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  1. Article: Ulipristal.

    Goldstone, Philip

    Australian prescriber

    2017  Volume 40, Issue 4, Page(s) 127

    Language English
    Publishing date 2017-08-01
    Publishing country Australia
    Document type Journal Article ; Comment
    ZDB-ID 1075442-8
    ISSN 0312-8008
    ISSN 0312-8008
    DOI 10.18773/austprescr.2017.052
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    Zs.A 3233: Show issues Location:
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  2. Article ; Online: Telephone follow-up after early medical abortion using Australia's first low sensitivity urine pregnancy test.

    Melville, Catriona / Goldstone, Philip / Moosa, Nisreen

    The Australian & New Zealand journal of obstetrics & gynaecology

    2023  Volume 63, Issue 6, Page(s) 797–802

    Abstract: Background: Follow-up after early medical abortion (EMA) in Australia often entails tracking serum human chorionic gonadotropin levels or performing ultrasonography in-clinic. In other countries, methods of follow-up such as using a low-sensitivity ... ...

    Abstract Background: Follow-up after early medical abortion (EMA) in Australia often entails tracking serum human chorionic gonadotropin levels or performing ultrasonography in-clinic. In other countries, methods of follow-up such as using a low-sensitivity urine pregnancy test (LSUPT), telephone evaluation and a questionnaire have been demonstrated to be safe and acceptable.
    Aims: To evaluate the safety and efficacy of telephone follow-up after EMA using an LSUPT and questionnaire.
    Materials and methods: A prospective observational cohort study of patients undergoing telephone follow-up after EMA using an LSUPT and questionnaire was conducted from March 26 to July 31, 2020. Outcomes of patients who returned to clinic because of a positive LSUPT were evaluated and adverse event rates were calculated. Routinely collected adverse event information was used to compare complication rates during the evaluation period with that prior to introduction of the LSUPT.
    Results: During the study period, 2223 patients underwent the new protocol. One hundred and ninety-seven patients had a positive LSUPT at their telephone follow-up. One hundred and thirty-two had an incomplete abortion, 11 had a continuing pregnancy, 53 had a complete abortion and one left the clinic before full assessment.
    Conclusions: Introduction of telephone follow-up with an at-home LSUPT reduced the number of patients requiring unnecessary clinic appointments, with over 90% of patients completing their follow-up at home. Complication rates during the study period were found to be at least comparable with previously identified organisational adverse events.
    MeSH term(s) Female ; Pregnancy ; Humans ; Follow-Up Studies ; Prospective Studies ; Abortion, Induced/adverse effects ; Abortion, Induced/methods ; Pregnancy Tests/methods ; Abortion, Spontaneous ; Telephone ; Misoprostol
    Chemical Substances Misoprostol (0E43V0BB57)
    Language English
    Publishing date 2023-07-14
    Publishing country Australia
    Document type Observational Study ; Journal Article
    ZDB-ID 390815-x
    ISSN 1479-828X ; 0004-8666
    ISSN (online) 1479-828X
    ISSN 0004-8666
    DOI 10.1111/ajo.13731
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  3. Article ; Online: Reply to: "mifepristone by prescription: not quite a reality in Australia".

    Grossman, Daniel / Goldstone, Philip

    Contraception

    2016  Volume 94, Issue 4, Page(s) 379

    MeSH term(s) Abortifacient Agents, Steroidal ; Abortion, Induced ; Australia ; Humans ; Mifepristone
    Chemical Substances Abortifacient Agents, Steroidal ; Mifepristone (320T6RNW1F)
    Language English
    Publishing date 2016
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80106-9
    ISSN 1879-0518 ; 0010-7824
    ISSN (online) 1879-0518
    ISSN 0010-7824
    DOI 10.1016/j.contraception.2016.05.003
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  4. Article ; Online: Abortion statistics and long-acting reversible contraception in Australia.

    Black, Kirsten I / Bateson, Deborah J / Goldstone, Philip

    The Australian & New Zealand journal of obstetrics & gynaecology

    2018  Volume 58, Issue 3, Page(s) E6–E7

    MeSH term(s) Abortion, Induced/statistics & numerical data ; Australia ; Data Collection ; Female ; Humans ; Long-Acting Reversible Contraception/statistics & numerical data ; Pregnancy
    Language English
    Publishing date 2018-05-18
    Publishing country Australia
    Document type Letter
    ZDB-ID 390815-x
    ISSN 1479-828X ; 0004-8666
    ISSN (online) 1479-828X
    ISSN 0004-8666
    DOI 10.1111/ajo.12810
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  5. Article ; Online: CRISPR-Cas9 screening identifies KRAS-induced COX-2 as a driver of immunotherapy resistance in lung cancer.

