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Cho BC, Penkov K, Bondarenko I, Kurochkin A, Pikiel J, Ahn HK, Korożan ME, Osipov M, Odintsova S, Braiteh F, Ribas A, Grilley-Olson JE, Lugowska I, Bonato V, Damore MA, Yang W, Jacobs IA, Bowers M, Li M, Johnson ML. A phase Ib/II dose expansion study of subcutaneous sasanlimab in patients with locally advanced or metastatic non-small-cell lung cancer and urothelial carcinoma. ESMO Open 2023; 8:101589. [PMID: 37385154 PMCID: PMC10485400 DOI: 10.1016/j.esmoop.2023.101589] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Sasanlimab is an antibody to the programmed cell death protein 1 receptor. We report updated data of subcutaneous sasanlimab in non-small-cell lung cancer (NSCLC) and urothelial carcinoma dose expansion cohorts from a first-in-human phase Ib/II study. PATIENTS AND METHODS Patients were ≥18 years of age with NSCLC or urothelial carcinoma, and no prior immunotherapies, who progressed on or were intolerant to systemic therapy, or for whom systemic therapy was refused or unavailable. Patients received subcutaneous sasanlimab at 300 mg every 4 weeks (q4w). Primary objectives were to evaluate safety, tolerability, and clinical efficacy by objective response rate (ORR). RESULTS Sixty-eight and 38 patients with NSCLC and urothelial carcinoma, respectively, received subcutaneous sasanlimab. Overall, sasanlimab was well tolerated; 13.2% of patients experienced grade ≥3 treatment-related adverse events. Confirmed ORR was 16.4% and 18.4% in the NSCLC and urothelial carcinoma cohorts, respectively. ORR was generally higher in patients with high programmed death-ligand 1 (PD-L1) expression (≥25%) and high tumor mutational burden (TMB; >75%). In the NSCLC and urothelial carcinoma cohorts, median progression-free survival (PFS) was 3.7 and 2.9 months, respectively; corresponding median overall survival (OS) was 14.7 and 10.9 months. Overall, longer median PFS and OS correlated with high PD-L1 expression and high TMB. Longer median PFS and OS were also associated with T-cell inflamed gene signature in the urothelial carcinoma cohort. CONCLUSIONS Subcutaneous sasanlimab at 300 mg q4w was well tolerated with promising clinical efficacy observed. Phase II and III clinical trials of sasanlimab are ongoing to validate clinical benefit. Subcutaneous sasanlimab may be a potential treatment option for patients with NSCLC or urothelial carcinoma.
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Affiliation(s)
- B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Seoul, Republic of Korea.
| | - K Penkov
- Private Healthcare Institution Clinical Hospital "RZhD-Medicine", St Petersburg, Russian Federation
| | - I Bondarenko
- Department of Oncology and Medical Oncology, Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Dnipro, Ukraine
| | - A Kurochkin
- Municipal Non-profit Enterprise of Sumy Regional Council, Sumy Regional Clinical Oncology Dispensary, Sumy, Ukraine
| | - J Pikiel
- Poradnia Onkologiczna, Szpitale Pomorskie Sp. z o.o, Gdynia, Poland
| | - H K Ahn
- Division of Medical Oncology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - M E Korożan
- Oddzial Onkologii Klinicznej, Szpital Grudziądz, Grudziądz, Poland
| | - M Osipov
- Sbhi "Lrcod", Vsevolozhsky District, Leningrad Region, Russian Federation
| | - S Odintsova
- Current Medical Technology, St Petersburg, Russian Federation
| | - F Braiteh
- Comprehensive Cancer Centers of Nevada, Las Vegas, USA
| | - A Ribas
- Jonsson Comprehensive Cancer Center, The University of California Los Angeles, Los Angeles, USA
| | | | - I Lugowska
- Early Phase Clinical Trials Unit, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | | | - W Yang
- Pfizer Inc, San Diego, USA
| | | | | | - M Li
- Pfizer Inc, San Francisco, USA
| | - M L Johnson
- Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, USA.
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Cook S, Hirschtick JL, Barnes G, Arenberg D, Bondarenko I, Patel A, Jiminez Mendoza E, Jeon J, Levy D, Meza R, Fleischer NL. Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study. BMJ Open 2023; 13:e062297. [PMID: 37085311 PMCID: PMC10124226 DOI: 10.1136/bmjopen-2022-062297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE Electronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study was to examine the prospective association between cigarette and ENDS use on self-reported incident hypertension. DESIGN Longitudinal cohort study. SETTING Nationally representative sample of the civilian, non-institutionalised population in the USA. PARTICIPANTS 17 539 adults aged 18 or older who participated at follow-up and had no self-reported heart condition or previous diagnosis of hypertension or high cholesterol at baseline. MEASURES We constructed a time-varying tobacco exposure, lagged by one wave, defined as no use, exclusive established use (every day or some days) of ENDS or cigarettes, and dual use. We controlled for demographics (age, sex, race/ethnicity and household income), clinical risk factors (family history of heart attack, obesity, diabetes and binge drinking) and smoking history (cigarette pack-years). OUTCOMES Self-reported incident hypertension diagnosis. RESULTS The self-reported incidence of hypertension was 3.7% between wave 2 and wave 5. At baseline, 18.0% (n=5570) of respondents exclusively smoked cigarettes; 1.1% (n=336) exclusively used ENDS; and 1.7% (n=570) were dual users. In adjusted models, exclusive cigarette use was associated with an increased risk of self-reported incident hypertension compared with non-use (adjusted HR (aHR) 1.21, 95% CI 1.06 to 1.38), while exclusive ENDS use (aHR 1.00, 95% CI 0.68 to 1.47) and dual use (aHR 1.15, 95% CI 0.87 to 1.52) were not. CONCLUSIONS We found that smoking increased the risk of self-reported hypertension, but ENDS use did not. These results highlight the importance of using prospective longitudinal data to examine the health effects of ENDS use.
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Affiliation(s)
- Steven Cook
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jana L Hirschtick
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Geoffrey Barnes
- Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan, USA
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas Arenberg
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Irina Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Akash Patel
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Levy
- Georgetown University, Washington, DC, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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Sánchez-Romero LM, Bondarenko I, Knoll M, Hirschtick JL, Cook S, Fleischer NL, Levy DT. Assessment of Electronic Nicotine Delivery Systems With Cigarette Use and Self-reported Wheezing in the US Adult Population. JAMA Netw Open 2023; 6:e236247. [PMID: 37010872 PMCID: PMC10071334 DOI: 10.1001/jamanetworkopen.2023.6247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Importance The prevalence of electronic nicotine delivery systems (ENDS) use has increased, leading to a concern about their respiratory health outcomes. It is unclear whether ENDS use increases the risk of wheezing, a common symptom of respiratory conditions. Objective To provide an analysis of the longitudinal association between ENDS and cigarette use and self-reported wheezing among US adults. Design, Setting, and Participants The US nationally representative Population Assessment of Tobacco and Health (PATH) Study was used. Longitudinal data for adults 18 years or older from wave 1 (2013-2014) to wave 5 (2018-2019) were analyzed. Data were analyzed from August 2021 to January 2023. Main Outcomes and Measures The prevalence of self-reported wheezing (waves 2-5) was estimated for 6 strata of tobacco product use (never cigarette and noncurrent ENDS use, never cigarette and current ENDS use, current cigarette and noncurrent ENDS use, current cigarette and current ENDS use, former cigarette and noncurrent ENDS use, and former cigarette and current ENDS use). A generalized estimating equations framework evaluated the association between cigarette and ENDS use and self-reported wheezing at the subsequent wave. An interaction term between cigarette and ENDS use was added to estimate the association between joint cigarette and ENDS use categories and the association of ENDS within strata of cigarette use. Results The analytical sample consisted of 17 075 US adults with a mean (SD) age of 45.4 (17) years, of whom 8922 (51%) were female and 10 242 (66%) were Non-Hispanic White. When compared with never cigarette and noncurrent ENDS use, the greatest association in reporting wheezing was for current cigarette and current ENDS use (adjusted odds ratio [AOR], 3.26; 95% CI, 2.82-3.77), which was similar to current cigarette and noncurrent ENDS use (AOR, 3.20; 95% CI, 2.91-3.51) and substantially greater than former cigarette and current ENDS use (AOR, 1.94; 95% CI, 1.57-2.41). Associations were small and not statistically significant for the odds of self-reported wheezing among never cigarette and current ENDS use when compared with never cigarette and noncurrent ENDS use (AOR, 1.20; 95% CI, 0.83-1.72), and for odds of wheezing and current cigarette and current ENDS use when compared with current cigarette and noncurrent ENDS use (AOR, 1.02; 95% CI, 0.91-1.15). Conclusions and Relevance In this cohort study, exclusive ENDS use was not associated with an increase in the risk of self-reported wheezing. However, a small increase in risk between ENDS use and wheezing was reported by individuals who use cigarettes. This study adds to the literature about the potential health effects associated with ENDS use.
