Supplementary materials: Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA

These are peer-reviewed supplementary figures and tables for the article 'Treatment patterns and economic burden of bacterial vaginosis among commercially insured women in the USA' published in the Journal of Comparative Effectiveness Research.Supplementary Figure 1: Timing of events for the treated and untreated subgroupsSupplementary Figure 2: The covariate balance between the treated and untreated subgroupsSupplementary Table 1: Procedure and NDC codes for CLL treatmentsSupplementary Table 2: Diagnosis codes for SPMsAim: Improved management of chronic lymphocytic leukemia (CLL) has resulted in a growing populationof CLL survivors; these patients have a higher risk of developing second primary malignancies (SPMs) versusthe general population. This retrospective cohort study aims to assess the timing, frequency, incidence andtypes of SPMs in treated and untreated patients with CLL in the USA, using the Surveillance, Epidemiology,and End Results (SEER) Medicare database, which links a nationally representative cancer registry withMedicare claims data. Patients & methods: Patients aged ≥66 years with newly diagnosed CLL between1 January 2010 and 31 December 2016, who were enrolled in Parts A and B of Medicare for ≥12 monthspre-diagnosis of CLL were selected from the database. Patients were assessed for ≥36 months until the endof continuous enrollment in Medicare Parts A, B and D, a switch to a health maintenance organization,death, or end of the study period (December 2019). Results: Of 3053 patients included in the analyses,620 (20.3%) were treated and 2433 (79.7%) were untreated within 36 months of diagnosis. Overall,638 (20.9%) patients developed a SPM, 26.8% of patients in the treated cohort and 19.4% of patientsin the untreated cohort. The most common SPMs for both cohorts were squamous cell carcinoma andacute myeloid leukemia. Among the 166 treated patients who developed a SPM, a greater proportiondeveloped their first SPM after treatment initiation versus those who developed their first SPM priorto treatment initiation (p therapy developed a SPM (p Findings indicate that treatment type and timing can affect SPM development in patients with CLL.Combined with previous findings, this can help inform best practices in monitoring for SPM in patientswith CLL.</p

Overall survival in patients with glioblastoma before and after bevacizumab approval

<p><b>Objective:</b> Glioblastoma (GBM) is an aggressive disease with limited therapeutic options. While bevacizumab was approved in 2009 for the treatment of patients with progressive GBM, its impact on overall survival (OS) remains unclear. Using US population-based cancer registry data (SEER), this study compared OS of patients diagnosed with GBM before and after bevacizumab approval.</p> <p><b>Methods:</b> Adult patients from SEER with a GBM diagnosis were divided into two cohorts: patients diagnosed in 2006–2008 (pre-bevacizumab cohort, <i>n</i> = 6,120) and patients diagnosed in 2010–2012 (post-bevacizumab cohort, <i>n</i> = 6,753). Patients were included irrespective of the treatments received. OS post-diagnosis was compared between the study cohorts utilizing Kaplan-Meier analyses and multivariate Cox proportional hazards regression.</p> <p><b>Results:</b> Among 12,873 patients with GBM, the median age was 62 years, 41% were women, 31% underwent gross total resection, and 75% received radiation therapy. Survival was stable within the 2006–2008 period (median survival = 9 months for each year), but increased after year 2009 (median survival = 10 and 11 months for years 2010/2011 and 2012, respectively). The adjusted hazard of death was significantly lower in the post-bevacizumab approval cohort (hazard ratio = 0.91, <i>p</i> < .01).</p> <p><b>Conclusions:</b> The results of this large population-based study suggested an improvement in OS among patients with a GBM diagnosis in 2010–2012 compared to 2006–2008. While the cause of this improvement cannot be proven in a retrospective analysis, the timing of the survival increase coincides with the approval of bevacizumab for the treatment of patients with progressive GBM, indicating a possible benefit of bevacizumab in this population.</p