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Mangalathevi Y, Azhany Y, Wan Hitam WH, Aziz ME. Optic Nerve Metastasis in Lung Adenocarcinoma. Cureus 2024; 16:e55413. [PMID: 38567233 PMCID: PMC10985281 DOI: 10.7759/cureus.55413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
In this article, we report a rare case of an optic nerve metastasis secondary to lung adenocarcinoma. The ocular manifestation was the first clinical sign of the disease, and further investigation led to the diagnosis of the underlying malignancy. A 59-year-old woman presented with progressive blurring of vision in the right eye for the past month. She had been having headaches for the past two weeks and left upper limb weakness for one day. She also had loss of appetite and weight for the past few months. She looked lethargic. On presentation, her bilateral eye vision was 6/18. Both anterior segments were unremarkable. Fundoscopy showed a normal optic disc in both eyes. A nervous system examination showed mild motor sensory impairment over the left upper and lower limbs and also impairment of cranial nerves V and VII. Brain computed tomography was conducted and revealed soft tissue lesions at the lateral aspect of the optic nerve and multiple recent cerebral infarcts. Brain and orbital magnetic resonance imaging showed a metastasis intraconal lesion at the right intraorbital segment of the optic nerve. CT thorax, abdomen, and pelvis were done. The finding revealed carcinoma of the left lung with distant metastasis. The patient's general condition deteriorated in less than two weeks. The family refused further intervention. The patient died three months after the initial presentation.
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Affiliation(s)
- Yelumalai Mangalathevi
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
| | - Yaakub Azhany
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
| | - Wan-Hazabbah Wan Hitam
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
| | - Mohd Ezane Aziz
- Department of Radiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, MYS
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Dzulkipli MR, Shafie AA, Maon SN, Ramli A, Yahaya AHM, Ho SW, Muhsin NIA, Ahmat ANMF. Determining the Willingness to Pay for Innovative Oncology Medicines in Malaysia. Value Health Reg Issues 2024; 40:19-26. [PMID: 37972430 DOI: 10.1016/j.vhri.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/29/2023] [Accepted: 10/02/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Early access to innovative oncology medicine is crucial to provide better treatment alternatives to patients with cancer. However, innovative oncology medicines often come at higher prices, thus limiting the government's ability for its universal coverage. Hence an alternative paying mechanism is needed. This study is intended to determine the willingness to pay (WTP) for innovative oncology medicines among Malaysians. METHODS A cross-sectional contingent valuation study on 571 Malaysians was conducted to elicit respondents' WTP value via bidding game approach. A double-bounded dichotomous choice was used in 3 hypothetical scenarios: innovative diabetes medicine, innovative oncology medicine one-off (IOMO), and innovative oncology medicine insurance. Univariate logistic regression was used to determine the factors affecting respondent's WTP, whereas the mean WTP value and the factors affecting amount to WTP was determined using a parametric 2-part model. RESULTS This study received 95% response rate. The mean age of the respondents is 48 years (SD 17) with majority of the respondents female (60.3%) and from ethnic Malay (62%). About 343 (64.7%) of the respondents expressed WTP for IOMO. Those in higher income bracket were willing to pay more for the access of IOMO than the overall WTP mean value (P = .046, coefficient 351.57). CONCLUSIONS More than half of Malaysian are willing to pay for IOMO at mean value of Malaysian Ringgit 279.10 (US dollar 66.77). Collaborative funding mechanisms and appropriate financial screening among the stakeholders could be introduced as methods to expedite the access of innovative oncology medicine among patients with cancer in Malaysia.