    Boumelha, Jesse / de Castro, Andrea / Bah, Nourdine / Cha, Hongui / de Carné Trécesson, Sophie / Rana, Sareena / Tomaschko, Mona / Anastasiou, Panayiotis / Mugarza, Edurne / Moore, Christopher / Goldstone, Robert / East, Philip / Litchfield, Kevin / Lee, Se-Hoon / Molina-Arcas, Miriam / Downward, Julian

    Cancer research

    2024  

    Abstract: Oncogenic KRAS impairs anti-tumor immune responses. As effective strategies to combine KRAS inhibitors and immunotherapies have so far proven elusive, a better understanding of how oncogenic KRAS drives immune evasion is needed to identify approaches ... ...

    Abstract Oncogenic KRAS impairs anti-tumor immune responses. As effective strategies to combine KRAS inhibitors and immunotherapies have so far proven elusive, a better understanding of how oncogenic KRAS drives immune evasion is needed to identify approaches that could sensitize KRAS-mutant lung cancer to immunotherapy. In vivo CRISPR-Cas9 screening in an immunogenic murine lung cancer model identified mechanisms by which oncogenic KRAS promotes immune evasion, most notably via upregulation of immunosuppressive cyclooxygenase-2 (COX-2) in cancer cells. Oncogenic KRAS potently induced COX-2 in both mouse and human lung cancer, which was suppressed using KRAS inhibitors. COX-2 acted via prostaglandin E2 (PGE2) to promote resistance to immune checkpoint blockade (ICB) in lung adenocarcinoma. Targeting COX-2/PGE2 remodeled the tumor microenvironment by inducing pro-inflammatory polarization of myeloid cells and influx of activated cytotoxic CD8+ T cells, which increased the efficacy of ICB. Restoration of COX-2 expression contributed to tumor relapse after prolonged KRAS inhibition. These results provide the rationale for testing COX-2/PGE2 pathway inhibitors in combination with KRASG12C inhibition or ICB in patients with KRAS-mutant lung cancer.
    Language English
    Publishing date 2024-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1432-1
    ISSN 1538-7445 ; 0008-5472
    ISSN (online) 1538-7445
    ISSN 0008-5472
    DOI 10.1158/0008-5472.CAN-23-2627
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  6. Article ; Online: Mifepristone by prescription: a dream in the United States but reality in Australia.

    Grossman, Daniel / Goldstone, Philip

    Contraception

    2015  Volume 92, Issue 3, Page(s) 186–189

    Abstract: The requirement that mifepristone be dispensed only by physicians in offices, clinics or hospitals - and not by prescription in pharmacies - has likely limited uptake by providers in the United States. However, in several other countries, provision by ... ...

    Abstract The requirement that mifepristone be dispensed only by physicians in offices, clinics or hospitals - and not by prescription in pharmacies - has likely limited uptake by providers in the United States. However, in several other countries, provision by prescription in pharmacies is allowed, including in Australia. Mifepristone was first registered in Australia in 2012, and in 2015, a composite package including 200 mg mifepristone and four tablets of misoprostol 200 mcg was registered. Both were approved as Schedule 4 medications, which require prescribing by a physician and may be dispensed at pharmacies. As part of the registration for both products, a risk management plan was instituted that has several components. First, physicians must be certified to prescribe mifepristone. General practitioners wishing to become certified must complete online training that includes prescribing requirements and managing the medical abortion process; obstetrician-gynecologists are exempt from the online learning module. Pharmacists must also be certified in order to dispense the medication, although this does not require additional training. When a pharmacist receives a prescription for mifepristone, she or he must confirm through a secure website that the prescriber is certified. In every region of the country, there are more certified prescribers and dispensers of mifepristone than the number of facilities providing abortion care. The experience in Australia demonstrates the feasibility of mifepristone by prescription and should be a model for expanding access to early medical abortion in the United States.
    MeSH term(s) Abortifacient Agents/administration & dosage ; Abortion, Induced/legislation & jurisprudence ; Australia ; Certification/legislation & jurisprudence ; Female ; Humans ; Mifepristone/administration & dosage ; Misoprostol/administration & dosage ; Nonprescription Drugs ; Pharmacies ; Pharmacists/standards ; Physicians/standards ; Pregnancy ; United States
    Chemical Substances Abortifacient Agents ; Nonprescription Drugs ; Misoprostol (0E43V0BB57) ; Mifepristone (320T6RNW1F)
    Language English
    Publishing date 2015-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80106-9
    ISSN 1879-0518 ; 0010-7824
    ISSN (online) 1879-0518
    ISSN 0010-7824
    DOI 10.1016/j.contraception.2015.06.014
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    Zs.A 629: Show issues Location:
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  7. Article ; Online: Efficacy and safety of mifepristone-buccal misoprostol for early medical abortion in an Australian clinical setting.

