29 research outputs found
Temporal Trends in Grade 3/4 Adverse Events and Associated Costs of Nivolumab Plus Cabozantinib Versus Sunitinib for Previously Untreated Advanced Renal Cell Carcinoma
Advanced Renal Cell Carcinoma; Adverse Events; NivolumabCarcinoma de células renales avanzado; Eventos adversos; NivolumabCarcinoma de cÚl·lules renals avançat; Esdeveniments adversos; NivolumabBackground and Objectives
Novel immunotherapy-based combination treatments have drastically improved clinical outcomes for previously untreated patients with advanced/metastatic renal cell carcinoma (aRCC). This study aimed to assess the temporal trends in grade 3/4 adverse event (AE) rates and associated costs of nivolumab plus cabozantinib combination therapy versus sunitinib monotherapy in previously untreated patients with aRCC.
Methods
Individual patient data from the CheckMate 9ER trial (nivolumab plus cabozantinib: N = 320; sunitinib: N = 320) were used to calculate the proportion of patients experiencing grade 3/4 AEs. AE unit costs were obtained from the United States (US) 2017 Healthcare Cost and Utilization Project (HCUP) and inflated to 2020 US dollars. Per-patient-per-month (PPPM) all-cause and treatment-related grade 3/4 AE costs over 18-months, temporal trends, and top drivers of AE costs were evaluated in both treatment arms.
Results
Overall, the proportion of patients experiencing grade 3/4 AEs decreased over time, with the highest rates observed in the first 3 months for the nivolumab plus cabozantinib and sunitinib arms. Compared with sunitinib, nivolumab plus cabozantinib was associated with consistently lower average all-cause AE costs PPPM [month 3: 3097 (p 0.05); month 18: 1755 (p > 0.05)]. Over 18 months, metabolism and nutrition disorders (182), and general disorders and administration site conditions (443), blood and lymphatic system disorders (177) were the costliest in the sunitinib arm. Trends of treatment-related AE costs were consistent with all-cause AE costs.
Conclusions
Nivolumab plus cabozantinib was associated with lower costs of grade 3/4 AE management PPPM than sunitinib, which accumulated over the 18-month study period
Grade 3/4 Adverse Event Costs of Immuno-oncology Combination Therapies for Previously Untreated Advanced Renal Cell Carcinoma
Advanced renal cell carcinoma; Adverse event cost; Nivolumab plus cabozantinibCarcinoma de células renales avanzado; Coste de eventos adversos; Nivolumab mås cabozantinibCarcinoma de cÚl·lules renals avançat; Cost d'esdeveniments adversos; Nivolumab més cabozantinibBackground
Despite 4 approved combination regimens in the first-line setting for advanced renal cell carcinoma (aRCC), adverse event (AE) costs data are lacking.
Materials and Methods
A descriptive analysis on 2 AE cost comparisons was conducted using patient-level data for the nivolumab-based therapies and published data for the pembrolizumab-based therapies. First, grade 3/4 AE costs were compared between nivolumabâ
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ipilimumab vs. nivolumabâ
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cabozantinib vs. pembrolizumabâ
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axitinib using data from the CheckMate 214 (median follow-up [mFU]: 13.1 months), CheckMate 9ER (mFU: 12.8 months), and KEYNOTE-426 (mFU: 12.8 months) trials, respectively. Second, grade 3/4 AE costs were compared between nivolumabâ
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ipilimumab vs. nivolumabâ
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cabozantinib vs. pembrolizumabâ
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lenvatinib using data from the CheckMate 214 (mFU: 26.7 months), CheckMate 9ER (mFU: 23.5 months), and KEYNOTE-581 (mFU: 26.6 months) trials, respectively. Per-patient costs for all-cause and treatment-related grade 3/4 AEs with corresponding any-grade AE ratesâ
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20% were calculated based on the Healthcare Cost and Utilization Project database and inflated to 2020 US dollars.
