9 research outputs found
Cost-effectiveness of different human papillomavirus vaccines in Singapore
<p>Abstract</p> <p>Background</p> <p>Human papillomavirus (HPV) vaccines are widely available and there have been studies exploring their potential clinical impact and cost-effectiveness. However, few studies have compared the cost-effectiveness among the 2 main vaccines available - a bivalent vaccine against HPV 16/18, and a quadrivalent vaccine against 6/11/16/18. We explore the cost-effectiveness of these two HPV vaccines in tropical Singapore.</p> <p>Methods</p> <p>We developed a Markov state-transition model to represent the natural history of cervical cancer to predict HPV infection, cancer incidence, mortality, and costs. Cytologic screening and treatment of different outcomes of HPV infection were incorporated. Vaccination was provided to a cohort of 12-year old females in Singapore, followed up until death. Based on available vaccines on the market, the bivalent vaccine had increased effectiveness against a wider range of HPV types, while the quadrivalent vaccine had effectiveness against genital warts. Incremental cost-effectiveness ratios (ICER) compared vaccination to no-vaccination, and between the two vaccines. Sensitivity analyses explored differences in vaccine effectiveness and uptake, and other key input parameters.</p> <p>Results</p> <p>For the no vaccination scenario, 229 cervical cancer cases occurred over the cohort's lifetime. The total discounted cost per individual due to HPV infection was SGD12,866 per life-year saved. For the bivalent vaccine, 197 cancers were prevented with an ICER of 12,488 per life-year saved. However, the cost per QALY saved for the quadrivalent vaccine compared to no vaccine was 10,392 for the bivalent vaccine, with the quadrivalent vaccine dominating the bivalent vaccine due to the additional QALY effect from reduction in genital warts. The overall outcomes were most sensitive to vaccine cost and coverage.</p> <p>Conclusion</p> <p>HPV vaccination is a cost-effective strategy, and should be considered a possible strategy to reduce the impact of HPV infection.</p
A novel MLL5 isoform that is essential to activate E6 and E7 transcription in HPV16/18-associated cervical cancers
10.1158/0008-5472.CAN-11-1271Cancer Research71216696-6707CNRE
Uterine leiomyosarcoma in asian patients: Validation of the revised federation of gynecology and obstetrics staging system and identification of prognostic classifiers
10.1634/theoncologist.2012-0124Oncologist17101286-1293OCOL
Progression-free survival analysis.
<p>Abbreviation: HR, hazard ratio; CI, confidence interval; NE, not estimable.</p>a<p>P values for age at diagnosis, CA125 and HER2 amplification ratio were based on Wald test, and P values for all other variables were based on the log-rank test.</p>b<p>Based on Wald test.</p>c<p>To interpret with caution as there were <10 deaths in the fitted multivariable model.</p
HER2 amplification, age, and frequency of cancers reported in family history of mEOC.
<p>(A) Previous genome-wide copy number alteration study on a small cohort of mEOC (n = 17) showed significant amplification of HER2. x-axis shows chromosomes 1-X, with alternating gray blocks. y-axis is the −log(q) where q is the false discovery rate. Positive values indicate amplification and negative values are deletion. (B) Age distribution was of normal distribution overall and for both HER2+ and HER2− cases. The median age was 48.3 (range: 15 to 89 years). (C) Frequency of reported cancers in family history. Majority of cancers were of breast and gastrointestinal (colon/stomach) origin. Note: some patients reported more than 1 case of cancer in family history.</p
Clinicopathologic features by HER2 status.
<p>Abbreviation: OGD, oesophagogastroduodenoscopy.</p
Survival outcomes by HER2 status.
<p>No statistical significance was observed for HER2+ compared to HER2− cases in (A) overall survival (log-rank p = 0.249), and (B) progression free survival (log-rank p = 0.120).</p