Cost-effectiveness of Chemotherapeutic Colon Cancer Regimens

https://openworks.mdanderson.org/sumexp21/1129/thumbnail.jp

Real-World Patterns of Everolimus Use in Patients with Metastatic Breast Cancer

© AlphaMed Press 2020 Background: There is limited literature on patterns of everolimus use and subsequent hospitalizations and emergency room (ER) visits in real-world clinical practice. In this study, we describe patterns of everolimus use and hospitalizations and ER visits in a large cohort of patients with breast cancer (BC). Materials and Methods: Patients with BC treated with everolimus were identified in the MarketScan database from 2009 to 2016. The pattern of everolimus use and frequency of associated ER visits and hospitalizations during treatment (between the first claim and 30 days after the last claim for everolimus) were identified. Descriptive statistics and regression models were used. Results: A total of 3,556 everolimus users were identified (median age of 60 years; median days of use, 112). The initial prescribed dose was 10 mg in 74.8% of the patients. Compared with the initial dose, 23.5% of patients had a dose change. Forty-six percent of patients were hospitalized or had an ER visit during the treatment with everolimus. Age greater than 71, higher comorbidity score, treatment year prior to 2012, and lower initial dose were found to be significantly associated with ER visit/hospitalization in the regression models. Conclusions: A significant proportion of patients receiving everolimus had an ER visit or hospitalization during the use of everolimus. These results provide data regarding risks and benefits of treatment with everolimus. These results will be helpful in identifying patients at higher risk of hospitalizations or ER visits and facilitate evidence-based decision making to avoid serious complications. Implications for Practice: Everolimus, a mammalian target of rapamycin inhibitor, is approved in combination with exemestane in patients with hormone receptor–positive tumors previously treated with anastrozole or letrozole. As new drugs become available, it is crucial to understand the adverse events and potential complications associated with the use of such drugs in the general population, outside of the controlled clinical trial setting. This study describes the patterns of everolimus use and adverse events, including hospitalization and emergency room visits, in a large cohort of patients with metastatic breast cancer in routine practice

Application of ultrasound and microencapsulation on Limosilactobacillus reuteri DSM 17938 as a metabolic attenuation strategy for tomato juice probiotication

Counteracting probiotic-induced physicochemical and sensory changes is a challenge in the development of probiotic beverages. The aim of the study is to apply ultrasound and microencapsulation for the attenuation of Limosilactobacillus reuteri DSM 17938 to avoid change in a probiotic tomato juice. Preliminarily, six ultrasound treatments were applied. Probiotic survival in acid environment (pH 2.5) and bile salts (1.5 g/l) after ultrasound treatment was also studied. The probiotic was inoculated in tomato juice in four forms: free cells (PRO-TJ), sonicated-free cells (US-TJ), untreated-microencapsulated (PRO-MC-TJ) and sonicated-microencapsulated cells (US-MC-TJ). Probiotic viability and pH were monitored during 28 days of storage at 4 and 20 °C. Sensory analysis was performed for PRO-TJ and US-MC-TJ sample (4 °C). Ultrasound (57 W for 6 min) did not affect cell survival and transitorily modulated probiotic acidifying capacity; it reduced probiotic survival in acidic environment but increased probiotic survival in bile salts solution. Ultrasound was effective in maintain pH value of tomato juice but only at 4 °C. Instead, microencapsulation with sodium-alginate leads to a more stable probiotic juice, particularly at 20 °C. Finally, probiotication slightly modified some sensory attributes of the juice. This study shows the potential of ultrasound and microencapsulation as attenuation strategies and highlights the need for process optimization to increase ultrasound efficacy

Concordance Between Electronic Health Record Data and Medicare Part D Claims Data for Oral Anticancer Drug Use

Real-world evidence from electronic health records (EHRs) and claims data are being evaluated for use in regulatory decision-making.1,2 The objective of our study was to determine the concordance between EHR and Medicare Part D (MPD) claims data for the receipt of oral anticancer agents, a rapidly growing treatment option for cancer

Preliminary lessons from COVID-19 disruptions of small-scale fishery supply chains

The ongoing COVID-19 pandemic and associated mitigation measures have disrupted global systems that support the health, food and nutrition security, and livelihoods of billions of people. These disruptions have likewise affected the small-scale fishery (SSF) sector, disrupting SSF supply chains and exposing weaknesses in the global seafood distribution system. To inform future development of adaptive capacity and resilience in the sector, it is important to understand how supply chain actors are responding in the face of a macroeconomic shock. Comparing across seven SSF case studies in four countries, we explore how actors are responding to COVID-19 disruptions, identify constraints to adaptive responses, and describe patterns of disruption and response across cases. In all cases examined, actors shifted focus to local and regional distribution channels and particularly drew on flexibility, organization, and learning to re-purpose pre-existing networks and use technology to their advantage. Key constraints to reaching domestic consumers included domestic restrictions on movement and labor, reduced spending power amongst domestic consumers, and lack of existing distribution channels. In addition, the lack of recognition of SSFs as essential food-producers and inequities in access to technology hampered efforts to continue local seafood supply. We suggest that the initial impacts from COVID-19 highlight the risks in of over-reliance on global trade networks. The SSFs that were able to change strategies most successfully had local organizations and connections in place that they leveraged in innovative ways. As such, supporting local and domestic networks and flexible organizations within the supply chain may help build resilience in the face of future macroeconomic shocks. Importantly, bolstering financial wellbeing and security within the domestic market both before and during such large-scale disruptions is crucial for supporting ongoing supply chain operations and continued food provision during macroeconomic crises

Colorectal and Breast Cancer Screening in the U.S. during the COVID-19 Pandemic

https://openworks.mdanderson.org/sumexp21/1063/thumbnail.jp

Cognitive Function in Older Breast Cancer Survivors after Chemotherapy​

https://openworks.mdanderson.org/sumexp23/1103/thumbnail.jp