Results
Per-patient all-cause grade 3/4 AE costs for nivolumabâ
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ipilimumab vs. nivolumabâ
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cabozantinib vs. pembrolizumabâ
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axitinib were 4508 vs. 741 vs. 4440 over ~12.8 months of FU. For nivolumabâ
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ipilimumab vs. nivolumabâ
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cabozantinib vs. pembrolizumabâ
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lenvatinib, per-patient all-cause grade 3/4 AE costs were 5800 vs. 863 vs. 5030 over ~26.6 months of FU.
Conclusion
Patients with aRCC treated with first-line nivolumab-based therapies had lower grade 3/4 all-cause and treatment-related AE costs than pembrolizumab-based therapies, suggesting a more favorable cost-benefit profile.This study was funded by Bristol Myers Squibb
Overview and characterization of penile cancer content across social media platforms
BackgroundSocial media platforms (SMP) are an emerging resource that allows physicians, patients, and families to converse on cancer prevention, diagnosis, and treatment. We aimed to characterize penile cancer (PC) content shared on SMP.MethodsWe searched PC posts on Twitter, Facebook, and Instagram from July 1st, 2021, through June 30th, 2022. Two independent, blinded reviewers analyzed the hashtags: #PenileCancer, #PenileCancerAwareness, and #PenileNeoplasm. Descriptive statistics were used for posts characterization, PearsonÂŽs correlation coefficient for associations, and Cohenâs weighted kappa coefficient for inter-rater agreement rate.ResultsA total of 791 posts were analyzed, with Twitter accounting for 52%, Facebook for 12.2%, and Instagram for 35.5%, and. Most posts originated from high-income countries, such as the United Kingdom (48.8%). We found no correlation between the number of posts with PC incidence (p = 0.64) or users on SMP (p = 0.27). Most accounts were classified as âsupport and awareness communitiesâ (43.6%) and âphysicians and clinical researchersâ (38.2%). Urology was the most common medical specialty to post (60.9%), followed by oncology (11.3%). Most posts were classified as âprevention and awareness for usersâ (45.1%). Global inter-reviewer agreement rate was almost perfect (k=0.95; p †0.01). On Twitter, âphysicians and clinical researchersâ shared more content on âtreatment updates and medical papers published in medical journals,â while on Facebook and Instagram, âsupport and awareness communitiesâ focused on âpersonal and support comments.âConclusionOverall, the number of PC posts was low compared to other neoplasms across the SMP evaluated in this study. âPhysicians and clinical researchersâ shared more content on Twitter, while âsupport and awareness communitiesâ on Facebook and Instagram. Encouraging the use of a common SMP among the medical community and general users could lead to a more effective communication between physicians, patients, and support groups, and to increased awareness of PC
Survey of third-party parenting options associated with fertility preservation available to patients with cancer around the globe
bstract
PURPOSE In the accompanying article, âSurvey of Fertility Preservation Options Available to Patients With Cancer
Around the Globe,â we showed that specific fertility preservation services may not be offered at various sites
around the world because of cultural and legal barriers. We assessed global and regional experiences as well as
the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and
resource for groups that wish to begin oncofertility interventions.
METHODS We provide data on the legalities of third-party assisted reproductive technologies and other familybuilding options in the 28 oncofertility-practicing countries surveyed.
RESULTS We found regional and country differences that will be important in the development of tailored
resources for physicians and for patient brochures that are sensitive to these local restrictions and
cultural norms.
CONCLUSION Because many patients first consult Web-based materials, the formal assessment of the availability
of these options provides members of the global oncofertility community with data to which they might otherwise
not have ready access to better serve their patients
Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe
Purpose: In the accompanying article, âAnalysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,â we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients
A View from the Past Into our Collective Future: The Oncofertility Consortium Vision Statement
Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future
Global Oncology Authorship and Readership Patterns
PURPOSE
Global Oncology is the movement to improve equitable access to cancer control and care, recognizing challenges because of economic and social factors between high-, middle-, and low-income countries (HIC, MIC, and LIC, respectively). The JCO Global Oncology ( JCO GO) is a major platform dedicated to publishing peer-reviewed research relevant to populations with limited resources. To assess the success of its goals of encouraging global interaction and increasing MIC and LIC engagement, we analyzed authorship and readership patterns.