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Affiliation(s)
| | | | - Marie Knoll
- Department of Oncology, Georgetown University, Washington, DC
| | | | - Steven Cook
- Department of Epidemiology, University of Michigan, Ann Arbor
| | | | - David T Levy
- Department of Oncology, Georgetown University, Washington, DC
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Kilickap S, Özgüroğlu M, Sezer A, Gumus M, Bondarenko I, Gogishvili M, Türk H, Cicin I, Bentsion D, Gladkov O, Clingan P, Sriuranpong V, He X, Pouliot JF, Seebach F, Lowy I, Gullo G, Rietschel P. 10MO EMPOWER-Lung 1: Cemiplimab (CEMI) monotherapy as first-line (1L) treatment of patients (pts) with brain metastases from advanced non-small cell lung cancer (aNSCLC) with programmed cell death-ligand 1 (PD-L1) ≥50% — 3-year update. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Kalinka E, Bondarenko I, Gogishvili M, Melkadze T, Baramidze A, Sezer A, Makharadze T, Kilickap S, Gumus M, Penkov K, Giorgadze D, Özgüroğlu M, He X, Pouliot JF, Seebach F, Lowy I, Gullo G, Rietschel P. 114M0 First-line cemiplimab for locally advanced non-small cell lung cancer: Updated subgroup analyses from EMPOWER-Lung 1 and EMPOWER-Lung 3. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00369-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Garassino M, Kilickap S, Özgüroğlu M, Sezer A, Gumus M, Bondarenko I, Gogishvili M, Nechaeva M, Schenker M, Cicin I, Fuang H, Kulyaba Y, Dvorkin M, Zyuhal K, Scheusan RI, He X, Kaul M, Okoye E, Li Y, Li S, Pouliot JF, Seebach F, Lowy I, Gullo G, Rietschel P. OA01.05 Three-year Outcomes per PD-L1 Status and Continued Cemiplimab Beyond Progression + Chemotherapy: EMPOWER-Lung 1. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Hirschtick JL, Cook S, Patel A, Barnes GD, Arenberg D, Bondarenko I, Levy DT, Jeon J, Jimenez Mendoza E, Meza R, Fleischer NL. Longitudinal Associations Between Exclusive and Dual Use of Electronic Nicotine Delivery Systems and Cigarettes and Self-Reported Incident Diagnosed Cardiovascular Disease Among Adults. Nicotine Tob Res 2023; 25:386-394. [PMID: 35907264 PMCID: PMC9910147 DOI: 10.1093/ntr/ntac182] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The cardiovascular health effects of electronic nicotine delivery systems (ENDS) use are not well characterized, making it difficult to assess ENDS as a potential harm reduction tool for adults who use cigarettes. AIMS AND METHODS Using waves 1-5 of the Population Assessment of Tobacco and Health Study (2013-2019), we analyzed the risk of self-reported incident diagnosed myocardial infarction (MI; 280 incident cases) and stroke (186 incident cases) associated with ENDS and/or cigarette use among adults aged 40 + using discrete time survival models. We employed a time-varying exposure lagged by one wave, defined as exclusive or dual established use of ENDS and/or cigarettes every day or some days, and controlled for demographics, clinical factors, and past smoking history. RESULTS The analytic samples (MI = 11 031; stroke = 11 076) were predominantly female and non-Hispanic White with a mean age of 58 years. At baseline, 14.2% of respondents exclusively smoked cigarettes, 0.6% exclusively used ENDS, and 1.0% used both products. Incident MI and stroke were rare during follow-up (< 1% at each wave). Compared to no cigarette or ENDS use, exclusive cigarette use increased the risk of MI (aHR 1.99, 95% CI = 1.40-2.84) and stroke (aHR 2.26, 95% CI = 1.51-3.39), while exclusive ENDS use (MI: aHR 0.61, 95% CI = 0.12-3.04; stroke: aHR 1.74, 95% CI = 0.55-5.49) and dual use (MI: aHR 1.84, 95% CI = 0.64-5.30; stroke: aHR 1.12, 95% CI = 0.33-3.79) were not significantly associated with the risk of either outcome. CONCLUSIONS Compared to non-use, exclusive cigarette use was associated with an increased risk of self-reported incident diagnosed cardiovascular disease over a 5-year period, while ENDS use was not associated with a statistically significant increase in the outcomes. IMPLICATIONS Existing literature on the health effects of ENDS use has important limitations, including potential reverse causation and improper control for cigarette smoking. We accounted for these issues by using a prospective design and adjusting for current and former smoking status and cigarette pack-years. In this context, we did not find that ENDS use was associated with a statistically significant increase in self-reported incident diagnosed myocardial infarction or stroke over a 5-year period. While more studies are needed, this analysis provides an important foundation and key methodological considerations for future research on the health effects of ENDS use.
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Affiliation(s)
- Jana L Hirschtick
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Steven Cook
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Akash Patel
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Geoffrey D Barnes
- Frankel Cardiovascular Center, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Douglas Arenberg
- Pulmonary Clinic, Department of Internal Medicine, University of Michigan Health System, Northville, MI, USA
| | - Irina Bondarenko
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, D.C., USA
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Evelyn Jimenez Mendoza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Ho G, Sezer A, Kilickap S, Gumus M, Bondarenko I, Ozguroglu M, Gogishvili M, He X, Gullo G, Rietschel P, Quek R. 334P Patient-reported outcomes with cemiplimab versus chemotherapy in advanced non-small cell lung cancer (aNSCLC): Geographic region subgroups in EMPOWER-Lung 1. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Ho G, Ozguroglu M, Kilickap S, Sezer A, Gumus M, Bondarenko I, Gogishvili M, Nechaeva M, Schenker M, Cicin I, Kulyaba Y, Dvorkin M, Zyuhal K, Scheusan R, Li S, Pouliot JF, Seebach F, Lowy I, Gullo G, Rietschel P. 327P Three years survival outcome and continued cemiplimab (CEMI) beyond progression with the addition of chemotherapy (chemo) for patients (pts) with advanced non-small cell lung cancer (NSCLC): The EMPOWER-lung 1 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Kilickap S, Sezer A, Gümüş M, Bondarenko I, Özgüroğlu M, Gogishvili M, He X, Gullo G, Rietschel P, Quek R. P1.15-12 Patient-reported Outcomes of Cemiplimab versus Chemotherapy in Advanced NSCLC: PD-L1 Level Subgroups in EMPOWER-Lung 1. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oza A, Lisyanskaya A, Fedenko A, de Melo A, Shparik Y, Bondarenko I, Colombo N, Lorusso D, Cibula D, Póka R, Oaknin A, Safra T, Maćkowiak-Matejczyk B, Ma L, Thomas D, Lin K, McLachlan K, Goble S, Kristeleit R. 518O Overall survival results from ARIEL4: A phase III study assessing rucaparib vs chemotherapy in patients with advanced, relapsed ovarian carcinoma and a deleterious BRCA1/2 mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Ahn MJ, Spigel D, Bondarenko I, Kalinka E, Cho B, Sugawara S, Galffy G, Shim B, Kislov N, Nagarkar R, Demedts I, Gans S, Oliva D, Stewart R, Lai Z, Grainger E, Shi X, Hussein M. P1.15-11 Durvalumab + Olaparib vs Durvalumab Alone as Maintenance Therapy in Metastatic NSCLC: Outcomes from the Phase 2 ORION Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Reinmuth N, Goldman J, Chen Y, Hotta K, Statsenko G, Hochmair M, Özgüroğlu M, Ji J, Garassino M, Poltoratskiy A, Verderame F, Havel L, Bondarenko I, Losonczy G, Conev N, Mann H, Chugh P, Dalvi T, Paz-Ares L. 1530P Durvalumab (D) + platinum-etoposide (EP) in first-line extensive-stage SCLC (ES SCLC): Effect of age and platinum agent on outcomes in CASPIAN. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bondarenko I, Sezer A, Kilickap S, Gümüş M, Özgüroğlu M, Gogishvili M, He X, Gullo G, Rietschel P, Quek R. 112P Patient-reported outcomes (PROs) with first-line (1L) cemiplimab in patients with locally advanced non-small cell lung cancer (laNSCLC): EMPOWER-Lung 1 subpopulation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Felip E, Altorki N, Zhou C, Vallieres E, Vynnychenko I, Akopov A, Martinez-Marti A, Chella A, Bondarenko I, Ursol G, Levchenko E, Kislov N, Liersch R, Belleli R, McNally V, Bennett E, Gitlitz B, Wakelee H. 80O Atezolizumab (atezo) vs best supportive care (BSC) in stage II-IIIA NSCLC with high PD-L1 expression: Sub-analysis from the pivotal phase III IMpower010 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mistry R, Bondarenko I, Jeon J, Brouwer AF, Mattingly DT, Hirschtick JL, Jimenez-Mendoza E, Levy DT, Land SR, Elliott MR, Taylor JMG, Meza R, Fleischer NL. Latent class analysis of use frequencies for multiple tobacco products in US adults. Prev Med 2021; 153:106762. [PMID: 34358593 PMCID: PMC8595688 DOI: 10.1016/j.ypmed.2021.106762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
