Joshua Brown (University of York): Publications

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University of York
Department of Philosophy

Undergraduate

26

Et al.; López et al.; Medin et al.; Ross et al. Collard, M., 25 Collman, P., 302
with M. Coltheart, A. Brooks, C. Brown, D. Brown, R. Brown, R. Bulmer, H. Bunn, R. Burt, and V. Bush

In Peter Carruthers, Stephen Stich & Michael Siegal (eds.), The Cognitive Basis of Science, Cambridge University Press. 2002.

Ethics
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RRx-001 Priming of PD-1 Inhibition in the Treatment of Small Cell Carcinoma of the Vagina: A Rare Gynecological Tumor
with C. Brzezniak, B. Oronsky, J. Trepel, T. A. Summers, P. Cabrales, M. J. Lee, R. Day, S. Jha, S. Caroen, K. Zeman, L. Ferry, C. Harmer, N. Oronsky, M. Lybeck, H. E. Lybeck, T. R. Reid, and C. A. Carter

© 2017 The Author. Published by S. Karger AG, Basel.Small cell carcinoma of the vagina is rare, so rare in fact that the total number reported in English-language journals is less than 30. Due to this extremely low incidence, no specific treatment guidelines have been established, and most of what is clinically known is derived from a handful of single case reports. However, as befitting its highly aggressive histologic features, which are reminiscent of small cell lung cancer, first-line treatm…Read more
© 2017 The Author. Published by S. Karger AG, Basel.Small cell carcinoma of the vagina is rare, so rare in fact that the total number reported in English-language journals is less than 30. Due to this extremely low incidence, no specific treatment guidelines have been established, and most of what is clinically known is derived from a handful of single case reports. However, as befitting its highly aggressive histologic features, which are reminiscent of small cell lung cancer, first-line treatment is modeled after SCLC. Herein is reported the case of a 51-year-old African-American patient with metastatic biopsy-proven small cell carcinoma of the vagina that progressed through multiple therapies: first-line cisplatin and etoposide and radiotherapy, followed by the tumor macrophage-stimulating agent RRx-001 in a clinical trial called QUADRUPLE THREAT, which per protocol preceded a mandated rechallenge with cisplatin and etoposide. RECIST v.1.1 tumor progression on both RRx-001 and cisplatin/etoposide was accompanied by central necrosis in several of the enlarged lymph nodes and hepatic metastases, which may have been evidence of pseudoprogression, accounting for her ongoing longer-than-expected survival, since the necrotic tissue may have primed the activity of the PD-1 inhibitor. The lack of response to RRx-001 is hypothesized to have correlated with sparse tumor macrophage infiltration, seen on pre- and post-treatment biopsies, since the mechanism of action of RRx-001 relates to stimulation of tumor-associated macrophages.