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Affiliation(s)
- Mohd Redhuan Dzulkipli
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; Faculty of Business and Management, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia
| | - Asrul Akmal Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
| | - Siti Noorsuriani Maon
- Faculty of Business and Management, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia
| | - Azuana Ramli
- Centre of Product and Cosmetics Evaluation, National Pharmaceutical Regulatory Agency (NPRA), Ministry of Health Malaysia, Petaling Jaya, Malaysia
| | | | - See Wan Ho
- Pharmacy Policy & Strategic Planning Division, Ministry of Health Malaysia, Petaling Jaya, Malaysia
| | - Nor Ilham Ainaa Muhsin
- Pharmacy Policy & Strategic Planning Division, Ministry of Health Malaysia, Petaling Jaya, Malaysia
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Sakamoto T, Matsubara T, Takahama T, Yokoyama T, Nakamura A, Tokito T, Okamoto T, Akamatsu H, Oki M, Sato Y, Tobino K, Ikeda S, Mori M, Mimura C, Maeno K, Miura S, Harada T, Nishimura K, Hiraoka M, Kenmotsu H, Fujimoto J, Shimokawa M, Yamamoto N, Nakagawa K. Biomarker Testing in Patients With Unresectable Advanced or Recurrent Non-Small Cell Lung Cancer. JAMA Netw Open 2023; 6:e2347700. [PMID: 38100106 PMCID: PMC10724778 DOI: 10.1001/jamanetworkopen.2023.47700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
Importance Biomarker testing for driver mutations is essential for selecting appropriate non-small cell lung cancer (NSCLC) treatment but is insufficient. Objective To investigate the status of biomarker testing and drug therapy for NSCLC in Japan for identifying problems in treatment. Design, Setting, and Participants The REVEAL cohort study included retrospective data collection and prospective follow-up from 29 institutions across Japan. Of 1500 patients diagnosed with advanced or recurrent NSCLC between January 1 and March 18, 2021, 1479 were eligible. Cases recognized at the wrong clinical stage (n = 12), diagnosed outside the study period (n = 6), not treated according to eligibility criteria before recurrence (n = 2), and with deficient consent acquisition procedure (n = 1) were excluded. Main Outcomes and Measures The primary end point was the biomarker testing status. Treatment-related factors were examined. Results Among the 1479 patients included in the analysis, the median age was 72 (range, 30-95) years; 1013 (68.5%) were men; 1161 (78.5%) had an Eastern Cooperative Oncology Group performance status 0 or 1; 1097 (74.2%) were current or past smokers; and 947 (64.0%) had adenocarcinoma. Biomarker status was confirmed in 1273 patients (86.1%). Multigene testing was performed in 705 cases (47.7%); single-gene testing, in 847 (57.3%); and both, in 279 (18.9%). Biomarker testing was performed for EGFR in 1245 cases (84.2%); ALK, in 1165 (78.8%); ROS1, in 1077 (72.8%); BRAF, in 803 (54.3%); and MET, in 805 (54.4%). Positivity rates among 898 adenocarcinoma cases included 305 (34.0%) for EGFR, 29 (3.2%) for ALK, 19 (2.1%) for ROS1, 11 (1.2%) for BRAF, and 14 (1.6%) for MET. Positivity rates among 375 nonadenocarcinoma cases were 14 (3.7%) for EGFR, 6 (1.6%) for ALK, 1 (0.3%) for ROS1, 3 (0.8%) for BRAF, and 8 (2.1%) for MET. Poor physical status, squamous cell carcinoma, and other comorbidities were associated with hampered multigene testing. Targeted therapy was received as first-line treatment by 263 of 278 cases (94.6%) positive for EGFR, 25 of 32 (78.1%) positive for ALK, 15 of 24 (62.5%) positive for ROS1, 9 of 12 (75.0%) positive for BRAF, and 12 of 19 (63.2%) positive for MET. Median overall survival of patients with positive findings for driver gene alteration and who received targeted therapy was 24.3 (95% CI, not reported) months; with positive findings for driver gene alteration and who did not receive targeted therapy, 15.2 (95% CI, 7.7 to not reported) months; and with negative findings for driver gene alteration, 11.0 (95% CI, 10.0-12.5) months. Multigene testing for nonadenocarcinomas and adenocarcinomas accounted for 705 (47.7%) of all NSCLC cases. Conclusions and Relevance These findings suggest that multigene testing has not been sufficiently implemented in Japan and should be considered prospectively, even in nonadenocarcinomas, to avoid missing rare driver gene alterations.