A persistent challenge is characterizing patterns of tobacco use in terms of product combinations and frequency. Using Wave 4 (2016-17) Population Assessment of Tobacco and Health Study adult data, we conducted latent class analyses (LCA) of past 30-day frequency of use for 9 tobacco products. One-step LCA with joint multinomial logistic regression models compared sociodemographic factors between users (n = 13,716) and non-users (n = 17,457), and between latent classes of users. We accounted for survey design and weights. Our analyses identified 6 classes: in addition to non-users (C0: 75.7%), we found 5 distinct latent classes of users: daily exclusive cigarette users (C1: 15.5%); occasional cigarette and polytobacco users (C2: 3.8%); frequent e-product and occasional cigarette users (C3: 2.2%); daily smokeless tobacco (SLT) and infrequent cigarette users (C4: 2.0%); and occasional cigar users (C5: 0.8%). Compared to C1: C2 and C3 had higher odds of being male (versus female), younger (especially 18-24 versus 55 years), and having higher education; C2 had higher, while C3 and C4 had lower, odds of being a racial/ethnic minority (versus Non-Hispanic White); C4 and C5 had much higher odds of being male (versus female) and heterosexual (versus sexual minority) and having higher income; and C5 had higher odds of college or more education. We identified three classes of daily or frequent users of a primary product (cigarettes, SLT or e-products) and two classes of occasional users (cigarettes, cigars and polytobacco). Sociodemographic differences in class membership may influence tobacco-related health disparities associated with specific patterns of use.
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Affiliation(s)
- Ritesh Mistry
- University of Michigan, Department of Health Behavior and Health Education, Ann Arbor, MI, United States of America.
| | - Irina Bondarenko
- University of Michigan, Department of Biostatistics, Ann Arbor, MI, United States of America
| | - Jihyoun Jeon
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Andrew F Brouwer
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Delvon T Mattingly
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Jana L Hirschtick
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Evelyn Jimenez-Mendoza
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - David T Levy
- Georgetown University, School of Medicine, Washington, DC, United States of America
| | - Stephanie R Land
- National Institutes of Health, National Cancer Institute, Bethesda, MD, United States of America
| | - Michael R Elliott
- University of Michigan, Department of Biostatistics, Ann Arbor, MI, United States of America
| | - Jeremy M G Taylor
- University of Michigan, Department of Biostatistics, Ann Arbor, MI, United States of America
| | - Rafael Meza
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Nancy L Fleischer
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
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Abstract
Multiple imputation is a well-established general technique for analyzing data with missing values. A convenient way to implement multiple imputation is sequential regression multiple imputation, also called chained equations multiple imputation. In this approach, we impute missing values using regression models for each variable, conditional on the other variables in the data. This approach, however, assumes that the missingness mechanism is missing at random, and it is not well-justified under not-at-random missingness without additional modification. In this paper, we describe how we can generalize the sequential regression multiple imputation imputation procedure to handle missingness not at random in the setting where missingness may depend on other variables that are also missing but not on the missing variable itself, conditioning on fully observed variables. We provide algebraic justification for several generalizations of standard sequential regression multiple imputation using Taylor series and other approximations of the target imputation distribution under missingness not at random. Resulting regression model approximations include indicators for missingness, interactions, or other functions of the missingness not at random missingness model and observed data. In a simulation study, we demonstrate that the proposed sequential regression multiple imputation modifications result in reduced bias in the final analysis compared to standard sequential regression multiple imputation, with an approximation strategy involving inclusion of an offset in the imputation model performing the best overall. The method is illustrated in a breast cancer study, where the goal is to estimate the prevalence of a specific genetic pathogenic variant.
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Affiliation(s)
| | | | - Michael R Elliot
- Department of Biostatistics, 1259University of Michigan, USA.,Survey Methodology Program, Institute for Social Research, USA
| | - Allison W Kurian
- Departments of Medicine and Epidemiology and Population Health, 6429Stanford University, USA
| | - Steven J Katz
- Department of Internal Medicine, 1259University of Michigan, USA
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18
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O'Malley D, Neffa M, Monk B, Melkadze T, Kryzhanivska A, Bulat I, Meniawy T, Bondarenko I, Ortuzar Feliu W, Ancukiewicz M, Lugowska I. 724MO Balstilimab (anti-PD-1) in combination with zalifrelimab (anti-CTLA-4): Final results from a phase II study in patients (pts) with recurrent/metastatic (R/M) cervical cancer (CC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Gafanov R, Powles T, Bedke J, Stus V, Waddell T, Nosov D, Pouliot F, Soulieres D, Melichar B, Azevedo S, McDermott R, Vynnychenko I, Borchiellini D, Markus M, Bondarenko I, Lin J, Burgents J, Molife L, Plimack E, Rini B. 669P Subsequent therapy following pembrolizumab + axitinib or sunitinib treatment for advanced renal cell carcinoma (RCC) in the phase III KEYNOTE-426 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Felip E, Vallieres E, Zhou C, Wakelee H, Bondarenko I, Sakai H, Saito H, Ursol G, Kawaguchi K, Liu Y, Levchenko E, Kislov N, Reck M, Liersch R, McNally V, Zhu Q, Ding B, Bennett E, Gitlitz B, Altorki N. LBA9 IMpower010: Sites of relapse and subsequent therapy from a phase III study of atezolizumab vs best supportive care after adjuvant chemotherapy in stage IB-IIIA NSCLC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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21
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Kurian AW, Abrahamse P, Bondarenko I, Hamilton AS, Deapen D, Gomez SL, Morrow M, Berek JS, Hofer TP, Katz SJ, Ward KC. Association of Genetic Testing Results with Mortality Among Women with Breast Cancer or Ovarian Cancer. J Natl Cancer Inst 2021; 114:245-253. [PMID: 34373918 DOI: 10.1093/jnci/djab151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/15/2021] [Accepted: 08/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Breast cancer and ovarian cancer patients increasingly undergo germline genetic testing. However, little is known about cancer-specific mortality among carriers of a pathogenic variant (PV) in BRCA1/2 or other genes in a population-based setting. METHODS Georgia and California Surveillance Epidemiology and End Results (SEER) registry records were linked to clinical genetic testing results. Women were included who had stages I-IV breast cancer or ovarian cancer diagnosed in 2013-2017; received chemotherapy; and linked to genetic testing results. Multivariable Cox proportional hazard models were used to examine the association of genetic results with cancer-specific mortality. RESULTS 22,495 breast and 4,320 ovarian cancer patients were analyzed, with a median follow-up of 41 months. PVs were present in 12.7% of breast cancer patients with estrogen and/or progesterone receptor-positive, HER2-negative cancer, 9.8% with HER2-positive cancer, 16.8% with triple-negative breast cancer and 17.2% with ovarian cancer. Among triple-negative breast cancer patients, cancer-specific mortality was lower with BRCA1 (hazard ratio [HR] = 0.49, 95% confidence interval [CI] = 0.35-0.69) and BRCA2 PVs (HR = 0.60, 95% CI = 0.41-0.89), and equivalent with PVs in other genes (HR = 0.65, 95% CI = 0.37-1.13), versus non-carriers. Among ovarian cancer patients, cancer-specific mortality was lower with PVs in BRCA2 (HR = 0.35, 95% CI = 0.25-0.49) and genes other than BRCA1/2 (HR = 0.47, 95% CI = 0.32-0.69). No PV was associated with higher cancer-specific mortality. CONCLUSIONS Among breast cancer and ovarian cancer patients treated with chemotherapy in the community, BRCA1/2 and other gene PV carriers had equivalent or lower short-term cancer-specific mortality than non-carriers. These results may reassure newly diagnosed patients and longer follow-up is ongoing.
