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Aberrations in plasma phospholipid fatty acids in lung cancer patients.

https://arctichealth.org/en/permalink/ahliterature128904
Source
Lipids. 2012 Apr;47(4):363-9
Publication Type
Article
Date
Apr-2012
Author
Rachel A Murphy
Taylor F Bureyko
Marina Mourtzakis
Quincy S Chu
M Thomas Clandinin
Tony Reiman
Vera C Mazurak
Author Affiliation
Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-126A Li Ka Shing Centre, Edmonton, AB T6G 2E1, Canada.
Source
Lipids. 2012 Apr;47(4):363-9
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy - metabolism - mortality
Aged
Antineoplastic Agents - administration & dosage - therapeutic use
Body mass index
Canada
Fatty Acids - analysis
Female
Humans
Lipid Metabolism - drug effects
Longitudinal Studies
Lung Neoplasms - drug therapy - metabolism - mortality
Male
Middle Aged
Neoplasm Staging
Phospholipids - analysis
Survival Rate
Weight Loss
Abstract
Abnormalities in lipid metabolism have been frequently observed in cancer and are associated with a poor prognosis. However, a detailed, longitudinal characterization of fatty acid status is lacking. This study aimed to assess plasma phospholipid fatty acids before chemotherapy, immediately after and 1 month following chemotherapy in a group of 50 patients newly diagnosed with lung cancer and explore factors which may contribute to aberrations in fatty acids. Their mean ± SD characteristics: age 64 ± 8.5 years, 75% advanced stage disease, body mass index 27.0 ± 5.4 kg/m², 6 month weight loss -4.6 ± 6.1%. Compared to patients with early stage disease, patients with advanced disease had abnormal fatty acid profiles including significantly lower (P
PubMed ID
22160451 View in PubMed
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Adjuvant chemotherapy for non-small cell lung cancer: practice patterns and outcomes in the general population of Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature127316
Source
J Thorac Oncol. 2012 Mar;7(3):559-66
Publication Type
Article
Date
Mar-2012
Author
Christopher M Booth
Frances A Shepherd
Yingwei Peng
Gail Darling
Gavin Li
Weidong Kong
William J Mackillop
Author Affiliation
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada. boothc@kgh.kari.net
Source
J Thorac Oncol. 2012 Mar;7(3):559-66
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy - epidemiology - mortality
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Canada - epidemiology
Carboplatin - administration & dosage
Carcinoma, Large Cell - drug therapy - epidemiology - mortality
Carcinoma, Non-Small-Cell Lung - drug therapy - epidemiology - mortality
Carcinoma, Squamous Cell - drug therapy - epidemiology - mortality
Chemotherapy, Adjuvant
Cisplatin - administration & dosage
Female
Follow-Up Studies
Humans
Lung Neoplasms - drug therapy - epidemiology - mortality
Male
Middle Aged
Neoplasm Staging
Physician's Practice Patterns
Retrospective Studies
Survival Rate
Treatment Outcome
Vinblastine - administration & dosage - analogs & derivatives
Young Adult
Abstract
Adjuvant chemotherapy (ACT) is known to improve survival in patients with early-stage non-small cell lung cancer. Herein, we describe chemotherapy regimens used, dose modifications, survival, and treatment-related toxicity in the general population.
All cases of non-small cell lung cancer diagnosed in Ontario in the period 2004-2006 who underwent surgical resection (n = 3354) were identified using the Ontario Cancer Registry in this population-based retrospective cohort study. We linked electronic records of treatment to the registry to identify all cases treated with ACT (n = 1032) and describe drugs, regimens, and dosages delivered. As a proxy measure of ACT-related toxicity, we evaluated deaths and hospitalizations within 16 weeks of starting ACT. Factors associated with dose modification were evaluated by logistic regression. The Cox proportional hazards model was used to describe associations between patient-, disease-, and treatment-related factors and survival.
