Long-term Survival of Multiple Myeloma Based on CBC Test at Diagnosis Using Defective Marshall-Olkin Cure Model

Introduction: As a malignant proliferative disorder, multiple myeloma (MM) is classified as a cancer of the immune system. Generally, a complete blood count (CBC) is the first test for a patient with symptoms of MM. Through CBC, physicians can monitor abnormalities in the blood. To normalize malignancies in their blood, patients must first go through conventional chemotherapy. Afterward, if eligible, subjects would receive high-dose therapy and hematopoietic stem cell transplantation (HSCT). Primarily, patients would be subjected to autologous hematopoietic stem cell transplantation (auto-HSCT). Materials and Methods: This retrospective cohort study consisted of 56 MM patients who were diagnosed between January 2010 and August 2016 and were followed up until February 2022. The survival rate of MM patients was assessed based on CBC test at the time of diagnosis. The clinical conditions, i.e., Thrombocytopenia, Leukopenia, and Anemia, were extracted from the CBC test and were used as the desired prognostic factors in companion with age at diagnosis. Overall survival based on the mentioned factors was analyzed using the defective Marshall-Olkin gompertz cure model, which was programmed in R software version 4.0.3. Results: The mean age at diagnosis was 52.76 (SD = 7.1). The probability of long-term survival for patients in this study was 46%, with five-year overall survival equaling 73.2%. Patients with thrombocytopenia had about 86% lower odds of long-term survival compared with patients with normal Platelet levels (Plt). Conclusion: The present study indicates that deficiency in Plt count is a significant factor leading to poor survival of MM patients

Restricted Mean Survival Time and Cure-Rate Modeling in Estimating Relapse-Free Survival Benefit With Adjuvant Dabrafenib + Trametinib Treatment in Melanoma

Abstract not available

Adjuvatno liječenje melanoma

For decades, interferon-alpha (IFN-α) has been the only option in the adjuvant treatment of high-risk melanoma. Despite numerous clinical trials and meta-analyzes, IFN-α is not yet a gold standard. It indeed showed benefit in progressionfree survival (PFS) and to a lesser extent in overall survival (OS) but at the cost of high toxicity. The emergence of new, revolutionary therapies in the treatment of metastatic melanoma, like immunotherapy (checkpoint inhibitors - CTLA4 and PD1 inhibitors) and targeted therapies (BRAF and MEK inhibitors), led to considering their potential effect in adjuvant/preventive use. A number of phase II and phase III trials analyzed the adjuvant application of targeted therapies and immunotherapies in completely resected stage III melanoma (IIIA, IIIB, IIIC) and stage IV melanoma (PD1 inhibitor nivolumab). They showed a clear benefit in relapse-free survival (RFS) and overall survival (OS). This led to a change in guidelines for adjuvant treatment of melanoma and approval of immunotherapy and targeted therapy by the FDA (Food and Drug Administration) and EMA (European medicines agency) in the indications mentioned above. Further trials are underway in other high-risk stages (like IIC) and in neoadjuvant treatment of stage III melanoma.Desetljećima je interferon alfa bio jedina opcija u adjuvatnoj terapiji visokorizičnog melanoma. Unatoč brojnim studijama i meta analizama, interferon nije zaživio kao zlatni standard liječenja visokorizičnog melanoma. Pokazao je svakako benefit u vremenu do progresije bolesti (PFS, progression free survival) te u manjem dijelu u ukupnom preživljenju (OS, overall survival) pod cijenu visoke toksičnosti. Pojavom revolucionarnih terapija u liječenju metastatskog melanoma; imunoterapije, anti CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) i anti PD-1 inhibitora (programmed cell death protein 1) te ciljane terapije (BRAF i MEK inhibitori) razmišljalo se o njihovom potencijalnom učinku u adjuvatnom/preventivnom smislu. Brojne studije faze II i III ispitivale su adjuvantnu primjenu ciljane terapije i imunoterapije u kompletno reseciranom stadiju III (IIIA, IIIB, IIIC) i stadiju IV (anti PD-1 inhibitor nivolumab). Pokazale su jasan benefit u vremenu do povratka bolesti (PFS) i ukupnom preživljenju (OS). Navedeni rezultati su promijenili smjernice za adjuvantnu terapiju kod melanoma u vidu registracije imunoterapije te ciljane terapije od strane FDA (Food and drug administration) i EMA (European medicines agency) za adjuvantnu primjenu. U tijeku su daljnja ispitivanja i u drugim visokorizičnim stadijima (npr. IIC) te neoadjuvantno liječenje stadija III

The Poisson-exponential regression model under different latent activation schemes

In this paper, a new family of survival distributions is presented. It is derived by considering that the latent number of failure causes follows a Poisson distribution and the time for these causes to be activated follows an exponential distribution. Three different activationschemes are also considered. Moreover, we propose the inclusion of covariates in the model formulation in order to study their effect on the expected value of the number of causes and on the failure rate function. Inferential procedure based on the maximum likelihood method is discussed and evaluated via simulation. The developed methodology is illustrated on a real data set on ovarian cancer. Mathematical subject classification: 62N01, 62N99