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Affiliation(s)
- Allison W Kurian
- Departments of Medicine and of Epidemiology & Population Health, Stanford University, Stanford, California
| | - Paul Abrahamse
- Department of Health Management and Policy, School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Irina Bondarenko
- Department of Health Management and Policy, School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Ann S Hamilton
- Department of Preventive Medicine in the Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Dennis Deapen
- Department of Preventive Medicine in the Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Scarlett L Gomez
- Department of Epidemiology & Biostatistics and Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | - Monica Morrow
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, New York
| | - Jonathan S Berek
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and Stanford Women's Cancer Center, Stanford University, Stanford, California
| | - Timothy P Hofer
- Department of Internal Medicine, University of Michigan and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Steven J Katz
- Department of Health Management and Policy, School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Kevin C Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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22
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Miles D, Ciruelos E, Schneeweiss A, Puglisi F, Peretz-Yablonski T, Campone M, Bondarenko I, Nowecki Z, Errihani H, Paluch-Shimon S, Wardley A, Merot JL, Trask P, du Toit Y, Pena-Murillo C, Revelant V, Klingbiel D, Bachelot T. Final results from the PERUSE study of first-line pertuzumab plus trastuzumab plus a taxane for HER2-positive locally recurrent or metastatic breast cancer, with a multivariable approach to guide prognostication. Ann Oncol 2021; 32:1245-1255. [PMID: 34224826 DOI: 10.1016/j.annonc.2021.06.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/15/2021] [Accepted: 06/27/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND The phase III CLinical Evaluation Of Pertuzumab And TRAstuzumab (CLEOPATRA) trial established the combination of pertuzumab, trastuzumab and docetaxel as standard first-line therapy for human epidermal growth factor receptor 2 (HER2)-positive locally recurrent/metastatic breast cancer (LR/mBC). The multicentre single-arm PERtUzumab global SafEty (PERUSE) study assessed the safety and efficacy of pertuzumab and trastuzumab combined with investigator-selected taxane in this setting. PATIENTS AND METHODS Eligible patients with inoperable HER2-positive LR/mBC and no prior systemic therapy for LR/mBC (except endocrine therapy) received docetaxel, paclitaxel or nab-paclitaxel with trastuzumab and pertuzumab until disease progression or unacceptable toxicity. The primary endpoint was safety. Secondary endpoints included progression-free survival (PFS) and overall survival (OS). Prespecified subgroup analyses included subgroups according to taxane, hormone receptor (HR) status and prior trastuzumab. Exploratory univariable analyses identified potential prognostic factors; those that remained significant in multivariable analysis were used to analyse PFS and OS in subgroups with all, some or none of these factors. RESULTS Of 1436 treated patients, 588 (41%) initially received paclitaxel and 918 (64%) had HR-positive disease. The most common grade ≥3 adverse events were neutropenia (10%, mainly with docetaxel) and diarrhoea (8%). At the final analysis (median follow-up: 5.7 years), median PFS was 20.7 [95% confidence interval (CI) 18.9-23.1] months overall and was similar irrespective of HR status or taxane. Median OS was 65.3 (95% CI 60.9-70.9) months overall. OS was similar regardless of taxane backbone but was more favourable in patients with HR-positive than HR-negative LR/mBC. In exploratory analyses, trastuzumab-pretreated patients with visceral disease had the shortest median PFS (13.1 months) and OS (46.3 months). CONCLUSIONS Mature results from PERUSE show a safety and efficacy profile consistent with results from CLEOPATRA and median OS exceeding 5 years. Results suggest that paclitaxel is a valid alternative to docetaxel as backbone chemotherapy. Exploratory analyses suggest risk factors that could guide future trial design.
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Affiliation(s)
- D Miles
- Mount Vernon Cancer Centre, Northwood, UK.
| | - E Ciruelos
- Medical Oncology Department Breast Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; HM Hospitales, Madrid, Spain
| | - A Schneeweiss
- Gynecologic Oncology Division, National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
| | - F Puglisi
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Centro di Riferimento Oncologico Aviano-National Cancer Institute, Aviano, Italy; Department of Medicine, University of Udine, Udine, Italy
| | - T Peretz-Yablonski
- Sharett Institute of Oncology and Center for Malignant Breast Diseases, Hadassah Medical Organization, Jerusalem, Israel
| | - M Campone
- Institut de Cancérologie de l'Ouest, Angers, France
| | - I Bondarenko
- Oncology and Medical Radiology Department, City Clinical Hospital No. 4, Dnipropetrovsk, Ukraine
| | - Z Nowecki
- Instytut im. Marii Skłodowskiej-Curie, Warsaw, Poland
| | - H Errihani
- National Institute of Oncology, Mohammed V Rabat University, Rabat, Morocco
| | - S Paluch-Shimon
- Division of Oncology, Sheba Medical Centre, Tel Hashomer, Israel
| | - A Wardley
- National Institute for Health Research Manchester Clinical Research Facility at the Christie NHS Foundation Trust, Manchester, UK; Outreach Research & Innovation Group, Manchester, UK
| | | | - P Trask
- Patient-Centered Outcomes Research, Genentech, Inc., South San Francisco, USA
| | - Y du Toit
- Product Development Medical Affairs Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - C Pena-Murillo
- Product Development Medical Affairs Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - V Revelant
- Global Product Development, Portfolio Clinical Safety, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - D Klingbiel
- Pharma Development Biometrics Biostatistics, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - T Bachelot
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
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23
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Zinzani PL, Capra M, Özcan M, Lv F, Li W, Yañez E, Sapunarova K, Lin T, Jin J, Jurczak W, Hamed A, Wang M, Baker R, Bondarenko I, Zhang Q, Feng J, Geissler K, Lazaroiu M, Saydam G, Szomor Á, Bouabdallah K, Galiulin R, Uchida T, Mongay Soler L, Cao A, Hiemeyer F, Mehra A, Childs BH, Shi Y, Matasar MJ. CHRONOS‐3: RANDOMIZED PHASE III STUDY OF COPANLISIB PLUS RITUXIMAB
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RITUXIMAB/PLACEBO IN RELAPSED INDOLENT NON‐HODGKIN LYMPHOMA (INHL). Hematol Oncol 2021. [DOI: 10.1002/hon.24_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. L. Zinzani
- IRCCS Azienda Ospedaliero‐Universitaria di Bologna Istituto di Ematologia “Seràgnoli” Università di Bologna, Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Bologna Italy
| | - M. Capra
- Hospital Mãe de Deus Centro de Hematologia e Oncologia Porto Alegre Brazil
| | - M. Özcan
- Ankara University School of Medicine Hematology Department Ankara Turkey
| | - F. Lv
- Fudan University Shanghai Cancer Center Department of Medical Oncology Shanghai China
| | - W. Li
- The First Hospital of Jilin University Department of Hematology Changchun China
| | - E. Yañez
- University of La Frontera, Department of Internal Medicine Oncology‐Hematology Unit Temuco Chile
| | - K. Sapunarova
- Medical University Department of Internal Medicine Hematology Division Plovdiv Bulgaria
| | - T. Lin
- Sun Yat‐sen University Cancer Center Department of Medical Oncology Guangzhou China
| | - J. Jin
- The First Affiliated Hospital of Zhejiang University College of Medicine Department of Hematology Hangzhou China
| | - W. Jurczak
- Maria Skłodowska‐Curie National Research Institute of Oncology Department of Clinical Oncology Krakow Poland
| | - A. Hamed
- Petz Aladár Megyei Oktató Kórház Hematológiai Osztály Gyor Hungary
| | - M.‐C. Wang
- Chang Gung Memorial Hospital Kaohsiung Department of Medicine Kaohsiung Taiwan
| | - R. Baker
- Perth Blood Institute, Murdoch University Western Australia Centre for Thrombosis and Haemostasis Perth Australia
| | - I. Bondarenko
- City Dnipropetrovsk Multi‐field Clinical Hospital 4 DSMA, Chemotherapy Department Dnipro Ukraine
| | - Q. Zhang
- Harbin Medical University Cancer Hospital Department of Medical Oncology Harbin China
| | - J. Feng
- Jiangsu Cancer Hospital Department of Medical Oncology Nanjing China
| | - K. Geissler
- Sigmund Freud University, 5th Medical Department with Hematology Oncology and Palliative Medicine Vienna Austria
