Mansur A. Ghani

University of California, San Diego

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Choice of Intra-arterial Therapy for Hepatocellular Carcinoma: Evidence and Future Horizons

Digestive Disease Interventions (2017)

Mansur A. Ghani Vinayak Thakur Jean‐François H. Geschwind

Abstract Hepatocellular carcinoma is the second most common cause of cancer-related deaths worldwide. Along with viral and alcoholic hepatitis, obesity is the leading cause for increasing incidence in the western world, specifically in the United States. As most patients initially present with intermediate to advanced stage disease, curative therapies such as ablation, surgical resection, or liver transplantation cannot usually be applied. Thus, intra-arterial therapies (IATs), such as transarterial chemoembolization (TACE), have become a mainstay of treatment. Several variations of transarterial embolotherapy, such as bland transarterial embolization or drug-eluting bead TACE, are currently available and used in clinical practice. Yttrium-90 radioembolization is a distinct IAT that relies on delivery of radiation to surrounding tissue for tumor death. However, no clear guidelines or evidence exist that would favor one of these options over the other, leaving the decision-making process open to influence by local expertise and experience. In addition, combining TACE with systemic antiangiogenic agents, such as the multityrosine kinase inhibitor sorafenib, has been investigated in several prospective clinical trials without clearly demonstrating substantial survival benefits of the combination over TACE alone. This review will summarize and discuss the available clinical evidence and indications for each treatment modality with the goal of facilitating clinical decision-making processes, and provide an overview of the ongoing efforts to compare different IAT modalities.

Lenvatinib

10.1055/s-0037-1603891

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Citations (1)

Pretreatment Drug use Characteristics and Experiences among Patients in a Voluntary Substance Abuse Treatment Center in Malaysia: A Mixed-Methods Approach

Substance Abuse (2016)

Archana Krishnan Shan-Estelle Brown Mansur A. Ghani Farrah Khan Adeeba Kamarulzaman

Drug use in Malaysia remains a significant public health and social problem despite implementation of harsh punitive drug policies such as forcibly placing suspected drug users into compulsory drug detention centers (CDDCs). Following criticism over human right violations in CDDCs, Malaysia has begun to transition towards voluntary drug treatment centers known as Cure & Care (C&C) centers. To best serve the needs of regional C&C centers, data on drug use are essential among patients accessing treatment. Using a mixed-methods approach, the authors examined pretreatment drug use characteristics and experiences with addiction treatment among C&C patients in Kelantan-a religiously conservative state in northeast Malaysia with high prevalence of drug use but where limited data are available on drug use patterns.A mixed-methods study utilizing surveys (n = 96) and semistructured interviews (n = 20) was conducted among a convenience sample of inpatients and outpatients at the Pengkalan Chepa C&C Center in Kelantan.Survey results showed that 89.6% of participants met screening criteria for moderate to severe addiction severity. Nearly 90% reported lifetime illicit amphetamine (syabu, meth, ice, and pil kuda) use, followed by alcohol (60.4%) and opioids (52.1%). Qualitative results pointed to the powerful influence of peer networks in drug initiation and relapse, and the positive effect of the C&C center on drug rehabilitation.The drug use profile of the Kelantan C&C center enrollees shows extensive pretreatment amphetamine use, polysubstance use, and injection drug use, including high-risk behaviors such as sharing needles, syringes, and containers. Evidence points to the need for integration of social support-oriented practices and behavioral interventions into the rehabilitation of drug users in this region.

Injection drug use

10.1080/08897077.2016.1146648

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Citations (13)

Treatment of Hepatocellular Carcinoma by Multimodal In Situ Vaccination Using Cryoablation and a Plant Virus Immunostimulant

Journal of Vascular and Interventional Radiology (2023)

Mansur A. Ghani Amandip Bangar Yunpeng Yang Eunkyeong Jung Consuelo Sauceda

To test the hypothesis that cryoablation combined with intratumoral immunomodulating nanoparticles from cowpea mosaic virus (CPMV) as an in situ vaccination approach induces systemic antitumoral immunity in a murine model of hepatocellular carcinoma (HCC).