    Goldstone, Philip / Walker, Clara / Hawtin, Katherine

    The Australian & New Zealand journal of obstetrics & gynaecology

    2017  Volume 57, Issue 3, Page(s) 366–371

    Abstract: Background: In 2014, a composite pack containing mifepristone-buccal misoprostol, indicated for use to 63 days gestation replaced the existing regimen for early medical abortion (EMA) in Australia.: Aims: To provide updated efficacy and safety ... ...

    Abstract Background: In 2014, a composite pack containing mifepristone-buccal misoprostol, indicated for use to 63 days gestation replaced the existing regimen for early medical abortion (EMA) in Australia.
    Aims: To provide updated efficacy and safety information for the use of mifepristone-buccal misoprostol for EMA in Australia, and assess the effect of patient age and gestational age on efficacy.
    Materials and methods: Observational cohort study of 15 008 women attending one of 16 Marie Stopes International clinics in Australia for an EMA (gestational age ≤ 63 days) between 1 March 2013 and 30 September 2015. Administration of 200 mg oral mifepristone in-clinic was followed 24-48 h later by 800 μg buccal misoprostol self-administered at home. Method success was defined as complete abortion not requiring surgical intervention.
    Results: Follow-up information was available for 87.14% (13 078/15 008) of women. Likelihood of follow-up was significantly lower for women from rural or remote locations (adjusted odds ratio, 0.47; P < 0.001). Medical abortion was successful in 95.16% (12 445/13 078) of women with follow-up. Higher patient and gestational ages were associated (P < 0.001) with a slight increase in method failure. There were 674 serious adverse events (5.15%), mainly due to method failure. Infection (15; 0.11%) and haemorrhage (17; 0.13%) were rare. One death was recorded (<0.01%); however, an association between EMA and cause of death, necrotising pneumonia, was not established.
    Conclusion: Mifepristone-buccal misoprostol is an effective and safe alternative to surgical termination of pregnancy up to 63 days gestation.
    MeSH term(s) Abortifacient Agents, Nonsteroidal/adverse effects ; Abortifacient Agents, Steroidal/adverse effects ; Abortion, Induced/methods ; Administration, Buccal ; Administration, Oral ; Adolescent ; Adult ; Australia ; Female ; Gestational Age ; Humans ; Maternal Age ; Middle Aged ; Mifepristone/adverse effects ; Misoprostol/adverse effects ; Pregnancy ; Pregnancy Trimester, First ; Prospective Studies ; Young Adult
    Chemical Substances Abortifacient Agents, Nonsteroidal ; Abortifacient Agents, Steroidal ; Misoprostol (0E43V0BB57) ; Mifepristone (320T6RNW1F)
    Language English
    Publishing date 2017-03-17
    Publishing country Australia
    Document type Journal Article ; Multicenter Study
    ZDB-ID 390815-x
    ISSN 1479-828X ; 0004-8666
    ISSN (online) 1479-828X
    ISSN 0004-8666
    DOI 10.1111/ajo.12608
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  8. Article ; Online: Selective advantage of epigenetically disrupted cancer cells via phenotypic inertia.

    Loukas, Ioannis / Simeoni, Fabrizio / Milan, Marta / Inglese, Paolo / Patel, Harshil / Goldstone, Robert / East, Philip / Strohbuecker, Stephanie / Mitter, Richard / Talsania, Bhavik / Tang, Wenhao / Ratcliffe, Colin D H / Sahai, Erik / Shahrezaei, Vahid / Scaffidi, Paola

    Cancer cell

    2022  Volume 41, Issue 1, Page(s) 70–87.e14

    Abstract: The evolution of established cancers is driven by selection of cells with enhanced fitness. Subclonal mutations in numerous epigenetic regulator genes are common across cancer types, yet their functional impact has been unclear. Here, we show that ... ...