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Affiliation(s)
- Tomohiro Sakamoto
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Taichi Matsubara
- Department of Thoracic Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Takayuki Takahama
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tatsuro Okamoto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hiroaki Akamatsu
- Department of Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Masahide Oki
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine, Iizuka Hospital, Iizuka, Japan
| | - Satoshi Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Masahide Mori
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka City, Japan
| | - Chihiro Mimura
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken Maeno
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Toshiyuki Harada
- Center for Respiratory Diseases, Japan Community Health Care Organization Hokkaido Hospital, Sapporo, Japan
| | | | - Manabu Hiraoka
- Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | - Junya Fujimoto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Nobuyuki Yamamoto
- Department of Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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Lam DCL, Liam CK, Andarini S, Park S, Tan DSW, Singh N, Jang SH, Vardhanabhuti V, Ramos AB, Nakayama T, Nhung NV, Ashizawa K, Chang YC, Tscheikuna J, Van CC, Chan WY, Lai YH, Yang PC. Lung Cancer Screening in Asia: An Expert Consensus Report. J Thorac Oncol 2023; 18:1303-1322. [PMID: 37390982 DOI: 10.1016/j.jtho.2023.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/23/2023] [Accepted: 06/10/2023] [Indexed: 07/02/2023]
Abstract
INTRODUCTION The incidence and mortality of lung cancer are highest in Asia compared with Europe and USA, with the incidence and mortality rates being 34.4 and 28.1 per 100,000 respectively in East Asia. Diagnosing lung cancer at early stages makes the disease amenable to curative treatment and reduces mortality. In some areas in Asia, limited availability of robust diagnostic tools and treatment modalities, along with variations in specific health care investment and policies, make it necessary to have a more specific approach for screening, early detection, diagnosis, and treatment of patients with lung cancer in Asia compared with the West. METHOD A group of 19 advisors across different specialties from 11 Asian countries, met on a virtual Steering Committee meeting, to discuss and recommend the most affordable and accessible lung cancer screening modalities and their implementation, for the Asian population. RESULTS Significant risk factors identified for lung cancer in smokers in Asia include age 50 to 75 years and smoking history of more than or equal to 20 pack-years. Family history is the most common risk factor for nonsmokers. Low-dose computed tomography screening is recommended once a year for patients with screening-detected abnormality and persistent exposure to risk factors. However, for high-risk heavy smokers and nonsmokers with risk factors, reassessment scans are recommended at an initial interval of 6 to 12 months with subsequent lengthening of reassessment intervals, and it should be stopped in patients more than 80 years of age or are unable or unwilling to undergo curative treatment. CONCLUSIONS Asian countries face several challenges in implementing low-dose computed tomography screening, such as economic limitations, lack of efforts for early detection, and lack of specific government programs. Various strategies are suggested to overcome these challenges in Asia.
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Affiliation(s)
- David Chi-Leung Lam
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Chong-Kin Liam
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sita Andarini
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia - Persahabatan Hospital, Jakarta, Indonesia
| | - Samina Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Daniel S W Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore; Division of Medical Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - Navneet Singh
- Lung Cancer Clinic, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Seung Hun Jang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Varut Vardhanabhuti
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Antonio B Ramos
- Department of Thoracic Surgery and Anesthesia, Lung Center of the Philippines, Quezon City, Philippines
| | - Tomio Nakayama
- Division of Screening Assessment and Management, National Cancer Center Institute for Cancer Control, Japan
| | - Nguyen Viet Nhung
- Vietnam National Lung Hospital, University of Medicine and Pharmacy, VNU Hanoi, Vietnam
| | - Kazuto Ashizawa
- Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jamsak Tscheikuna
- Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Wai Yee Chan
- Imaging Department, Gleneagles Hospital Kuala Lumpur, Jalan Ampang, 50450 Kuala Lumpur; Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Pan-Chyr Yang
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan & National Taiwan University Hospital, Taipei, Taiwan.
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Nyanti LE, Chua CZ, Loo HC, Khor CZ, Toh ESY, Gill RS, Chan ET, Tan KY, Rosli T, Rahim MAA, Ibrahim A, Huan NC, Ramarmuty HYD, Kannan KKS. Determinants of Willingness to Undergo Lung Cancer Screening among High-Risk Current and Ex-smokers in Sabah, Malaysia: A Cross-Sectional Pilot Study. Tuberc Respir Dis (Seoul) 2023; 86:284-293. [PMID: 37643812 PMCID: PMC10555520 DOI: 10.4046/trd.2023.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 08/28/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer. METHODS A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening. RESULTS A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening. CONCLUSION Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.