| | - M. Lazaroiu
- S.C. Policlinica de Diagnostic Rapid S.A. Department of Hematology Brasov Romania
| | - G. Saydam
- Ege Üniversitesi Tıp Fakültesi Division of Hematology Izmir Turkey
| | - Á. Szomor
- Pécsi Tudományegyetem Klinikai Központ 1st Department of Internal Medicine Pécs Hungary
| | - K. Bouabdallah
- University Hospital of Bordeaux Hematology and Cellular Therapy Department Bordeaux France
| | - R. Galiulin
- Clinical Oncological Dispensary of Omsk Region Department of Chemotherapy for Children and Adults Omsk Russian Federation
| | - T. Uchida
- Japanese Red Cross Nagoya Daini Hospital Department of Hematology and Oncology Nagoya Japan
| | - L. Mongay Soler
- Bayer HealthCare Pharmaceuticals, Inc. Clinical Development Whippany USA
| | - A. Cao
- Bayer HealthCare Pharmaceuticals, Inc. Clinical Statistics Whippany USA
| | - F. Hiemeyer
- Pharmaceuticals Division, Bayer AG Clinical Statistics Berlin Germany
| | - A. Mehra
- Bayer HealthCare Pharmaceuticals, Inc. Clinical Development Whippany USA
| | - B. H. Childs
- Bayer HealthCare Pharmaceuticals, Inc. Clinical Development Whippany USA
| | - Y. Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Department of Medical Oncology Beijing China
| | - M. J. Matasar
- Memorial Sloan Kettering Cancer Center Department of Medicine New York USA
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24
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Bondarenko I, Privalova E. THE ROLE OF HIGH-RESOLUTION ULTRASOUND IN THE DIAGNOSTICS OF FACIAL AND NECK SKIN AFTER LASER RESURFACING. Georgian Med News 2021:134-139. [PMID: 34248043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
High-resolution ultrasound (US) was used to examine 25 patients before the procedure and at the 2nd, 7th, 21st days and in 1.5 months after combined exposure to the skin of the face and neck with the Er:YAG laser in cold ablation mode and with the neodymium (Nd:YAG) laser in long pulse mode. The maximum dermis thickness was noted in the middle third (the standard measurement point along the mid-pupillary line in the projection of the infraorbital foramen) and composed 1,75±0,29 mm, the minimum on the neck and in infraorbital area - 1,2 (1,15; 1,3) mm and 1,15±0,15 mm, respectively. On the second day after the procedure, there was a significant increase up to 2,63±0,33 mm in the dermal thickness in the middle third in the projection of the infraobital foramen and up to 1,57±0,23 mm in the submental area of the neck due to all its layers in comparison with the values given before the procedure (p=0.005, p<0.0001). Visualization of the dermis layers was difficult in B-mode during ultrasound, the toughness of the tissues decreased at compression elastography, pronounced vascularization was detected in the CDI mode in comparison with the initial one before the procedure and persisted up to 6 weeks. The ultrasound image in B-mode corresponded to the initial parameters starting from the 7th day.
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Affiliation(s)
- I Bondarenko
- Central Research Institute of Radiation Diagnostics, Russian Federation
| | - E Privalova
- Central Research Institute of Radiation Diagnostics, Russian Federation
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25
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Li Y, Bondarenko I, Elliott MR, Hofer TP, Taylor JM. Using multiple imputation to classify potential outcomes subgroups. Stat Methods Med Res 2021; 30:1428-1444. [PMID: 33884937 DOI: 10.1177/09622802211002866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With medical tests becoming increasingly available, concerns about over-testing, over-treatment and health care cost dramatically increase. Hence, it is important to understand the influence of testing on treatment selection in general practice. Most statistical methods focus on average effects of testing on treatment decisions. However, this may be ill-advised, particularly for patient subgroups that tend not to benefit from such tests. Furthermore, missing data are common, representing large and often unaddressed threats to the validity of most statistical methods. Finally, it is often desirable to conduct analyses that can be interpreted causally. Using the Rubin Causal Model framework, we propose to classify patients into four potential outcomes subgroups, defined by whether or not a patient's treatment selection is changed by the test result and by the direction of how the test result changes treatment selection. This subgroup classification naturally captures the differential influence of medical testing on treatment selections for different patients, which can suggest targets to improve the utilization of medical tests. We can then examine patient characteristics associated with patient potential outcomes subgroup memberships. We used multiple imputation methods to simultaneously impute the missing potential outcomes as well as regular missing values. This approach can also provide estimates of many traditional causal quantities of interest. We find that explicitly incorporating causal inference assumptions into the multiple imputation process can improve the precision for some causal estimates of interest. We also find that bias can occur when the potential outcomes conditional independence assumption is violated; sensitivity analyses are proposed to assess the impact of this violation. We applied the proposed methods to examine the influence of 21-gene assay, the most commonly used genomic test in the United States, on chemotherapy selection among breast cancer patients.
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Affiliation(s)
- Yun Li
- Division of Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Irina Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Timothy P Hofer
- Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.,VA Health Service Research & Development Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Jeremy Mg Taylor
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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26
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Kilickap S, Sezer A, Gümüş M, Bondarenko I, Özgüroğlu M, Gogishvili M, Turk H, Cicin I, Bentsion D, Gladkov O, Clingan P, Sriuranpong V, Rizvi N, Li S, Lee S, Makharadze T, Paydas S, Nechaeva M, Seebach F, Weinreich D, Yancopoulos G, Gullo G, Lowy I, Rietschel P. OA01.03 Clinical Benefits of First-Line (1L) Cemiplimab Monotherapy by PD-L1 Expression Levels in Patients With Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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Cho B, Wu Y, Lopes G, Kudaba I, Kowalski D, Turna H, De Castro G, Caglevic C, Zhang L, Karaszewska B, Laktionov K, Srimuninnimit V, Bondarenko I, Kubota K, Yin L, Lin J, Souza F, Mok T. FP13.04 KEYNOTE-042 3-Year Survival Update: 1L Pembrolizumab vs Platinum-Based Chemotherapy for PD-L1+ Locally Advanced/Metastatic NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.143] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Reeves AN, Elliott MR, Brooks MM, Karvonen-Gutierrez CA, Bondarenko I, Hood MM, Harlow SD. Symptom clusters predict risk of metabolic-syndrome and diabetes in midlife: the Study of Women's Health Across the Nation. Ann Epidemiol 2021; 58:48-55. [PMID: 33631313 DOI: 10.1016/j.annepidem.2021.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/20/2021] [Accepted: 02/18/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE Women's cardio-metabolic risk increases in midlife. Previous work relating menopause symptoms to diabetes/Metabolic Syndrome (MetS) does not consider the adverse impact of multiple concurrent physical and psychological symptoms in midlife. METHODS Data are from 3097 participants in the Study of Women's Health Across the Nation, a cohort of midlife women followed for over 20 years. Baseline latent symptom classes (LSC) were derived from 58 questions assessing physical, psychological and menopausal symptoms. Six identified LSCs ranged from 1 (most symptoms present at high severity) to 6 (few symptoms present at low severity). Accelerated failure time models estimated time to onset of type 2 diabetes and MetS for each LSC. RESULTS Women with multiple high/moderate severity symptoms had an earlier onset of diabetes (13.2%, 14.1% and 20.8% earlier onset in LSCs 1, 2, 3, respectively) and MetS (15.5%, 13.0% and 19.7% earlier onset in LSCs 1, 2, 3, respectively) than women with few/low severity symptoms. CONCLUSIONS Having multiple concurrent moderate to high intensity physical and psychological symptoms in midlife are associated with early onset of diabetes and MetS. Monitoring and subsequent intervention on a broad range of symptoms in midlife may significantly mitigate cardio-metabolic risk during this critical life stage.