ACT regimens were identified for 584 of 1032 ACT cases. Almost all cases included cisplatin- or carboplatin-based regimens (478/584, 82%, and 99/584, 17%, respectively). The most common regimen was a vinroelbine/cisplatin doublet (412/584, 71%); 64% of these cases had a dose reduction or omission. Dose modification was not associated with inferior survival on multivariate analysis. Twelve percent of all ACT cases were admitted to hospital within 16 weeks of starting ACT, and there was a 1.6% death rate potentially attributable to ACT. Survival of all ACT cases was comparable with outcomes reported in clinical trials.
ACT regimens used, toxicity, and survival outcomes in the general population are comparable with those reported in clinical trials. Dose modifications used in clinical practice are not associated with inferior survival.
PubMed ID
22307012 View in PubMed
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Adjuvant chemotherapy in resected lung cancer: two-year experience in a university hospital.

https://arctichealth.org/en/permalink/ahliterature155571
Source
Can Respir J. 2008 Jul-Aug;15(5):270-4
Publication Type
Article
Author
Nichole Bouchard
Francis Laberge
Bruno Raby
Sylvie Martin
Yves Lacasse
Author Affiliation
Clinique d'oncologie ambulatoire, Hôpital Laval, Sainte-Foy, Quebec.
Source
Can Respir J. 2008 Jul-Aug;15(5):270-4
Language
English
Publication Type
Article
Keywords
Antineoplastic Agents - therapeutic use
Chemotherapy, Adjuvant
Female
Follow-Up Studies
Hospitals, University - statistics & numerical data
Humans
Lung Neoplasms - drug therapy - mortality - surgery
Male
Middle Aged
Pneumonectomy - methods
Quebec - epidemiology
Retrospective Studies
Survival Rate - trends
Time Factors
Treatment Outcome
Abstract
Randomized trials have confirmed the benefits of adjuvant chemotherapy in improving survival in resected early-stage non-small-cell lung cancer (NSCLC). The extent to which these results have translated into clinical practice is unknown.
To examine the referral pattern of patients with resected lung cancer to adjuvant chemotherapy, and to compare compliance and toxicities with current literature.
A retrospective analysis of all patients who underwent a surgical resection for lung cancer at Laval Hospital (Quebec City, Quebec) from March 2004 to January 2006 was conducted.
A total of 258 patients underwent surgery. Seven patients were excluded because of early postoperative death, and two patients were excluded because of incomplete data. Data from 249 patients were analyzed (94% NSCLC). Fifty per cent were referred to medical oncology for consideration of adjuvant chemotherapy, including 37 of 61 patients with stage II NSCLC. One hundred patients received chemotherapy. No significant difference in age, sex, comorbidities and surgical procedures was observed between those who received chemotherapy and those who did not. Chemotherapy was initiated 47 days (median) after the surgery and consisted mainly of cisplatin-vinorelbine (38%), cisplatin-etoposide (22%) and carboplatin-paclitaxel (20%). Sixty-six per cent of the patients completed all four cycles. Grade 3 or 4 toxicities consisted mainly of fatigue (23%) and cytopenia (40%). No death was registered; 15% had to be hospitalized because of adverse effects.
Although adjuvant chemotherapy is gaining acceptance in clinical practice, more patients should be referred to medical oncology following surgical resection. Compliance and toxicity are similar to or better than those described in published randomized trials.
Notes
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Cites: Am J Respir Crit Care Med. 2002 Nov 1;166(9):1166-9612403687
Cites: N Engl J Med. 2004 Jan 22;350(4):351-6014736927
Cites: N Engl J Med. 2004 Jan 22;350(4):379-9214736930
Cites: Am J Clin Oncol. 1982 Dec;5(6):649-557165009
Cites: Chest. 2007 Sep;132(3 Suppl):324S-339S17873178
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Cites: N Engl J Med. 2005 Jun 23;352(25):2589-9715972865
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Cites: J Thorac Oncol. 2007 Jan;2(1):39-4317410008
Cites: Chest. 1997 Jun;111(6):1710-79187198
PubMed ID
18716690 View in PubMed
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Adjuvant chemotherapy uptake in non-small cell lung cancer.