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Affiliation(s)
- Larry Ellee Nyanti
- Medical Department, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Chia Zhen Chua
- Medical Department, Hospital Queen Elizabeth II, Kota Kinabalu, Malaysia
| | - Han Chuan Loo
- Medical Department, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
| | - Cheng Zhi Khor
- Medical Department, Hospital Queen Elizabeth II, Kota Kinabalu, Malaysia
| | | | | | - Eng Tat Chan
- Medical Department, Hospital Queen Elizabeth II, Kota Kinabalu, Malaysia
| | - Ker Yin Tan
- Medical Department, Hospital Queen Elizabeth II, Kota Kinabalu, Malaysia
| | - Taufiq Rosli
- Respiratory Department, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
| | - Muhammad Aklil Abd Rahim
- Public Health Department, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Arfian Ibrahim
- Department of Respiratory, Gleneagles Hospital Kota Kinabalu, Kota Kinabalu, Malaysia
| | - Nai Chien Huan
- Respiratory Department, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
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Tang ASO, Leong TS, Wong QY, Tan XY, Ko CT, Ngew KY, Teh EKJ, Chew LP. The Sarawak Myelofibrosis (SaMy) experience: Demographics and outcome of myelofibrosis patients in Sarawak, Malaysia. SAGE Open Med 2023; 11:20503121231194433. [PMID: 37705719 PMCID: PMC10496467 DOI: 10.1177/20503121231194433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/27/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction: Myelofibrosis is a rare disease. There is currently no published data reporting the demographics and outcome of myelofibrosis patients in Malaysia. We aimed to study the demographics, clinical characteristics, and outcome of our patients in Sarawak. Materials and methods: This non-interventional, retrospective, and multi-center study was conducted on secondary data of medical records collected at four Sarawak Public Hospitals. All adult myelofibrosis patients diagnosed between January 2001 and December 2021 were included. Results: A total of 63 patients (male 31) with myelofibrosis were included-47 (74.6%) primary and 16 (25.4%) secondary myelofibrosis. Eleven had antecedent polycythaemia vera, whereas five transformed from essential thrombocythaemia. The combined annual incidence rate was 0.182 per 100,000 population. The period prevalence per 100,000 population over the entire study duration was 2.502. The median age was 59.0 years (33.0-93.0). Majority had high-risk (34/63(54.0%)) and intermediate-2 risk disease (19/63(30.2%)). JAK2V617F mutation was identified in 52 patients (82.5%), followed by CALR mutation in 6 (9.5%) and negative for both mutations in 5 (7.9%). Hydroxyurea was used as first-line therapy in 41/63 (65.1%), followed by interferon (8/63(12.7%)) and ruxolitinib (4/63(6.3%)). Out of 46 patients who received second-line therapy, 18 (39.1%) were switched to ruxolitinib and 9 (19.6%) to interferon. The median age of survival for overall patients was 6.8 years. The use of ruxolitinib in myelofibrosis patients showed a better overall 5-year survival compared to the no ruxolitinib arm, despite no statistical significance (p = 0.34). Patients who had good performance status had lower hazard of death than patients who had poor performance status (high-risk (95% confidence intervals): 0.06(0.013-0.239), p < 0.001). Patients with intermediate risk disease had better overall survival compared to those in high-risk group (95% confidence intervals): 0.24(0.082-0.695), p = 0.009). Conclusion: This registry provides a real-world overview of myelofibrosis patients in our state and highlights the key insight into the unmet clinical need.
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Affiliation(s)
- Andy Sing Ong Tang
- Department of Medicine, Haematology Unit, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
| | - Tze Shin Leong
- Department of Medicine, Haematology Unit, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
| | - Qi Ying Wong
- Department of Medicine, Miri Hospital, Ministry of Health Malaysia, Miri, Sarawak, Malaysia
| | - Xin Yee Tan
- Department of Medicine, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia
| | - Ching Tiong Ko
- Department of Medicine, Haematology Unit, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
| | - Kok Yew Ngew
- RWE, CONEXTS, Novartis Corporation (Malaysia) Sdn Bhd, Petaling Jaya, Malaysia
| | - Erik Kah Jin Teh
- Medical Affairs, Novartis Corporation (Malaysia) Sdn Bhd, Petaling Jaya, Malaysia
| | - Lee Ping Chew
- Department of Medicine, Haematology Unit, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
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Rehman M, Ahmad U, Waseem M, Ali B, Tariq MI. Effects of Exercise Training in Patients with Lung Cancer during Chemotherapy Treatment. Malays J Med Sci 2023; 30:141-152. [PMID: 37102045 PMCID: PMC10125234 DOI: 10.21315/mjms2023.30.2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/06/2022] [Indexed: 04/28/2023] Open
Abstract
Background Cancer is the second greatest cause of death and disability after cardiovascular disease. Objective To determine the effects of exercise training in patients with lung cancer during chemotherapy treatment. Methods A randomised clinical trial was conducted in Shaukat Khanum Memorial Cancer Hospital and Institute of Radiotherapy and Nuclear Medicine (IRNUM) Peshawar. A total of 40 participants were randomly divided into two groups: i) the Experimental group (EG, n = 20) and ii) Control group (CG, n = 20). Both groups received exercise training for 4 weeks, with five sessions per week. The EG received pulmonary rehabilitation and aerobic training. The CG received only pulmonary rehabilitation. Both groups were evaluated at baseline and after 6 weeks through Mindful Attention Awareness Scale (MAAS) Urdu version, Six Minute Walk Test (6MWT), digital spirometry, Borgs scale, Hospital Anxiety and Depression Scale (HADs) and Visual Analogue Scale (VAS). Results Both the EG and CG showed significant improvement in MAAS scores at post-study with a (P < 0.001). The scores of 6MWT were improved significantly in both groups after intervention with a (P = 0.001). The patient's anxiety scores were significantly improved in both groups after intervention with a (P < 0.001), while depression scores were also improved considerably between the two groups at post-level with a (P < 0.001). Regarding spirometry value, both groups showed significant improvement after intervention for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC (P < 0.001). Both groups show significant differences in patient pain intensity and dyspnea at post-level with P < 0.001. Conclusion This study concluded that pulmonary rehabilitation along with aerobic training can be more effective than pulmonary rehabilitation alone for patients with lung cancer during chemotherapy treatment.
