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Santero M, de Mas J, Rifà B, Clavero I, Rexach I, Bonfill Cosp X. Assessing the methodological strengths and limitations of the Spanish Society of Medical Oncology (SEOM) guidelines: a critical appraisal using AGREE II and AGREE-REX tool. Clin Transl Oncol 2024; 26:85-97. [PMID: 37368198 PMCID: PMC10761528 DOI: 10.1007/s12094-023-03219-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The Spanish Society of Medical Oncology (SEOM) has provided open-access guidelines for cancer since 2014. However, no independent assessment of their quality has been conducted to date. This study aimed to critically evaluate the quality of SEOM guidelines on cancer treatment. METHODS Appraisal of Guidelines for Research and Evaluation II (AGREE II) and AGREE-REX tool was used to evaluate the qualities of the guidelines. RESULTS We assessed 33 guidelines, with 84.8% rated as "high quality". The highest median standardized scores (96.3) were observed in the domain "clarity of presentation", whereas "applicability" was distinctively low (31.4), with only one guideline scoring above 60%. SEOM guidelines did not include the views and preferences of the target population, nor did specify updating methods. CONCLUSIONS Although developed with acceptable methodological rigor, SEOM guidelines could be improved in the future, particularly in terms of clinical applicability and patient perspectives.
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Affiliation(s)
| | - Júlia de Mas
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Berta Rifà
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Inés Clavero
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Irene Rexach
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
| | - Xavier Bonfill Cosp
- Universitat Autònoma Barcelona (UAB), Barcelona, Spain
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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2
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Lv Y, Jin P, Chen Z, Zhang P. Characterization of hazard infiltrating immune cells and relative risk genes in bladder urothelial carcinoma. Am J Transl Res 2020; 12:7510-7527. [PMID: 33312386 PMCID: PMC7724318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/08/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Bladder urothelial carcinoma (BLCA) is one of the most common malignancies in urinary system. With the development of next-generation sequencing technology, we intended to investigate prognostic immune cells and related signature to predict the prognosis of BLCA and potential therapeutic targets. METHODS We obtained the transcriptome profiles of 573 BLCA patients from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. The fractions of immune cells in each sample was calculated by "CIBERSORT" algorithm. Tumor Infiltrating Immune Cells Scores (TIICS) was accordingly derived and Receiver Operating Characteristic (ROC) curve was conducted to evaluate the predictive efficiency. Moreover, differential analysis was performed between two TIICS groups and hub TIICS-related immune signature was identified. The correlation of key immune genes and immune-infiltrating immune cells was evaluated based on the TIMER database. An Immune Signature Prognostic Index (ISPI) based on these signatures was constructed with superior predictive accuracy. Last, the TIICS model or related immune signature were all validated in an independent cohort from the GSE13507. RESULTS The least absolute shrinkage and selection operator (LASSO) algorithm was utilized to screen the 6 hub tumor-infiltrating immune cells in TCGA cohort, where higher infiltrating levels of M0 Macrophages, M2 Macrophages and Neutrophils were hazard factors, while CD8+ T cells and memory activated CD4+ T cells were protective factors. CONCLUSION Taken together, our study identified several prognostic immune cells and related immune signature in BLCA, shedding insight on the individualized immunotherapy or potential drug targets.
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Affiliation(s)
- Yinxiang Lv
- Department of Oncology, People’s Hospital of Xinchang CountyXinchang, Zhejiang Province, China
| | - Peng Jin
- Organ Transplant Center, Xiangya Hospital, Central South UniversityChangsha, Hunan Province, China
| | - Zheng Chen
- Organ Transplant Center, The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou, Guangdong Province, China
| | - Peng Zhang
- Organ Transplant Center, The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou, Guangdong Province, China
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3
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Maisch P, Retz M, Gschwend JE, Koll F, Schmid SC. Clinical Practice Guidelines for Bladder Cancer: A Systematic Review and Meta-Analysis Using the AGREE II Instrument. Urol Int 2020; 105:31-40. [PMID: 32829338 DOI: 10.1159/000509431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/07/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Numerous health care organizations have established guidelines on diagnosis and treatment of bladder cancer. However, the lack of a standardized guideline development approach results in considerable differences of the guidelines' methodological quality. OBJECTIVE To assess the methodological quality of all relevant clinical practice guidelines (CPGs) for urinary bladder cancer and provide a reference for clinicians in choosing guidelines of high methodological quality. EVIDENCE ACQUISITION A systematic literature search was conducted in Medline via PubMed, 4 CPG databases, and 7 databases of interdisciplinary organizations. CPGs for non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) with the topics screening, pathology, diagnosis, treatment, and aftercare published in English language between 2012 and 2018 were included. The CPG quality was analyzed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. EVIDENCE SYNTHESIS A total of 16 CPGs were included for the quality appraisal. Because of predefined criteria, 5 CPGs were "strongly recommended" (American Urological Association NMIBC, European Association of Urology [EAU] NMIBC, EAU MIBC, National Institute for Health and Care Excellence, and National Comprehensive Cancer Network), 4 CPGs were "weakly recommended" and 7 CPGs were "not recommended." CONCLUSIONS The methodological quality of bladder cancer guidelines is diverse. Considering the rapid development of new therapies (e.g., immune checkpoint inhibitors), "living guidelines" of high methodological quality, such as the EAU NMIBC or MIBC guideline, will become more relevant in the future guideline's landscape.
