11 research outputs found
A modified regimen of biweekly gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer is both tolerable and effective: a retrospective analysis
Background: Treatment with nab-paclitaxel with gemcitabine demonstrates a survival advantage when compared with single-agent gemcitabine. However, the combination is associated with significant toxicities, leading to a high rate of drug discontinuation. We implemented a modified regimen of gemcitabine and nab-paclitaxel (mGNabP) in an attempt to minimize toxicities while maintaining efficacy. Methods: A total of 79 evaluable patients with metastatic pancreatic adenocarcinoma (mPC) treated with a modified regimen of gemcitabine (1000 mg/m 2 ) and nab-paclitaxel (125 mg/m 2 ) on days 1, 15 of every 28-day cycle were identified from our prospective database. A total of 57 patients received this regimen as first-line treatment and were evaluated for toxicities, progression-free survival (PFS), and overall survival (OS). Overall, 22 patients with advanced or metastatic PC treated with the modified regimen outside the first-line setting were only evaluated for toxicities. Results: The median OS and PFS were 10 months [95% confidence interval (CI) 5.9–13 months] and 5.4 months (95% CI 4.1–7.4 months) for patients that received the modified regimen as first-line therapy. Neurotoxicity occurred in 27% with only 1.6% of patients experiencing grade ⩾3 toxicity. The incidence of grade ⩾3 neutropenia was 19%, resulting in growth factor support in 12% of patients. This rate was similar in patients who received the modified regimen for first-line treatment of mPC versus the overall group. Conclusions: A modified regimen of biweekly nab-paclitaxel with gemcitabine is associated with a lower cost, acceptable toxicity profile and appears to be relatively effective in pancreatic cancer. Prospective randomized studies confirming its potential benefits compared with standard weekly mGNabP are warranted
A modified regimen of biweekly gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer is both tolerable and effective: a retrospective analysis
Adoption of triplet therapy and clinical outcomes in routine practice among newly diagnosed multiple myeloma patients not receiving frontline stem cell transplant in the USA
Transfusion-free interval is associated with improved survival in patients with higher-risk myelodysplastic syndromes engaged in routine care
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Real-world comparative effectiveness of triplets containing bortezomib (B), carfilzomib (C), daratumumab (D), or ixazomib (I) in relapsed/refractory multiple myeloma (RRMM) in the US.
Multiple available combinations of proteasome inhibitors, immunomodulators (IMIDs), and monoclonal antibodies are shifting the relapsed/refractory multiple myeloma (RRMM) treatment landscape. Lack of head-to-head trials of triplet regimens highlights the need for real-world (RW) evidence. We conducted an RW comparative effectiveness analysis of bortezomib (V), carfilzomib (K), ixazomib (I), and daratumumab (D) combined with either lenalidomide or pomalidomide plus dexamethasone (Rd or Pd) in RRMM. A retrospective cohort of patients initiating triplet regimens in line of therapy (LOT) ≥ 2 on/after 1/1/2014 was followed between 1/2007 and 3/2018 in Optums deidentified US electronic health records database. Time to next treatment (TTNT) was estimated using Kaplan-Meier methods; regimens were compared using covariate-adjusted Cox proportional hazard models. Seven hundred forty-one patients (820 patient LOTs) with an Rd backbone (VRd, n = 349; KRd, n = 218; DRd, n = 99; IRd, n = 154) and 348 patients (392 patient LOTs) with a Pd backbone (VPd, n = 52; KPd, n = 146; DPd, n = 149; IPd, n = 45) in LOTs ≥2 were identified. More patients ≥75 years received IRd (39.6%), IPd (37.8%), and VRd (36.7%) than other triplets. More patients receiving VRd/VPd were in LOT2 vs other triplets. Unadjusted median TTNT in LOT ≥ 2: VRd, 13.9; KRd, 8.7; IRd, 11.4; DRd, not estimable (NE); and VPd, 12.0; KPd, 6.7; IPd, 9.5 months; DPd, NE. In covariate-adjusted analysis, only KRd vs DRd was associated with a significantly higher risk of next LOT initiation/death (HR 1.72; P = 0.0142); no Pd triplet was significantly different vs DPd in LOT ≥ 2. Our data highlight important efficacy/effectiveness gaps between results observed in phase 3 clinical trials and those realized in the RW
Yttrium-90 Radioembolization as Salvage Therapy for Colorectal Cancer With Liver Metastases
Real-world comparative effectiveness of triplets containing bortezomib (B), carfilzomib (C), daratumumab (D), or ixazomib (I) in relapsed/refractory multiple myeloma (RRMM) in the US
Multiple available combinations of proteasome inhibitors,
immunomodulators (IMIDs), and monoclonal antibodies are shifting the
relapsed/refractory multiple myeloma (RRMM) treatment landscape. Lack of
head-to-head trials of triplet regimens highlights the need for
real-world (RW) evidence. We conducted an RW comparative effectiveness
analysis of bortezomib (V), carfilzomib (K), ixazomib (I), and
daratumumab (D) combined with either lenalidomide or pomalidomide plus
dexamethasone (Rd or Pd) in RRMM. A retrospective cohort of patients
initiating triplet regimens in line of therapy (LOT) >= 2 on/after
1/1/2014 was followed between 1/2007 and 3/2018 in Optum’s deidentified
US electronic health records database. Time to next treatment (TTNT) was
estimated using Kaplan-Meier methods; regimens were compared using
covariate-adjusted Cox proportional hazard models. Seven hundred
forty-one patients (820 patient LOTs) with an Rd backbone (VRd, n = 349;
KRd, n = 218; DRd, n = 99; IRd, n = 154) and 348 patients (392 patient
LOTs) with a Pd backbone (VPd, n = 52; KPd, n = 146; DPd, n = 149; IPd,
n = 45) in LOTs >= 2 were identified. More patients >= 75 years received
IRd (39.6%), IPd (37.8%), and VRd (36.7%) than other triplets. More
patients receiving VRd/VPd were in LOT2 vs other triplets. Unadjusted
median TTNT in LOT >= 2: VRd, 13.9; KRd, 8.7; IRd, 11.4; DRd, not
estimable (NE); and VPd, 12.0; KPd, 6.7; IPd, 9.5 months; DPd, NE. In
covariate-adjusted analysis, only KRd vs DRd was associated with a
significantly higher risk of next LOT initiation/death (HR 1.72; P =
0.0142); no Pd triplet was significantly different vs DPd in LOT >= 2.
Our data highlight important efficacy/effectiveness gaps between results
observed in phase 3 clinical trials and those realized in the RW