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Affiliation(s)
- Muheebur Rehman
- Department of Life Science, Abasyn University, Peshawar, Pakistan
| | - Uzair Ahmad
- College of Physical Therapy, Northwest Institute of Health Sciences, Peshawar, Pakistan
| | - Mehwish Waseem
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Babar Ali
- Department of Paramedics, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Muhammad Iqbal Tariq
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
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Poh ME, How SH, Ho GF, Pang YK, Hasbullah HH, Tho LM, Muhamad Nor I, Lim BC, Ho KF, Thiagarajan M, Samsudin A, Omar A, Ong CK, Soon SY, Tan JYK, Zainal Abidin MA. Real-World Treatment and Outcomes of ALK-Positive Metastatic Non-Small Cell Lung Cancer in a Southeast Asian Country. Cancer Manag Res 2023; 15:31-41. [PMID: 36660237 PMCID: PMC9844146 DOI: 10.2147/cmar.s393729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Purpose Anaplastic lymphoma kinase (ALK) inhibitors are associated with good overall survival (OS) for ALK-positive metastatic non-small cell lung cancer (NSCLC). However, these treatments can be unavailable or limited by financial constraints in developing countries. Using data from a nationwide lung cancer registry, the present study aimed to identify treatment patterns and clinical outcomes of ALK-positive NSCLC in Malaysia. Methods This retrospective study examined data of patients with ALK-positive NSCLC from 18 major hospitals (public, private, or university teaching hospitals) throughout Malaysia between January 1, 2015 and December 31, 2020 from the National Cardiovascular and Thoracic Surgical Database (NCTSD). Data on baseline characteristics, treatments, radiological findings, and pathological findings were collected. Overall survival (OS) and time on treatment (TOT) were calculated using the Kaplan-Meier method. Results There were 1581 NSCLC patients in the NCTSD. Based on ALK gene-rearrangement test results, only 65 patients (4.1%) had ALK-positive advanced NSCLC. Of these 65 patients, 59 received standard-of-care treatment and were included in the analysis. Crizotinib was the most commonly prescribed ALK inhibitor, followed by alectinib and ceritinib. Patients on ALK inhibitors had better median OS (62 months for first-generation inhibitors, not reached at time of analysis for second-generation inhibitors) compared to chemotherapy (27 months), but this was not statistically significant (P=0.835) due to sample-size limitations. Patients who received ALK inhibitors as first-line therapy had significantly longer TOT (median of 11 months for first-generation inhibitors, not reached for second-generation inhibitors at the time of analysis) compared to chemotherapy (median of 2 months; P<0.01). Conclusion Patients on ALK inhibitors had longer median OS and significantly longer TOT compared to chemotherapy, suggesting long-term benefit.