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Affiliation(s)
- Philipp Maisch
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany,
| | - Margitta Retz
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Florestan Koll
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Sebastian C Schmid
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
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4
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Van de Wiele C, Sathekge M, de Spiegeleer B, de Jonghe PJ, Beels L, Maes A. PSMA-Targeting Positron Emission Agents for Imaging Solid Tumors Other Than Non-Prostate Carcinoma: A Systematic Review. Int J Mol Sci 2019; 20:E4886. [PMID: 31581638 PMCID: PMC6801742 DOI: 10.3390/ijms20194886] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Despite its name, prostate-specific membrane antigen (PSMA) has been shown using immunohistochemistry (IHC) to also be over-expressed in the tumor neovasculature of a wide variety of solid tumors other than prostate carcinoma. Accordingly, positron-emitting radiolabeled small molecules targeting PSMA, initially developed for positron emission tomography in prostate carcinomas, are currently being explored for their staging and restaging potential as an alternative imaging modality in other solid tumor types where 18-F-fluorodeoxyglucose (FDG)-PET imaging has low diagnostic accuracy. In this paper, the currently available literature in this field is reviewed. Preliminary, mainly retrospective studies are encouraging, with evidence of improved diagnostic sensitivity and specificity in clear cell renal carcinoma, glioma, and hepatocellular carcinoma, leading to a change in patient management in several patients. However, the results published thus far warrant confirmation by larger prospective studies additionally assessing the longitudinal impact on patient outcomes.
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Affiliation(s)
- Christophe Van de Wiele
- Department of Nuclear Medicine, AZ Groeninge, 8500 Kortrijk, Belgium.
- Department of Nuclear Medicine and Radiology, University Ghent, 9000 GHent, Belgium.
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria, 0001 Pretoria, South-Africa.
| | - Bart de Spiegeleer
- Laboratory of Drug Quality and Registration, University Ghent, 9000 Ghent, Belgium.
| | | | - Laurence Beels
- Department of Nuclear Medicine, AZ Groeninge, 8500 Kortrijk, Belgium.
| | - Alex Maes
- Department of Nuclear Medicine, AZ Groeninge, 8500 Kortrijk, Belgium.
- Department of Imaging and Pathology, KULAK, University of Leuven, 3000 Leuven, Belgium.
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5
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Klén R, Salminen AP, Mahmoudian M, Syvänen KT, Elo LL, Boström PJ. Prediction of complication related death after radical cystectomy for bladder cancer with machine learning methodology. Scand J Urol 2019; 53:325-331. [PMID: 31552774 DOI: 10.1080/21681805.2019.1665579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To create a pre-operatively usable tool to identify patients at high risk of early death (within 90 days post-operatively) after radical cystectomy and to assess potential risk factors for post-operative and surgery related mortality.Materials and methods: Material consists of 1099 consecutive radical cystectomy (RC) patients operated at 16 different hospitals in Finland 2005-2014. Machine learning methodology was utilized. For model building and testing, the data was randomly divided into training data (n = 733, 66.7%) and independent testing data (n = 366, 33.3%). To predict the risk of early death after RC from baseline variables, a binary classifier was constructed using logistic regression with lasso regularization. Finally, a user-friendly risk table was constructed for practical use.Results: The model resulted in an area under the receiver operating characteristic curve (AUROC) of 0.73 (95% CI = 0.59-0.87). The strongest risk factors were: American Society of Anesthesiologists physical status classification (ASA), congestive heart failure (CHF), age adjusted Charlson comorbidity index (ACCI) and chronic pulmonary disease.Conclusion: This study with a novel methodological approach adds CHF and chronic pulmonary disease to previously known independent prognostic risk factors for early death after RC. Importantly, the risk prediction tool uses purely pre-operative data and can be used before surgery.