https://arctichealth.org/en/permalink/ahliterature154462
Source
J Thorac Oncol. 2008 Nov;3(11):1272-8
Publication Type
Article
Date
Nov-2008
Author
Tallal Younis
Turki Al-Fayea
Kiran Virik
Wojciech Morzycki
Nathalie Saint-Jacques
Author Affiliation
Division of Medical Oncology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. tallal.younis@cdha.nshealth.ca
Source
J Thorac Oncol. 2008 Nov;3(11):1272-8
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Aged
Canada
Carcinoma, Non-Small-Cell Lung - drug therapy - pathology - surgery
Chemotherapy, Adjuvant
Combined Modality Therapy
Female
Humans
Lung Neoplasms - drug therapy - pathology - surgery
Male
Neoplasm Staging
Nova Scotia
Organoplatinum Compounds - therapeutic use
Prognosis
Retrospective Studies
Abstract
Adjuvant chemotherapy in non-small cell lung cancer (NSCLC) has become a new standard of care. This study examines the uptake patterns for adjuvant chemotherapy outside of clinical trials.
A retrospective study of all patients diagnosed with NSCLC in the year 2005 who underwent curative-intent surgery in Nova Scotia, Canada was conducted. Logistic regression models and discriminant function analyses were employed to identify cofactors associated with referral to medical oncology and/or utilization of adjuvant chemotherapy.
Of 540 patients with NSCLC, 108 underwent curative-intent surgery (67% lobectomy; 15% pneumonectomy; 19% wedge resection) for NSCLC (39% IA; 24% IB; 25% II; 14% III). Referral to medical oncology was observed in 44% (47 of 108) of all patients including 73% (30 of 41) of those with stage II-III. Adjuvant chemotherapy utilization was observed in 62% (29 of 47) of those referred including 73% (22 of 30) of those with stage II-III. Overall, 27% (29 of 108) of all patients received adjuvant chemotherapy, including 54% (22 of 41) of those with stage II-III. Higher uptake was significantly associated with age (younger versus older), stage (II/III versus I), and surgery type (pneumonectomy versus wedge). Weaker associations were observed with other cofactors including surgeon, health center, mean household income, and surgery-medical oncologist consult timeline.
The uptake of adjuvant chemotherapy in patients with resected NSCLC outside of clinical trials is low overall, but is higher among younger patients and those with more advanced stages. These uptake patterns may allow future planning of health resource utilization and/or improvement of chemotherapy utilization rates.
PubMed ID
18978562 View in PubMed
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Adjuvant vinorelbine and cisplatin in elderly patients: National Cancer Institute of Canada and Intergroup Study JBR.10.

https://arctichealth.org/en/permalink/ahliterature164056
Source
J Clin Oncol. 2007 Apr 20;25(12):1553-61
Publication Type
Article
Date
Apr-20-2007
Author
Carmela Pepe
Baktiar Hasan
Timothy L Winton
Lesley Seymour
Barbara Graham
Robert B Livingston
David H Johnson
James R Rigas
Keyue Ding
Frances A Shepherd
Author Affiliation
Division of Medical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada. carmela.pepe@mail.mcgill.ca
Source
J Clin Oncol. 2007 Apr 20;25(12):1553-61
Date
Apr-20-2007
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Canada
Carcinoma, Non-Small-Cell Lung - drug therapy - mortality - pathology - surgery
Chemotherapy, Adjuvant
Cisplatin - therapeutic use
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Geriatric Assessment
Humans
Lung Neoplasms - drug therapy - mortality - pathology - surgery
Male
Maximum Tolerated Dose
Middle Aged
Neoplasm Staging
Pneumonectomy
Probability
Prognosis
Proportional Hazards Models
Risk assessment
Survival Analysis
Vinblastine - adverse effects - analogs & derivatives - therapeutic use
Abstract
Recent trials have shown significant survival benefit from adjuvant chemotherapy for non-small-cell lung cancer (NSCLC). Whether elderly patients tolerate platinum-based adjuvant chemotherapy and derive the same survival advantage is unknown. This retrospective study evaluated the influence of age on survival, adjuvant chemotherapy delivery, and toxicity in National Cancer Institute of Canada (NCIC) Clinical Trials Group study JBR.10.