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Affiliation(s)
- Mau Ern Poh
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Soon Hin How
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
- Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | - Gwo Fuang Ho
- Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Harissa H Hasbullah
- Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh, Selangor, Malaysia
- Oncology and Radiotherapy Department, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Lye Mun Tho
- Department of Clinical Oncology, Beacon Hospital, Petaling Jaya, Selangor, Malaysia
| | - Ibtisam Muhamad Nor
- Oncology and Radiotherapy Department, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Bee Chiu Lim
- Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | - Kean Fatt Ho
- Mount Miriam Cancer Hospital, Tanjong Bungah, Penang, Malaysia
| | | | - Azlina Samsudin
- Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia
| | - Azza Omar
- Respiratory Unit, Medical Department, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
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9
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Mutational Profiling of Lung Cancer Using Next Generation Sequencing: A Malaysian Real-World Clinical Diagnostic Experience. JOURNAL OF MOLECULAR PATHOLOGY 2023. [DOI: 10.3390/jmp4010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Lung cancer is one of the most common cancers and a leading cause of cancer-related mortality in Malaysia. This analysis aimed to evaluate the prevalence of actionable and common mutations, as well as co-mutations frequently occurring with EGFR variants in lung cancer. Mutational profiling of lung tumour samples was performed using next generation sequencing (NGS) panels at the Subang Jaya Medical Centre laboratory. A total of 469 lung tumour samples referred from several medical facilities in Malaysia were analysed and 84% were of the adenocarcinoma subtype. The three most frequent mutations found were EGFR (46.5%), TP53 (37.5%) and KRAS (14.3%). Actionable mutations with approved drug targets for lung cancer were detected in 63.5% of patient samples. Among patients with EGFR mutations, deletions in exon 19 were detected in 44.5% and p.L858R in 38.5% of samples. The most common co-mutations for samples with EGFR mutations were found in the TP53 gene (38.1%). A median turnaround time (TAT) of 3 working days was achievable with an automated NGS platform. NGS testing can provide valuable information on the mutational landscape and the prevalence of common or actionable mutations present in lung cancer patients. This real-world experience demonstrates the high percentage of actionable mutations detected and highlights the value of NGS testing in a clinical diagnostic setting.
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10
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Kuan J, Masir N. A case report of synchronous primary gastric hodgkin lymphoma and lung adenocarcinoma and literature review. JOURNAL OF APPLIED HEMATOLOGY 2023. [DOI: 10.4103/joah.joah_100_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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11
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Nightingale C, Bavor C, Stone E, Rankin NM. Lung Cancer Screening: Implementation Challenges and Health Equity Considerations For the Western Pacific Region. JCO Glob Oncol 2023; 9:e2200329. [PMID: 36749907 PMCID: PMC10166439 DOI: 10.1200/go.22.00329] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- Claire Nightingale
- Center for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Claire Bavor
- Center for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Emily Stone
- Department of Lung Transplantation and Thoracic Medicine, St Vincent's Hospital Sydney, Darlinghurst, Australia.,Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Nicole M Rankin
- Center for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Sydney School of Public Health, The University of Sydney, Camperdown, Australia
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12
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Chow YP, Zainul Abidin N, Kow KS, Tho LM, Wong CL. Analytical and clinical validation of a custom 15-gene next-generation sequencing panel for the evaluation of circulating tumor DNA mutations in patients with advanced non-small-cell lung cancer. PLoS One 2022; 17:e0276161. [PMID: 36256645 PMCID: PMC9578623 DOI: 10.1371/journal.pone.0276161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This is a pilot proof-of-concept study to evaluate the utility of a custom 15-gene circulating tumor DNA (ctDNA) panel as a potential companion molecular next-generation sequencing (NGS) assay for identifying somatic single nucleotide variants and indels in non-small-cell lung cancer (NSCLC) patients. The custom panel covers the hotspot mutations in EGFR, KRAS, NRAS, BRAF, PIK3CA, ERBB2, MET, KIT, PDGFRA, ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 genes which serve as biomarkers for guiding treatment decisions in NSCLC patients. METHOD The custom 15-gene ctDNA NGS panel was designed using ArcherDX Assay Designer. A total of 20 ng or 50 ng input ctDNA was used to construct the libraries. The analytical performance was evaluated using reference standards at different allellic frequencies (0.1%, 1%, 5% and parental). The clinical performance was evaluated using plasma samples collected from 10 treatment naïve advanced stage III or IV NSCLC patients who were tested for tissue EGFR mutations. The bioinformatics analysis was performed using the proprietary Archer Analysis Software. RESULTS For the analytical validation, we achieved 100% sensitivity and specificity for the detection of known mutations in the reference standards. The limit of detection was 1% allelic frequency. Clinical validation showed that the clinical sensitivity and specificity of the assay for detecting EGFR mutation were 83.3% and 100% respectively. In addition, the NGS panel also detected other mutations of uncertain significance in 6 out of 10 patients. CONCLUSION This preliminary analysis showed that the custom 15-gene ctDNA NGS panel demonstrated good analytical and clinical performances for the EGFR mutation. Further studies incorporating the validation of other candidate gene mutations are warranted.