Cryoablation

Cowpea mosaic virus

HCCS

10.1016/j.jvir.2023.03.016

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Citations (5)

Identifying Quantitative Enhancement-Based Imaging Biomarkers In Patients With Colorectal Cancer Liver Metastases Undergoing Loco-Regional Tumor Therapy

Mansur A. Ghani

Source

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Citations (0)

Irinotecan-Eluting 75–150-μm Embolics Lobar Chemoembolization in Patients with Colorectal Cancer Liver Metastases: A Prospective Single-Center Phase I Study

Journal of Vascular and Interventional Radiology (2018)

Arash Fereydooni Brian Letzen Mansur A. Ghani Milena Miszczuk Steffen Huber

Clinical endpoint

Refractory (planetary science)

10.1016/j.jvir.2018.08.010

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Citations (14)

Patients’ economic considerations of treatment for methamphetamine and opiate use at an innovative drug treatment center in Malaysia

Drug and Alcohol Dependence (2014)

Shan-Estelle Brown Archana Krishnan Mansur A. Ghani Farrah Khan Adeeba Kamarulzaman

Calorie

10.1016/j.drugalcdep.2014.09.099

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Citations (0)

Stimulating Antitumoral Immunity by Percutaneous Cryoablation and Combination Immunoadjuvant Therapy in a Murine Model of Hepatocellular Carcinoma

Journal of Vascular and Interventional Radiology (2023)

Tyler Mandt Amandip Bangar Consuelo Sauceda Manasi Das Carolyn Rydyznski Moderbacher

Immunoadjuvant

10.1016/j.jvir.2023.05.008

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Citations (4)

Imaging Biomarkers and Liquid Biopsy to Predict Therapy Response in Cervical Cancer

Journal of Nuclear Medicine (2021)

Mansur A. Ghani Joy Liau Ramez N. Eskander Loren K. Mell Tahir Yusufaly

2025 Objectives: 1. Review current practice in radiological treatment monitoring of cervical cancer. 2. Understand challenges with accurately assessing response of cervical cancer treated with concurrent chemoradiotherapy. 3. Highlight several promising imaging biomarkers as well as circulating tumor DNA (ctDNA) from liquid biopsy to monitor cervical cancer response to therapy. Abstract Summary: Cervical cancer is one of the most common cancers in women worldwide and approximately 40% of patients present with locally advanced cervical cancer (LACC). Cisplatin-based chemoradiotherapy (CRT) is the standard of care for LACC, however, approximately one-third of patients experience recurrence after CRT. Currently, contrast enhanced computed tomography (CT) and magnetic resonance imaging (MRI) are most commonly used to assess therapy response in cervical cancer using Response Evaluation Criteria in Solid Tumors (RECIST 1.1) but it is often difficult to distinguish residual or recurrent disease from post-treatment changes, and disease within sub-centimeter lymph nodes may be missed. FDG-PET/CT is advantageous for assessment of sub-centimeter lymph nodes in high grade disease using PET Response Criteria in Solid Tumors (PERCIST) but is less sensitive for lower grade malignancy. Given these drawbacks, there is a need to incorporate additional imaging techniques and biomarkers into assessment of treatment response. In this work we review potential approaches on incorporating liquid biopsy with CT, PET and MR imaging biomarkers for assessment of therapy response and recurrence in cervical cancer. There are several such imaging biomarkers under investigation that show promise in this arena. FDG PET/CT and PET/MRI may be especially useful modalities for this purpose. Imaging biomarkers which can be obtained with FDG PET include the change in maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) before and after treatment. Furthermore, methods to determine boundaries for MTV and TLG may include fixed SUVmax threshold, relative percentage of SUVmax and an adaptive region-growing method. Recent studies measuring whole-body MTV and TLG demonstrated prognostic significance in several cancers and are being evaluated in cervical cancer. Diffusion-weighted imaging (DWI) is a promising MRI technique that provides unique information regarding tumor cellularity and integrity of the cell membrane. In particular, changes in the apparent diffusion coefficient (ADC) have been show to precede reductions of tumor size. However, no single imaging biomarker may be sufficient for the accurate assessment of treatment response of cervical cancer. Future work should be aimed at not only combining different imaging biomarkers, but also on incorporating molecular markers such as circulating tumor DNA (ctDNA). It has recently been shown that longitudinal monitoring of metastatic relapsed cervical cancer (MRCC) with ctDNA in liquid biopsy samples provides both predictive and prognostic information during treatment. A system that incorporates PET, CT, MRI and ctDNA levels may provide early and accurate prediction of LACC and MRCC response to CRT.

Chemoradiotherapy

Cervical lymph nodes

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Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia

Substance Use & Misuse (2017)

Farrah Khan Archana Krishnan Mansur A. Ghani Jeffrey A. Wickersham Jeannia J. Fu

Background: As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services. Objectives: We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia's second C&C Center located in Kota Bharu, Kelantan. Methods: In June-July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Results: Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance: Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia's ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely.

Turnover

Substance abuse treatment

10.1080/10826084.2016.1267217

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Citations (15)

Identifying enhancement-based staging markers on baseline MR imaging in patients with colorectal cancer liver metastases undergoing loco-regional tumor therapy

Journal of Vascular and Interventional Radiology (2017)

Mansur A. Ghani Julius Chapiro Brian Letzen Vishav Bir S Thakur MingDe Lin

Cut-off

10.1016/j.jvir.2016.12.621

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Citations (0)