Pretreatment characteristics and survival were compared for 327 young ( 65 years) patients. Chemotherapy delivery and toxicity were compared for 213 treated patients (63 elderly, 150 young).
Baseline demographics by age were similar with the exception of histology (adenocarcinoma: 58% young, 43% elderly; squamous: 32% young, 49% elderly; P = .001) and performance status (PS; PS 0: 53% young, 41% elderly; P = .01). Chemotherapy significantly prolonged overall survival for elderly patients (hazard ratio, 0.61; 95% CI, 0.38 to 0.98; P = .04). This benefit is similar to the effect for all patients in JBR.10. Mean dose-intensities of vinorelbine and cisplatin were 13.2 and 18.0 mg/m2/wk in young, respectively, and 9.9 and 14.1 mg/m2/wk in elderly patients (vinorelbine, P = .0004; cisplatin, P = .001), respectively. The elderly received significantly fewer doses of vinorelbine (P = .014) and cisplatin (P = .006). Fewer elderly patients completed treatment and more refused treatment (P = .03). There were no significant differences in toxicities, hospitalization, or treatment-related death by age group. Fifteen (11.9%) of 126 deaths in the young resulted from nonmalignant causes, and 15 (21.1%) of 71 in the elderly (P = .13).
Despite elderly patients' receiving less chemotherapy, adjuvant vinorelbine and cisplatin improves survival in patients older than 65 years with acceptable toxicity. Adjuvant chemotherapy should not be withheld from elderly patients.
PubMed ID
17442999 View in PubMed
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An estimate of the cost of conducting phase II trials in lung cancer.

https://arctichealth.org/en/permalink/ahliterature199188
Source
Lung Cancer. 2000 May;28(2):85-95
Publication Type
Article
Date
May-2000
Author
W K Evans
S. Dahrouge
J. Stapleton
C. Quinn
D. Pollock
B. Waterfield
D. Lister
F. Hansel
A. Smith
Author Affiliation
The Ottawa Regional Cancer Centre, 190 Melrose Avenue, Ottowa, Canada.
Source
Lung Cancer. 2000 May;28(2):85-95
Date
May-2000
Language
English
Publication Type
Article
Keywords
Antineoplastic Combined Chemotherapy Protocols - economics - therapeutic use
Canada
Carcinoma, Small Cell - drug therapy - economics
Clinical Trials, Phase II as Topic - economics
Costs and Cost Analysis
Drug Costs
Humans
Lung Neoplasms - drug therapy - economics
Retrospective Studies
Abstract
Although it is commonly assumed that clinical trials are more costly than standard therapy, there have been no previous studies of the cost of conducting phase II trials in lung cancer. We retrospectively analyzed two National Cancer Institute of Canada phase II trials in previously untreated small cell lung cancer (SCLC) to determine the costs of conducting the trials in a cancer treatment centre. Both studies were clinical trials undertaken as part of the NCIC's Investigational New Drug program: IND 69 and IND 50 evaluated docetaxel (taxotere) and gemcitabine, respectively.
data management costs in a Canadian cancer treatment centre were determined from the time estimates provided by data managers to complete various protocol related tasks. Nursing and pharmacy personnel measured the time and supplies necessary to prepare and administer the chemotherapy. Physician fees were determined from the type and number of care visits required by the clinical protocols. Laboratory tests and imaging studies were costed according to the Ontario Health Insurance Plan (OHIP) Schedule of Fees and Benefits. To estimate whether phase II trials are more costly than standard treatment, we determined the cost of four cycles of VP-16-cisplatin, a standard treatment for SCLC.