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Affiliation(s)
- Alexis N Reeves
- Epidemiologic Science, School of Public Health, University of Michigan, Ann Arbor, MI.
| | - Michael R Elliott
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Maria M Brooks
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | | | - Irina Bondarenko
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Michelle M Hood
- Epidemiologic Science, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Siobán D Harlow
- Epidemiologic Science, School of Public Health, University of Michigan, Ann Arbor, MI; Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
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29
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Sahin U, Türeci Ö, Manikhas G, Lordick F, Rusyn A, Vynnychenko I, Dudov A, Bazin I, Bondarenko I, Melichar B, Dhaene K, Wiechen K, Huber C, Maurus D, Arozullah A, Park JW, Schuler M, Al-Batran SE. FAST: a randomised phase II study of zolbetuximab (IMAB362) plus EOX versus EOX alone for first-line treatment of advanced CLDN18.2-positive gastric and gastro-oesophageal adenocarcinoma. Ann Oncol 2021; 32:609-619. [PMID: 33610734 DOI: 10.1016/j.annonc.2021.02.005] [Citation(s) in RCA: 178] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Claudin 18.2 (CLDN18.2) is contained within normal gastric mucosa epithelial tight junctions; upon malignant transformation, CLDN18.2 epitopes become exposed. Zolbetuximab, a chimeric monoclonal antibody, mediates specific killing of CLDN18.2-positive cells through immune effector mechanisms. PATIENTS AND METHODS The FAST study enrolled advanced gastric/gastro-oesophageal junction and oesophageal adenocarcinoma patients (aged ≥18 years) with moderate-to-strong CLDN18.2 expression in ≥40% tumour cells. Patients received first-line epirubicin + oxaliplatin + capecitabine (EOX, arm 1, n = 84) every 3 weeks (Q3W), or zolbetuximab + EOX (loading dose, 800 mg/m2 then 600 mg/m2 Q3W) (arm 2, n = 77). Arm 3 (exploratory) was added after enrolment initiation (zolbetuximab + EOX 1000 mg/m2 Q3W, n = 85). The primary endpoint was progression-free survival (PFS) and overall survival (OS) was a secondary endpoint. RESULTS In the overall population, both PFS [hazard ratio (HR) = 0.44; 95% confidence interval (CI), 0.29-0.67; P < 0.0005] and OS (HR = 0.55; 95% CI, 0.39-0.77; P < 0.0005) were significantly improved with zolbetuximab + EOX (arm 2) compared with EOX alone (arm 1). This significant PFS benefit was retained in patients with moderate-to-strong CLDN18.2 expression in ≥70% of tumour cells (HR = 0.38; 95% CI, 0.23-0.62; P < 0.0005). Significant improvement in PFS was also reported in the overall population of arm 3 versus arm 1 (HR = 0.58; 95% CI, 0.39-0.85; P = 0.0114) but not in high CLDN18.2-expressing patients; no significant improvement in OS was observed in either population. Most adverse events (AEs) related to zolbetuximab + EOX (nausea, vomiting, neutropenia, anaemia) were grade 1-2. Grade ≥3 AEs showed no substantial increases overall (zolbetuximab + EOX versus EOX alone). CONCLUSIONS In advanced gastric/gastro-oesophageal junction and oesophageal adenocarcinoma patients expressing CLDN18.2, adding zolbetuximab to first-line EOX provided longer PFS and OS versus EOX alone. Zolbetuximab + EOX was generally tolerated and AEs were manageable. Zolbetuximab 800/600 mg/m2 is being evaluated in phase III studies based on clinical benefit observed in the overall population and in patients with moderate-to-strong CLDN18.2 expression in ≥70% of tumour cells.
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Affiliation(s)
- U Sahin
- Department of Experimental and Translational Oncology, TRON - Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Oncology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany
| | - Ö Türeci
- Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany; CI3 - Cluster of Individualized Immune Intervention, Mainz, Germany; formerly of Ganymed Pharmaceuticals GmbH
| | - G Manikhas
- Department of Oncology, City Clinical Oncology Center, St. Petersburg, Russia
| | - F Lordick
- Department of Medicine II and University Cancer Center Leipzig, University of Leipzig Medical Center, Leipzig, Germany
| | - A Rusyn
- Department of Oncology, Transcarpathian Regional Clinical Oncological Center, Uzhhorod, Ukraine
| | - I Vynnychenko
- Sumy State University, Sumy Regional Clinical Oncology Center, Oncothoracic Department, Sumy, Ukraine
| | - A Dudov
- Department of Oncology, Acibadem City Clinic Mladost, Sofia, Bulgaria
| | - I Bazin
- Department of Clinical Pharmacology and Chemotherapy, Russian Oncology Research Center n. a. N.N. Blokhin, Moscow, Russia
| | - I Bondarenko
- Dnipropetrovsk Medical Academy, City Multispecialty Clinical Hospital #4, Department of Chemotherapy, Dnipropetrovsk, Ukraine
| | - B Melichar
- Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic
| | - K Dhaene
- MD Dhaene Pathology Lab BVBA, Destelbergen, Belgium
| | - K Wiechen
- Department of Pathology, Klinikum Worms GmbH, Institute for Pathology, Worms, Germany
| | - C Huber
- Department of Experimental and Translational Oncology, TRON - Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany; CI3 - Cluster of Individualized Immune Intervention, Mainz, Germany; formerly of Ganymed Pharmaceuticals GmbH
| | - D Maurus
- Formerly of Ganymed Pharmaceuticals GmbH, Mainz, Germany
| | - A Arozullah
- Astellas Pharma Global Development, Inc., Northbrook, USA
| | - J W Park
- Astellas Pharma Global Development, Inc., Northbrook, USA
| | - M Schuler
- West German Cancer Center, University Duisburg-Essen, and German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - S-E Al-Batran
- Institute of Clinical Cancer Research (IKF) at Krankenhaus Nordwest, Frankfurt, Germany.
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Kurian AW, Ward KC, Abrahamse P, Bondarenko I, Hamilton AS, Deapen D, Morrow M, Berek JS, Hofer TP, Katz SJ. Time Trends in Receipt of Germline Genetic Testing and Results for Women Diagnosed With Breast Cancer or Ovarian Cancer, 2012-2019. J Clin Oncol 2021; 39:1631-1640. [PMID: 33560870 DOI: 10.1200/jco.20.02785] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Genetic testing is important for breast and ovarian cancer risk reduction and treatment, yet little is known about its evolving use. METHODS SEER records of women of age ≥ 20 years diagnosed with breast or ovarian cancer from 2013 to 2017 in California or Georgia were linked to the results of clinical germline testing through 2019. We measured testing trends, rates of variants of uncertain significance (VUS), and pathogenic variants (PVs). RESULTS One quarter (25.2%) of 187,535 patients with breast cancer and one third (34.3%) of 14,689 patients with ovarian cancer were tested; annually, testing increased by 2%, whereas the number of genes tested increased by 28%. The prevalence of test results by gene category for breast cancer cases in 2017 were BRCA1/2, PVs 5.2%, and VUS 0.8%; breast cancer-associated genes or ovarian cancer-associated genes (ATM, BARD1, BRIP1, CDH1, CHEK2, EPCAM, MLH1, MSH2, MSH6, NBN, NF1, PALB2, PMS2, PTEN, RAD51C, RAD51D, STK11, and TP53), PVs 3.7%, and VUS 12.0%; other actionable genes (APC, BMPR1A, MEN1, MUTYH, NF2, RB1, RET, SDHAF2, SDHB, SDHC, SDHD, SMAD4, TSC1, TSC2, and VHL) PVs 0.6%, and VUS 0.5%; and other genes, PVs 0.3%, and VUS 2.6%. For ovarian cancer cases in 2017, the prevalence of test results were BRCA1/2, PVs 11.0%, and VUS 0.9%; breast or ovarian genes, PVs 4.0%, and VUS 12.6%; other actionable genes, PVs 0.7%, and VUS 0.4%; and other genes, PVs 0.3%, and VUS 0.6%. VUS rates doubled over time (2013 diagnoses: 11.2%; 2017 diagnoses: 26.8%), particularly for racial or ethnic minorities (47.8% Asian and 46.0% Black, v 24.6% non-Hispanic White patients; P < .001). CONCLUSION A testing gap persists for patients with ovarian cancer (34.3% tested v nearly all recommended), whereas adding more genes widened a racial or ethnic gap in VUS results. Most PVs were in 20 breast cancer-associated genes or ovarian cancer-associated genes; testing other genes yielded mostly VUS. Quality improvement should focus on testing indicated patients rather than adding more genes.
