst C, Bojang F, Quaife SL, Dickson JL, Tisi S, Hall H, Verghese P, Creamer A, Prendecki R, McCabe J, Gyertson K, Bowyer V, El -Emir E, Cotton A, Mehta S, Levermore C, Mullin A-M, Teague J, Farrelly L, Nair A, Devaraj A, Hackshaw A, Janes Set al., 2023, The SUMMIT Study: Utilising a written 'Next Steps' information booklet to prepare participants for potential lung cancer screening results and follow-up, LUNG CANCER, Vol: 176, Pages: 75-81, ISSN: 0169-5002

Journal article

Dickson JL, Hall H, Horst C, Tisi S, Verghese P, Mullin A-M, Teague J, Farrelly L, Bowyer V, Gyertson K, Bojang F, Levermore C, Anastasiadis T, McCabe J, Navani N, Nair A, Devaraj A, Hackshaw A, Quaife SL, Janes SMet al., 2023, Uptake of invitations to a lung health check offering low-dose CT lung cancer screening among an ethnically and socioeconomically diverse population at risk of lung cancer in the UK (SUMMIT): a prospective, longitudinal cohort study, LANCET PUBLIC HEALTH, Vol: 8, Pages: E130-E140, ISSN: 2468-2667

Journal article

Hunter B, Chen M, Ratnakumar P, Alemu E, Logan A, Linton-Reid K, Tong D, Senthivel N, Bhamani A, Bloch S, Kemp S, Boddy L, Jain S, Gareeboo S, Rawal B, Doran S, Navani N, Nair A, Bunce C, Kaye S, Blackledge M, Aboagye E, Devaraj A, Lee Ret al., 2022, A radiomics-based decision support tool improves lung cancer diagnosis in combination with the Herder score in large lung nodules, EBioMedicine, Vol: 86, ISSN: 2352-3964

Background:Large lung nodules (≥15 mm) have the highest risk of malignancy, and may exhibit important differences in phenotypic or clinical characteristics to their smaller counterparts. Existing risk models do not stratify large nodules well. We aimed to develop and validate an integrated segmentation and classification pipeline, incorporating deep-learning and traditional radiomics, to classify large lung nodules according to cancer risk.Methods:502 patients from five U.K. centres were recruited to the large-nodule arm of the retrospective LIBRA study between July 2020 and April 2022. 838 CT scans were used for model development, split into training and test sets (70% and 30% respectively). An nnUNet model was trained to automate lung nodule segmentation. A radiomics signature was developed to classify nodules according to malignancy risk. Performance of the radiomics model, termed the large-nodule radiomics predictive vector (LN-RPV), was compared to three radiologists and the Brock and Herder scores.Findings:499 patients had technically evaluable scans (mean age 69 ± 11, 257 men, 242 women). In the test set of 252 scans, the nnUNet achieved a DICE score of 0.86, and the LN-RPV achieved an AUC of 0.83 (95% CI 0.77–0.88) for malignancy classification. Performance was higher than the median radiologist (AUC 0.75 [95% CI 0.70–0.81], DeLong p = 0.03). LN-RPV was robust to auto-segmentation (ICC 0.94). For baseline solid nodules in the test set (117 patients), LN-RPV had an AUC of 0.87 (95% CI 0.80–0.93) compared to 0.67 (95% CI 0.55–0.76, DeLong p = 0.002) for the Brock score and 0.83 (95% CI 0.75–0.90, DeLong p = 0.4) for the Herder score. In the international external test set (n = 151), LN-RPV maintained an AUC of 0.75 (95% CI 0.63–0.85). 18 out of 22 (82%) malignant nodules in the Herder 10–70% category in the test set were identified as high risk by the decision-support tool, and may have been referred for earl

Journal article

Tisi S, Dickson JL, Horst C, Quaife SL, Hall H, Verghese P, Gyertson K, Bowyer V, Levermore C, Mullin A-M, Teague J, Farrelly L, Nair A, Devaraj A, Hackshaw A, Hurst JR, Janes SMet al., 2022, Detection of COPD in the SUMMIT Study lung cancer screening cohort using symptoms and spirometry, EUROPEAN RESPIRATORY JOURNAL, Vol: 60, ISSN: 0903-1936

Journal article

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