The total cost of performing the docetaxel study was $18443 for an average cost per case of $1317 and an average cost per treatment cycle of $683. The gemcitabine study cost more, due to the fact that the drug proved to be active against SCLC and more cycles of therapy were administered to a larger number of patients. Laboratory and administration costs were also higher, because of the drug administration schedule. The total cost of this study was estimated to be $64670 and the average cost per patient entered was $2230 with an average cost per treatment cycle of $898. In comparison, the estimated cost of four cycles of VP-16-cisplatin chemotherapy was $3948 or $987 per treatment cycle. The major cost drivers in the clinical trials were laboratory and imaging tests which made up 17 and 39%, respectively, of the costs of the taxotere study, and 29 and 27%, respectively, for the gemcitabine study. Data management costs contributed 21 and 13% of the total costs, respectively.
As the main cost drivers in these phase II clinical trials are laboratory and imaging tests, the cost of clinical trials could potentially be reduced by ensuring that only essential tests are required by protocol. Not surprisingly, the cost of conducting a trial of an active agent is greater than for an inactive agent, because more patients are treated and each patient receives more treatment. The implications for the per-case funding of phase II clinical trials are discussed.
PubMed ID
10717326 View in PubMed
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Antiestrogen use and survival of women with non-small cell lung cancer in Manitoba, Canada.

https://arctichealth.org/en/permalink/ahliterature113520
Source
Horm Cancer. 2013 Oct;4(5):270-6
Publication Type
Article
Date
Oct-2013
Author
S A Lother
G A Harding
G. Musto
S. Navaratnam
M W Pitz
Author Affiliation
Faculty of Medicine, University of Manitoba, 260 Brodie Centre, 727 McDermot Ave, Winnipeg, MB, R3E3P5, Canada.
Source
Horm Cancer. 2013 Oct;4(5):270-6
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada
Carcinoma, Non-Small-Cell Lung - drug therapy - mortality - pathology
Cohort Studies
Estrogen Receptor Modulators - administration & dosage
Female
Humans
Lung Neoplasms - drug therapy - mortality - pathology
Manitoba - epidemiology
Middle Aged
Prognosis
Proportional Hazards Models
Survival Analysis
Treatment Outcome
Abstract
Lung cancer is the leading cause of cancer death worldwide. Sex differences in lung cancer incidence and survival are known. Female sex is an independent good prognostic factor. Estrogens appear to play a key role in lung cancer outcomes. Accordingly, antiestrogen use may also influence survival in female non-small cell lung cancer (NSCLC) patients. In this study, we compared survival among antiestrogen users and nonusers. We performed a retrospective population-based study. Using the Manitoba Cancer Registry (MCR), we identified all women diagnosed with NSCLC from 2000 to 2007. The population-based Drug Program Information Network was accessed to establish which patients received antiestrogens. Demographic data (e.g., smoking patterns, stage, histology) were gathered from the MCR and by chart review. Survival differences between antiestrogen-exposed and not exposed groups were compared using multivariable Cox regression. Two thousand three hundred twenty women fit our patient criteria, of which 156 had received antiestrogens. Exposure to antiestrogens was associated with a significantly decreased mortality in those exposed both before and after the diagnosis of NSCLC (adjusted hazard ratio, 0.42, p?=?0.0006). This association remained consistent across age and stage groups. Antiestrogen use before and after the diagnosis of NSCLC is associated with decreased mortality. This supports previous evidence that estrogens may play a key role in the biology and outcomes of NSCLC and suggests a potential therapeutic use for these agents in this disease.
PubMed ID
23715671 View in PubMed
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Brain relapses in chemotherapy-treated small cell lung cancer: a retrospective review of two time-dose regimens of therapeutic brain irradiation.

https://arctichealth.org/en/permalink/ahliterature22498
Source
Lung Cancer. 1996 Sep;15(2):171-81
Publication Type
Article
Date
Sep-1996
Author
F. Bach
J B Sørensen
L. Adrian
H. Larsen
S W Langer
K M Nelausen
S A Engelholm
Author Affiliation
Department of Oncology, University Hospital Herlev, Copenhagen, Denmark.