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Affiliation(s)
- Yock Ping Chow
- Clinical Research Centre, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Norziha Zainul Abidin
- Molecular Diagnostics Laboratory, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Ken Siong Kow
- Department of Medicine, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Lye Mun Tho
- Department of Medicine, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Chieh Lee Wong
- Clinical Research Centre, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
- Molecular Diagnostics Laboratory, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
- Department of Medicine, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
- Haematology Unit, Department of Medicine, Sunway Medical Centre, Petaling Jaya, Selangor Darul Ehsan, Malaysia
- Centre for Haematology, Hammersmith Hospital, London, United Kingdom
- Faculty of Medicine, Imperial College London, London, United Kingdom
- * E-mail:
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13
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Soo R, Mery L, Bardot A, Kanesvaran R, Keong TC, Pongnikorn D, Prasongsook N, Hutajulu SH, Irawan C, Manan AA, Thiagarajan M, Sripan P, Peters S, Storm H, Bray F, Stahel R. Diagnostic work-up and systemic treatment for advanced non-squamous non-small-cell lung cancer in four Southeast Asian countries. ESMO Open 2022; 7:100560. [PMID: 35988454 PMCID: PMC9588878 DOI: 10.1016/j.esmoop.2022.100560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Lung cancer is the second most common cancer and leading cause of cancer mortality worldwide. Recent advances in molecular testing and targeted therapy have improved survival among patients with metastatic non-small-cell lung cancer (NSCLC). We sought to quantify and describe molecular testing among metastatic non-squamous NSCLC cases in selected Southeast Asian countries and describe first-line therapy chosen. PATIENTS AND METHODS A retrospective study was conducted based on incident lung cancer cases diagnosed between 2017 and 2019 in Lampang (Thailand), Penang (Malaysia), Singapore and Yogyakarta (Indonesia). Cases (n = 3413) were defined using the International Classification of Diseases for Oncology third edition. In Singapore, a clinical series obtained from the National Cancer Centre was used to identify patients, while corresponding population-based cancer registries were used elsewhere. Tumor and clinical information were abstracted by chart review according to a predefined study protocol. Molecular testing of epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK) gene rearrangement, ROS1 gene rearrangement and BRAF V600 mutation was recorded. RESULTS Among 2962 cases with a specified pathological diagnosis (86.8%), most patients had non-squamous NSCLC (75.8%). For cases with staging information (92.1%), the majority presented with metastatic disease (71.3%). Overall, molecular testing rates in the 1528 patients with stage IV non-squamous NSCLC were 67.0% for EGFR, 42.3% for ALK, 39.1% for ROS1, 7.8% for BRAF and 36.1% for PD-L1. Among these patients, first-line systemic treatment included chemotherapy (25.9%), targeted therapy (35.6%) and immunotherapy (5.9%), with 31% of patients having no record of antitumor treatment. Molecular testing and the proportion of patients receiving treatment were highly heterogenous between the regions. CONCLUSIONS This first analysis of data from a clinically annotated registry for lung cancer from four settings in Southeast Asia has demonstrated the feasibility of integrating clinical data within population-based cancer registries. Our study results identify areas where further development could improve patient access to optimal treatment.
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Affiliation(s)
- R Soo
- Department of Hematology-Oncology, National University Hospital, Singapore, Singapore
| | - L Mery
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - A Bardot
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - R Kanesvaran
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - T C Keong
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - D Pongnikorn
- Cancer Registry Unit, Lampang Cancer Hospital, Lampang, Thailand
| | - N Prasongsook
- Medical Oncology Division, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - S H Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - C Irawan
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - A Ab Manan
- Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - M Thiagarajan
- Department of Radiotherapy and Oncology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - P Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiangmai, Thailand
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - H Storm
- Danish Cancer Society, Copenhagen, Denmark
| | - F Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - R Stahel
- ETOP IBCSG Partners Foundation, Bern, Switzerland.
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14
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Jiwnani S, Penumadu P, Ashok A, Pramesh CS. Lung Cancer Management in Low and Middle-Income Countries. Thorac Surg Clin 2022; 32:383-395. [PMID: 35961746 DOI: 10.1016/j.thorsurg.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Lung cancer is an increasing problem in the developing world due to rising trends in smoking, high incidence of air pollution, lack of awareness and screening, delayed presentation, and diagnosis at the advanced stage. Even after diagnosis, there are disparities in access to health care facilities and inequitable distribution of resources and treatment options. In addition, the shortage of trained personnel and infrastructure adds to the challenges faced by patients with lung cancer in these regions. A multi-pronged effort targeting tobacco cessation, health promotion and awareness, capacity building, and value-based care are the need of the hour.