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Affiliation(s)
- Allison W Kurian
- Departments of Medicine and of Epidemiology & Population Health, Stanford University, Stanford, CA
| | - Kevin C Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Paul Abrahamse
- Department of Health Management and Policy, School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Irina Bondarenko
- Department of Health Management and Policy, School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Ann S Hamilton
- Department of Preventive Medicine in the Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Dennis Deapen
- Department of Preventive Medicine in the Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Monica Morrow
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jonathan S Berek
- Department of Obstetrics and Gynecology and Women's Cancer Center, Stanford University, Stanford, CA
| | - Timothy P Hofer
- Department of Internal Medicine, University of Michigan and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Steven J Katz
- Department of Health Management and Policy, School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, MI
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Bondarenko I, Privalova E, Shumina Y. SONOGRAPHY OF THE FACE AND NECK REGION SOFT TISSUES IN ASSESSMENT OF THE COMPLICATIONS CAUSES AFTER FACIAL CONTOURING. Georgian Med News 2021:74-79. [PMID: 33814395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
132 women after facial contouring on terms from 2 weeks to 15 years after filler injection were examined by sonography (US). They had complaints of the edema, hypercorrection, asymmetry, discomfort and anxiety about the excess of the terms that filler had spent into the soft tissues. HA fillers were injected in 111 cases (84.1%), silicon agents - in 13 cases (9.8%), CaHA - in 6 (4.5%), PMMA - on 1 (0.8%) and one patient have had non-hyalouronic filler with unknown origin (0.8%). According to the US data, nasolacrimal and palpebromar fissures were the most common location of fillers or the echo signs of fibrotic changes in the projection of their injection - 54 patients, just like the lips region and nasolabial folds - 52 cases. The US of the skin and the soft tissues of the face and neck region prescribed to the patients in order to carry out the differential diagnosis of complaints' causes, to determine the treatment tactics and for planning cosmetic procedures.
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Affiliation(s)
- I Bondarenko
- Central Research Institute of Radiation Diagnostics, Moscow, Russia
| | - E Privalova
- Central Research Institute of Radiation Diagnostics, Moscow, Russia
| | - Y Shumina
- Central Research Institute of Radiation Diagnostics, Moscow, Russia
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Ascierto PA, Lewis KD, Di Giacomo AM, Demidov L, Mandalà M, Bondarenko I, Herbert C, Mackiewicz A, Rutkowski P, Guminski A, Simmons B, Ye C, Hooper G, Wongchenko MJ, Goodman GR, Yan Y, Schadendorf D. Prognostic impact of baseline tumour immune infiltrate on disease-free survival in patients with completely resected, BRAF v600 mutation-positive melanoma receiving adjuvant vemurafenib. Ann Oncol 2021; 31:153-159. [PMID: 31912791 DOI: 10.1016/j.annonc.2019.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We conducted a retrospective exploratory analysis to evaluate the effects of baseline tumour immune infiltrate on disease-free survival (DFS) outcomes in patients with fully resected stage IIC-IIIC melanoma receiving adjuvant vemurafenib monotherapy or placebo in the BRIM8 study. PATIENTS AND METHODS BRIM8 was a phase III, international, double-blind, randomised, placebo-controlled study. Eligible patients with BRAFV600 mutation-positive, completely resected melanoma were randomly assigned to oral vemurafenib (960 mg twice daily) or matching placebo for 52 weeks. The primary end point was DFS. The association of CD8+ T-cell infiltration and programmed death ligand 1 (PD-L1) expression with DFS, as measured by immunohistochemistry, was explored retrospectively. RESULTS Four hundred ninety-eight patients were randomly assigned to receive adjuvant vemurafenib (n = 250) or placebo (n = 248); tumour samples were available for biomarker analysis for approximately 60% of patients. In the pooled biomarker population, placebo-treated patients with <1% CD8+ T cells in the tumour centre had shorter median DFS than those with ≥1% CD8+ T cells (7.7 versus 47.8 months). DFS benefit from vemurafenib versus placebo was greater in patients with <1% CD8+ T cells [hazard ratio (HR) 0.56; 95% confidence interval (CI) 0.34-0.92) than in patients with ≥1% CD8+ T cells (HR 0.77; 95% CI 0.48-1.22). Likewise, median DFS was shorter among placebo-treated patients with <5% versus ≥5% PD-L1+ immune cells (IC) in the tumour (7.2 versus 47.8 months). A greater DFS benefit with vemurafenib versus placebo was observed in patients with <5% PD-L1+IC (HR 0.36; 95% CI 0.24-0.56) than in patients with ≥5% PD-L1+IC (HR 0.99; 95% CI 0.58-1.69). CONCLUSIONS The presence of CD8+ T cells and PD-L1+IC are favourable prognostic factors for DFS. Treatment with adjuvant vemurafenib may overcome the poor DFS prognosis associated with low CD8+ T-cell count or PD-L1 expression. CLINICALTRIALS. GOV IDENTIFIER NCT01667419.
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Affiliation(s)
- P A Ascierto
- Melanoma Unit, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy.
| | - K D Lewis
- Department of Medicine, University of Colorado Comprehensive Cancer Center, Aurora, Colorado, USA
| | - A M Di Giacomo
- Division of Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - L Demidov
- Department of Biotherapy, N. N. Blokhin Russian Cancer Research Center, Ministry of Health, Moscow, Russia
| | - M Mandalà
- Department of Oncology and Haematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy
| | - I Bondarenko
- Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine
| | - C Herbert
- Bristol Haematology and Oncology Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A Mackiewicz
- Department of Cancer Immunology, Poznan University of Medical Sciences, Med-POLONIA, Poznan, Poland
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - A Guminski
- Melanoma Translational Research Group, Melanoma Institute Australia, Wollstonecraft, New South Wales, Australia
| | - B Simmons
- Product Development Oncology, Genentech, Inc., South San Francisco, California, USA
| | - C Ye
- Oncology Biostatistics, Genentech, Inc., South San Francisco, California, USA
| | - G Hooper
- Clinical Development Department, Roche Products Ltd., Welwyn Garden City, UK
| | - M J Wongchenko
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California, USA
| | - G R Goodman
- Safety Science Oncology, Genentech, Inc., South San Francisco, California, USA
| | - Y Yan
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California, USA
| | - D Schadendorf
- Department of Dermatology, Essen University Hospital, Essen, Germany; German Cancer Consortium, Heidelberg, Germany
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Lyubchenko E, Bondarenko I, Timofeeva T. Methods of diagnosis of hip dysplasia in dogs. BIO Web Conf 2021. [DOI: 10.1051/bioconf/20213700043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To diagnose hip dysplasia, you can use a test system, the essence of which is to create a subhabitation in the hip joint of the dog, laid on the side, while there is a click in the joint, which means that the test is positive, while the pressure on the knee joint of the hip joint does not happen. The most common method of diagnosing dysplasia worldwide is X-ray, in which the age of the dogs studied should be more than a year, and large and giant breeds are studied in the range of one to one and a half years, with the animal laid on the back so that the X-ray image shows the pelvis with the wings of the iliac bone and femurs, including the knee joints, therefore, it is also necessary to use sedation, which allows you to comply with all the requirements for styling. The resulting X-rays are assessed according to the main Xray characteristics of the hip joint, taking measurements on six parameters presented in the text of this article, and determining the type of dysplasia. Computed tomography and magnetic resonance imaging can reveal the instability of the pathology in the hip joint and improve understanding of the disease process.