Source
Lung Cancer. 1996 Sep;15(2):171-81
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Adult
Aged
Brain Neoplasms - radiotherapy - secondary
Carcinoma, Small Cell - drug therapy - pathology
Dose-Response Relationship, Radiation
Female
Humans
Lung Neoplasms - drug therapy - pathology
Male
Middle Aged
Prognosis
Prospective Studies
Radiotherapy Dosage
Sex Factors
Abstract
The incidence of brain metastases secondary to small cell lung cancer (SCLC) is about 35% and the treatment strategy of brain irradiation with respect to dose and fractionation is controversial. In order to evaluate treatment outcome of brain irradiation in SCLC patients with brain relapse, we retrospectively evaluated all patients treated with brain irradiation in the eastern part of Denmark from 1988 to 1992 (PCI patients excluded). During this 5-year period, 101 evaluable patients were included (44 females, 57 males) (median age 61 years; range, 39-75 years). Forty-four patients, of whom 43 were in extracerebral complete remission (CR), received extended course (EC) brain irradiation (> 45 Gy, treatment schedule > 4 weeks). Fifty-seven patients received short course (SC) brain irradiation (
PubMed ID
8882983 View in PubMed
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Challenges to implementation of an epidermal growth factor receptor testing strategy for non-small-cell lung cancer in a publicly funded health care system.

https://arctichealth.org/en/permalink/ahliterature108458
Source
J Thorac Oncol. 2013 Sep;8(9):1136-41
Publication Type
Article
Date
Sep-2013
Author
Peter M Ellis
Sunil Verma
Sandeep Sehdev
Jawaid Younus
Natasha B Leighl
Author Affiliation
Department of Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario, Canada. peter.ellis@jcc.hhsc.ca
Source
J Thorac Oncol. 2013 Sep;8(9):1136-41
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - drug therapy - genetics - pathology
Aged
Aged, 80 and over
Canada
Carcinoma, Non-Small-Cell Lung - drug therapy - genetics - pathology
Female
Financing, Government
Follow-Up Studies
Health Plan Implementation
Health Services - trends
Humans
Lung Neoplasms - drug therapy - genetics - pathology
Male
Middle Aged
Mutation - genetics
Neoplasm Staging
Practice Guidelines as Topic - standards
Prognosis
Protein Kinase Inhibitors - therapeutic use
Quinazolines - therapeutic use
Receptor, Epidermal Growth Factor - genetics
Survival Rate
Abstract
Data from seven recent randomized clinical trials have demonstrated that epidermal growth factor (EGFR) mutation status is predictive of improved progression-free survival and quality of life from first-line EGFR tyrosine kinase inhibitor therapy compared with platinum-based chemotherapy. We examined barriers to the initial implementation of a national EGFR testing policy in Canada.
Five laboratories across Canada underwent a validation and quality-control exercise for EGFR mutation testing using reverse transcriptase-polymerase chain reaction with financial support from the pharmaceutical industry for the initial 12 months. Oncologists registered patients with nonquamous histology for EGFR mutation testing using a Web-based platform. Basic demographics were collected including age, histology, sex, smoking status, and ethnicity. The decision to prescribe gefitinib was subsequently registered on the system.
Between March and December 2010, 2104 requests were received for EGFR mutation testing. Demographic details are as follows: adenocarcinoma (91.6%); Asian ethnicity (13.9%); female (58%); light/never smoker (41.3%); stage IV disease (87.1%). The number of tests requested each month ranged from 200 to 250. Mutation testing was conducted in 1771 of 2104 requests (84%). The median turnaround time for EGFR testing was 18 days (standard deviation 9.7). Gefitinib was prescribed in 302 patients (17.1%). The number of test requests dropped to 50 to 100 per month at the end of the initial 12 months.
There was rapid uptake of EGFR mutation testing into routine clinical practice in Canada. Uptake of EGFR mutation testing dropped substantially once funding from pharmaceutical industry was discontinued. There is a need for a national strategy to ensure resources are in place to implement molecular testing for new molecularly targeted agents.
PubMed ID
23887170 View in PubMed
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117 records – page 1 of 12.