    Abstract The evolution of established cancers is driven by selection of cells with enhanced fitness. Subclonal mutations in numerous epigenetic regulator genes are common across cancer types, yet their functional impact has been unclear. Here, we show that disruption of the epigenetic regulatory network increases the tolerance of cancer cells to unfavorable environments experienced within growing tumors by promoting the emergence of stress-resistant subpopulations. Disruption of epigenetic control does not promote selection of genetically defined subclones or favor a phenotypic switch in response to environmental changes. Instead, it prevents cells from mounting an efficient stress response via modulation of global transcriptional activity. This "transcriptional numbness" lowers the probability of cell death at early stages, increasing the chance of long-term adaptation at the population level. Our findings provide a mechanistic explanation for the widespread selection of subclonal epigenetic-related mutations in cancer and uncover phenotypic inertia as a cellular trait that drives subclone expansion.
    MeSH term(s) Humans ; Mutation ; Neoplasms/genetics ; Neoplasms/pathology ; Phenotype
    Language English
    Publishing date 2022-11-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2078448-X
    ISSN 1878-3686 ; 1535-6108
    ISSN (online) 1878-3686
    ISSN 1535-6108
    DOI 10.1016/j.ccell.2022.10.002
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  9. Article ; Online: Reply to 'Response to Current barriers and potential strategies to increase the use of long-acting reversible contraception (LARC) to reduce the rate of unintended pregnancies in Australia: An expert roundtable discussion'.

    Bateson, Deborah / Mazza, Danielle / Frearson, Meredith / Goldstone, Philip / Kovacs, Gab / Baber, Rod

    The Australian & New Zealand journal of obstetrics & gynaecology

    2017  Volume 57, Issue 6, Page(s) E16–E17

    MeSH term(s) Australia ; Contraception ; Contraceptive Agents, Female ; Female ; Humans ; Long-Acting Reversible Contraception ; Pregnancy ; Pregnancy, Unplanned
    Chemical Substances Contraceptive Agents, Female
    Language English
    Publishing date 2017-10-25
    Publishing country Australia
    Document type Letter ; Comment
    ZDB-ID 390815-x
    ISSN 1479-828X ; 0004-8666
    ISSN (online) 1479-828X
    ISSN 0004-8666
    DOI 10.1111/ajo.12686
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  10. Article ; Online: Understanding the acceptability of e-mental health--attitudes and expectations towards computerised self-help treatments for mental health problems.

    Musiat, Peter / Goldstone, Philip / Tarrier, Nicholas

    BMC psychiatry

    2014  Volume 14, Page(s) 109

    Abstract: Background: E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health ... ...

    Abstract Background: E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of the present study was to investigate the acceptability of e-mental health and m-mental health in the general population.
    Methods: An advisory group of service users identified dimensions that potentially influence an individual's decision to engage with a particular treatment for mental health problems. A large sample (N = 490) recruited through email, flyers and social media was asked to rate the acceptability of different treatment options for mental health problems on these domains. Results were analysed using repeated measures MANOVA.
    Results: Participants rated the perceived helpfulness of an intervention, the ability to motivate users, intervention credibility, and immediate access without waiting time as most important dimensions with regard to engaging with a treatment for mental health problems. Participants expected face-to-face therapy to meet their needs on most of these dimensions. Computerised treatments and smartphone applications for mental health were reported to not meet participants' expectations on most domains. However, these interventions scored higher than face-to-face treatments on domains associated with the convenience of access. Overall, participants reported a very low likelihood of using computerised treatments for mental health in the future.
    Conclusions: Individuals in this study expressed negative views about computerised self-help intervention and low likelihood of use in the future. To improve the implementation and uptake, policy makers need to improve the public perception of such interventions.
    MeSH term(s) Adolescent ; Adult ; Aged ; Attitude ; Female ; Health Behavior ; Humans ; Male ; Mental Disorders/psychology ; Mental Disorders/therapy ; Mental Health ; Mental Health Services ; Middle Aged ; Patient Acceptance of Health Care ; Remote Consultation ; Self Care ; Therapy, Computer-Assisted ; Young Adult
    Language English
    Publishing date 2014-04-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1471-244X
    ISSN (online) 1471-244X
    DOI 10.1186/1471-244X-14-109
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