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Affiliation(s)
- Riku Klén
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Turku PET Centre, University of Turku, Turku, Finland
| | - Antti P Salminen
- Department of Urology, Turku University Hospital and University of Turku, Turku, Finland
| | - Mehrad Mahmoudian
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department of Future Technologies, University of Turku, Turku, Finland
| | - Kari T Syvänen
- Department of Urology, Turku University Hospital and University of Turku, Turku, Finland
| | - Laura L Elo
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
| | - Peter J Boström
- Department of Urology, Turku University Hospital and University of Turku, Turku, Finland
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6
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An overview on the methodological and reporting quality of dose–response meta-analysis on cancer prevention. J Cancer Res Clin Oncol 2019; 145:1201-1211. [DOI: 10.1007/s00432-019-02869-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/19/2019] [Indexed: 12/22/2022]
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7
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González Del Alba A, De Velasco G, Lainez N, Maroto P, Morales-Barrera R, Muñoz-Langa J, Pérez-Valderrama B, Basterretxea L, Caballero C, Vazquez S. SEOM clinical guideline for treatment of muscle-invasive and metastatic urothelial bladder cancer (2018). Clin Transl Oncol 2018; 21:64-74. [PMID: 30565086 PMCID: PMC6339669 DOI: 10.1007/s12094-018-02001-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 12/24/2022]
Abstract
The goal of this article is to provide recommendations about the management of muscle-invasive (MIBC) and metastatic bladder cancer. New molecular subtypes of MIBC are associated with specific clinical–pathological characteristics. Radical cystectomy and lymph node dissection are the gold standard for treatment and neoadjuvant chemotherapy with a cisplatin-based combination should be recommended in fit patients. The role of adjuvant chemotherapy in MIBC remains controversial; its use must be considered in patients with high-risk who are able to tolerate a cisplatin-based regimen, and have not received neoadjuvant chemotherapy. Bladder-preserving approaches are reasonable alternatives to cystectomy in selected patients for whom cystectomy is not contemplated either for clinical or personal reasons. Cisplatin-based combination chemotherapy is the standard first-line protocol for metastatic disease. In the case of unfit patients, carboplatin–gemcitabine should be considered the preferred first-line chemotherapy treatment option, while pembrolizumab and atezolizumab can be contemplated for individuals with high PD-L1 expression. In cases of progression after platinum-based therapy, PD-1/PD-L1 inhibitors are standard alternatives. Vinflunine is another option when anti-PD-1/PD-L1 therapy is not possible. There are no data from randomized clinical trials regarding moving on to immuno-oncology agents.
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Affiliation(s)
- A González Del Alba
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Joaquin Rodrigo 2, 28222, Majadahonda, Madrid, Spain.
| | - G De Velasco
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - N Lainez
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - P Maroto
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Morales-Barrera
- Medical Oncology Department, Vall d'Hebron Institute of Oncology, Vall d' Hebron University Hospital, Barcelona, Spain
| | - J Muñoz-Langa
- Medical Oncology Department, Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - B Pérez-Valderrama
- Medical Oncology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - L Basterretxea
- Medical Oncology Department, Hospital Donostia-Donostia Ospitalea, Donostia, Spain
| | - C Caballero
- Medical Oncology Department, Ciberonc, Centro de Investigación Biomédica en Red Cáncer. Hospital General Universitario de Valencia, Valencia, Spain
| | - S Vazquez
- Medical Oncology Department, Hospital Universitario Lucus Augusti, Lugo, Spain
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Ramírez de Olano A, Bellmunt J, Rodrigo A, Álvarez L, Terrádez A, García-Foncillas J, Laes JF. A Case Report Demonstrating the Potential Clinical Benefit of Exhaustive Molecular Profiling in an Aggressive Muscle-Invasive High-Grade Metastatic Urothelial Carcinoma. Case Rep Oncol 2017; 10:493-500. [PMID: 28690523 PMCID: PMC5498960 DOI: 10.1159/000477337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/05/2017] [Indexed: 11/19/2022] Open
Abstract
We present a muscle-invasive high-grade metastatic urothelial carcinoma patient, aged 71 years, with rapid progression from the diagnosis and a poor prognosis after 3 lines of treatment. A clinical exhaustive genomic profile was performed with the goal of finding potential actionable molecular alterations. The patient showed significant symptomatic and laboratory improvement with a nonstandard chemotherapy combination treatment identified by the molecular profiling, which would otherwise not have been considered. This approach illustrates the clinical benefit of a comprehensive genomic analysis in an aggressive and refractory urothelial carcinoma.
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Affiliation(s)
| | | | - Ana Rodrigo
- Biosequence S.L., Valencia, Spain.,OncoDNA SA, Gosselies, Belgium
| | - Luis Álvarez
- Biosequence S.L., Valencia, Spain.,OncoDNA SA, Gosselies, Belgium.,I3S Instituto de Investigação e Inovação da Universidade do Porto, Porto, Portugal
| | - Adriana Terrádez
- Biosequence S.L., Valencia, Spain.,OncoDNA SA, Gosselies, Belgium
| | - Jesús García-Foncillas
- Biosequence S.L., Valencia, Spain.,Institute University Hospital "Fundación Jiménez Díaz", Madrid, Spain
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Santaballa A, Martín M. SEOM guidelines 2016: an update. Clin Transl Oncol 2016; 18:1161-1162. [DOI: 10.1007/s12094-016-1592-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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