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Affiliation(s)
- Sabita Jiwnani
- Division of Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, India.
| | - Prasanth Penumadu
- Department of Surgical Oncology, Jawaharlal Institute of Medical Education and Research, JIPMER, 5343, 3rd Floor, SSB, Gorimedu, Pondicherry 605006, India
| | - Apurva Ashok
- Division of Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Tata Memorial Hospital, 3rd Floor, Dr. E. Borges Road, Parel, Mumbai 400012, India
| | - C S Pramesh
- Division of Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Tata Memorial Hospital, Main Building, Ground Floor, Dr. E. Borges Road, Parel, Mumbai 400012, India
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15
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How SH, Tho LM, Liam CK, Hasbullah HH, Ho GF, Muhammad Nor I, Poh ME, Ho KF, Thiagarajan M, Samsudin A, Omar A, Ong CK, Pang YK, Soon SY. Programmed death-ligand 1 expression and use of immune checkpoint inhibitors among patients with advanced non-small-cell lung cancer in a resource-limited country. Thorac Cancer 2022; 13:1676-1683. [PMID: 35502623 PMCID: PMC9161340 DOI: 10.1111/1759-7714.14442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Immune checkpoint inhibitor (ICI) therapy is an established treatment for advanced non‐small‐cell lung cancer (NSCLC) and programmed death ligand‐1 (PD‐L1) expression is a recognized biomarker to determine response to therapy. We retrospectively analyzed NSCLC patients in the Malaysia Lung Cancer Registry (MLCR) and report on the clinical characteristics associated with PD‐L1 expression and ICI use in Malaysia, a low‐ to middle‐income country. Methods All 901 NSCLC patients in the MLCR who were diagnosed from January 1, 2017 to December 31, 2020 from 14 hospitals across the country were analyzed. Results Out of 901 patients, 505 had PDL‐1 testing done with complete data available only in 489 patients. The most common histology was adenocarcinoma (84.7%) followed by squamous cell carcinoma (10.2%). The majority (95%) presented with stage 3 or 4. The number and percentage of patients with PDL‐1 tumor proportion scores of ≥50%, 1–49%, and <1% were 138 (28.2%), 158 (32.3%), and 193 (39.5%), respectively. In multivariate analysis, the presence of genomic mutation is the only independent characteristic associated with negative PD‐L1 expression (crude odds ratio 0.579, 95% confidence interval 0.399–0.840, p = 0.004). Of 292 patients eligible for ICI therapy, only 100 patients (34.2%) received ICIs. Seventy‐eight patients received ICI therapy as first‐line treatment, 15 patients as second‐line treatment, and 7 patients as third‐line treatment. Conclusions This is the first analysis on PD‐L1 expression and ICI use in Malaysia. Despite the proven efficacy of ICI therapy, only 56% of our patients had PD‐L1 tests performed and only 34.2% of eligible patients received ICIs.
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Affiliation(s)
- Soon Hin How
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Malaysia
| | - Lye Mun Tho
- Department of Clinical Oncology, Beacon Hospital, Petaling Jaya, Malaysia
| | - Chong Kin Liam
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Harissa H Hasbullah
- Oncology Unit, Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh, Malaysia.,Oncology and Radiotherapy Department, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Gwo Fuang Ho
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ibtisam Muhammad Nor
- Oncology and Radiotherapy Department, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Mau Ern Poh
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Azza Omar
- Respiratory Unit, Medical Department, Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia
| | | | - Yong Kek Pang
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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16
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Baba Shekh AO, Abdul Wahab R, Yahya NA. Formulation of roselle extract water-in-oil nanoemulsion for controlled pulmonary delivery. J DISPER SCI TECHNOL 2022. [DOI: 10.1080/01932691.2022.2046044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Adil Omer Baba Shekh
- Faculty of Science, Department of Chemistry, Universiti Teknologi Malaysia, Baharu, Malaysia
- Enzyme Technology and Green Synthesis Group, Faculty of Science, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Roswanira Abdul Wahab
- Faculty of Science, Department of Chemistry, Universiti Teknologi Malaysia, Baharu, Malaysia
- Enzyme Technology and Green Synthesis Group, Faculty of Science, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Nur Azzanizawaty Yahya
- Faculty of Science, Department of Chemistry, Universiti Teknologi Malaysia, Baharu, Malaysia
- Enzyme Technology and Green Synthesis Group, Faculty of Science, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
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