METHODS
Metadata of logged views between January 1, 2018, and June 30, 2019, of articles published in 2018 by JCO GO were identified using Google Analytics. The country of origin of each author and those who accessed the journal were categorized according to the 2019 income group World Bank Classification (WBC).
RESULTS
One hundred thirty-two articles were published in JCO GO in 2018. Corresponding authors came from 34 nations: 35% HIC, 47% MIC, and 18% LIC. The top publishing countries were the United States, India, Brazil, Mexico, and Nigeria. Article authors were solely from within one WBC group in 41% (23% HIC, 16% MIC, and 2% LIC). In those with mixed-WBC authorship origins, collaborations were 42% HIC + MIC, 11% HIC + LIC, and 6% HIC + MIC + LIC, but none with MIC + LIC. Regarding viewing, 87,860 views originated from 180 countries (82% of the WBC list): 35% HIC, 51% MIC, and 14% LIC. The most common accessing nations were the United States, India, the United Kingdom, Brazil, and Ethiopia.
CONCLUSION
More than half of JCO GO's authorship comes from mixed WBC groups, with viewership extending to most of the world's nations. Areas to address are low level of LIC corresponding authors, few papers from authors across all WBC groups, no publications from MIC + LIC collaborations, and a low percentage of readership by LIC. These data provide focus to target interventions aimed at reducing the academic segregation of LIC and improving interactions across all WBC countries
Local control rates of metastatic renal cell carcinoma (RCC) to the bone using stereotactic body radiation therapy: Is RCC truly radioresistant?
AbstrakBakteri heterotrofik sangat berperan penting dalam sistem perairan karena kemampuan aktivitas metabolismenya. Bakteri tersebut berinteraksi dengan logam dan mineral dalam lingkungan alam dan sintetis, mengubah keadaan fisik dan kimianya sehingga mempengaruhi aktivitas, pertumbuhan dan kelangsungan hidup bakteri. Penelitian ini bertujuan untuk mengisolasi dan mengkarakterisasi bakteri resisten logam timbal (Pb) dan asam di Situ Cibintu, Cibinong, Jawa Barat. Sampel air diambil dari 3 titik di Situ Cibuntu dan dianalisis distribusi bakteri heterotrofiknya. Isolat bakteri dikultur di media Triptone Glucose Yeast (TGY). Selanjutnya dilakukan resistensi terhadap logam timbal (Pb) dan asam. Hasil penelitian menunjukkan bahwa jumlah bakteri heterotrof di Situ Cibuntu rata-rata 3,5x103 cfu m/L. Mayoritas (73%) isolat bakteri resisten terhadap logam timbal sebanyak 47% dan resisten terhadap asam (pH 4). Bakteri yang resisten didominasi oleh Gram negatif. Penelitian ini memberikan pengetahuan mengenai kemampuan adaptasi bakteri heterotrof pada lingkungan logam dan asam.Abstract Heterotrophic bacteria play an important role in aquatic systems because of their ability of metabolic activities. They interact with metals and minerals in natural and synthetic environments, altering their physical and chemical state, with metals and minerals also able to affect activity, microbial growth and survival. The purpose of study is to isolate and characterize the lead (Pb) and acid resistant of heterotrophic bacteria strains isolated from pond Cibuntu, Cibinong, West Java. Water samples were collected from three points around pond Cibuntu and analyzed the distribution of heterotrophic bacteria. The bacterial isolates were screened on Triptone Glucose Yeast (TGY) agar plates. Lead (Pb) metal and acidic tolerance were tested. In the present study, the population density of heterotrophic bacteria were recorded 3.5x103 cfu m/L. The majority (73%) of bacteria isolates were resistant to lead and 47% to acid (pH 4). The most abundant type of bacteria resistant is Gram negative. This experiment provides the base to link the adaptation capabilities of heterotrophic bacteria in metal and acid environment.Permalink/DOI: http://dx.doi.org/10.15408/kauniyah.v9i2.308