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Sezer A, Kilickap S, Gümüş M, Bondarenko I, Özgüroğlu M, Gogishvili M, Turk H, Çiçin İ, Bentsion D, Gladkov O, Clingan P, Sriuranpong V, Rizvi N, Li S, Lee S, Gullo G, Lowy I, Rietschel P. 378MO EMPOWER-Lung 1: Phase III first-line (1L) cemiplimab monotherapy vs platinum-doublet chemotherapy (chemo) in advanced non-small cell lung cancer (NSCLC) with programmed cell death-ligand 1 (PD-L1) ≥50%. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Ji J, Goldman J, Garassino M, Chen Y, Reinmuth N, Hotta K, Poltoratskiy A, Trukhin D, Hochmair M, Özgüroğlu M, Statsenko G, Voitko O, Conev N, Bondarenko I, Spencer S, Xie M, Jones S, Franks A, Shrestha Y, Paz-Ares L. 379MO Durvalumab (D) ± tremelimumab (T) + platinum-etoposide (EP) in 1L ES-SCLC: Characterization of long-term clinical benefit and tumour mutational burden (TMB) in CASPIAN. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Xu B, Zhang Q, Sun T, Li W, Teng Y, Hu X, Bondarenko I, Adamchuk H, Li Y, Shan B, Cheng J, Wang X, Chen Y, Jiang W, Liu S, Zhang X, Liu E, Luk A, Wang Q, Chai K. HLX02, a China-manufactured trastuzumab biosimilar versus EU-sourced trastuzumab: Results of a global phase 3, randomized, double-blind efficacy and safety comparative study in metastatic breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30708-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sezer A, Kilickap S, Gümüş M, Bondarenko I, Özgüroğlu M, Gogishvili M, Turk H, Çiçin İ, Bentsion D, Gladkov O, Clingan P, Sriuranpong V, Rizvi N, Li S, Lee S, Gullo G, Lowy I, Rietschel P. LBA52 EMPOWER-Lung 1: Phase III first-line (1L) cemiplimab monotherapy vs platinum-doublet chemotherapy (chemo) in advanced non-small cell lung cancer (NSCLC) with programmed cell death-ligand 1 (PD-L1) ≥50%. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2285] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Goldman J, Garassino M, Chen Y, Reinmuth N, Hotta K, Poltoratskiy A, Trukhin D, Hochmair M, Özgüroğlu M, Ji J, Statsenko G, Voitko O, Conev N, Bondarenko I, Spencer S, Xie M, Jones S, Franks A, Shrestha Y, Paz-Ares L. LBA86 Durvalumab (D) ± tremelimumab (T) + platinum-etoposide (EP) in 1L ES-SCLC: Characterization of long-term clinical benefit and tumour mutational burden (TMB) in CASPIAN. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Turner N, Dent R, O'Shaughnessy J, Kim SB, Isakoff S, Barrios C, Saji S, Bondarenko I, Nowecki Z, Lian Q, Reilly SJ, Hinton H, Wongchenko M, Mani A, Oliveira M. 283MO Ipatasertib (IPAT) + paclitaxel (PAC) for PIK3CA/AKT1/PTEN-altered hormone receptor-positive (HR+) HER2-negative advanced breast cancer (aBC): Primary results from Cohort B of the IPATunity130 randomised phase III trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Miles D, Ciruelos E, Schneeweiss A, Puglisi F, Peretz-Yablonski T, Campone M, Bondarenko I, Nowecki Z, Errihani H, Paluch-Shimon S, Wardley A, Merot J, du Toit Y, Klingbiel D, Revelant V, Bachelot T. 288P Final results from PERUSE, a global study of pertuzumab (P), trastuzumab (H) and investigator’s chosen taxane as first-line therapy for HER2-positive locally recurrent/metastatic breast cancer (LR/mBC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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O'Malley D, Oaknin A, Monk B, Leary A, Selle F, Alexandre J, Randall L, Rojas C, Neffa M, Kryzhanivska A, Gladieff L, Berton D, Meniawy T, Lugowska I, Bondarenko I, Moore K, Ortuzar Feliu W, Ancukiewicz M, Shapiro I, Ray-Coquard I. LBA34 Single-agent anti-PD-1 balstilimab or in combination with anti-CTLA-4 zalifrelimab for recurrent/metastatic (R/M) cervical cancer (CC): Preliminary results of two independent phase II trials. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2264] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Zhang Q, Xu B, Sun T, Li W, Teng Y, Hu X, Bondarenko I, Adamchuk H, Li Y, Shan B, Liu S, Jiang W, Zhang X, Luk A, Chai K. 287P Efficacy, safety and pharmacokinetics of a proposed trastuzumab biosimilar HLX02 compared with trastuzumab in metastatic breast cancer: A global phase III study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ghosh K, Bondarenko I, Messer KL, Stewart ST, Raghunathan T, Rosen AB, Cutler DM. Attributing medical spending to conditions: A comparison of methods. PLoS One 2020; 15:e0237082. [PMID: 32776954 PMCID: PMC7416958 DOI: 10.1371/journal.pone.0237082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 07/20/2020] [Indexed: 11/19/2022] Open
Abstract
To understand the cost burden of medical care it is essential to partition medical spending into conditions. Two broad strategies have been used to measure disease-specific spending. The first attributes each medical claim to the condition that physicians list as its cause. The second decomposes total spending for a person over a year to their cumulative set of health conditions. Traditionally, this has been done through regression analysis. This paper has two contributions. First, we develop a new cost attribution method to attribute spending to conditions using a more flexible attribution approach, based on propensity score analysis. Second, we compare the propensity score approach to the claims-based approach and the regression approach in a common set of beneficiaries age 65 and older in the 2009 Medicare Current Beneficiary Survey. Our estimates show that the three methods have important differences in spending allocation and that the propensity score model likely offers the best theoretical and empirical combination.
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Affiliation(s)
- Kaushik Ghosh
- The National Bureau of Economic Research, Cambridge, Massachusetts, United States of America
| | - Irina Bondarenko
- Institute for Social Research and Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Kassandra L. Messer
- Institute for Social Research and Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Susan T. Stewart
- The National Bureau of Economic Research, Cambridge, Massachusetts, United States of America
| | - Trivellore Raghunathan
- Institute for Social Research and Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Allison B. Rosen
- The National Bureau of Economic Research, Cambridge, Massachusetts, United States of America
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - David M. Cutler
- The National Bureau of Economic Research, Cambridge, Massachusetts, United States of America
- Department of Economics, Harvard University, Cambridge, Massachusetts, United States of America
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Glybochko P, Fomin V, Avdeev S, Moiseev S, Yavorovskiy A, Brovko M, Umbetova K, Aliev V, Bulanova E, Bondarenko I, Volkova O, Gaynitdinova V, Gneusheva T, Dubrovin K, Kapustina V, Kraeva V, Merzhoeva Z, Nuralieva G, Nogtev P, Panasyuk V, Politov M, Popov A, Popova E, Raspopina N, Royuk V, Sorokin Y, Trushenko N, Khalikova E, Tsareva N, Chikina S, Chichkova N, Akulkina L, Bulanov N, Ermolova L, Zykova A, Kitbalian A, Moiseev A, Potapov P, Tao E, Sholomova V, Shchepalina A, Yakovleva A. Clinical characteristics of 1007 intensive care unitpatients with SARS-CoV-2 pneumonia. ACTA ACUST UNITED AC 2020. [DOI: 10.32756/0869-5490-2020-2-21-29] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Harlow SD, Elliott MR, Bondarenko I, Thurston RC, Jackson EA. Monthly variation of hot flashes, night sweats, and trouble sleeping: effect of season and proximity to the final menstrual period (FMP) in the SWAN Menstrual Calendar substudy. Menopause 2020; 27:5-13. [PMID: 31567864 PMCID: PMC6934911 DOI: 10.1097/gme.0000000000001420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Although reproductive function is influenced by season, few studies have evaluated seasonal effects on menopausal symptoms. We assessed the impact of season and proximity to the final menstrual period (FMP) on frequency of symptom reporting. METHODS In all, 955 participants in the Study of Women's Health Across the Nation recorded whether or not they had experienced menopausal symptoms on a monthly menstrual calendar over a 10-year period. We modeled the log-odds of presence of a given symptom each month using a logistic mixed-effects model, assuming a third-order polynomial before the FMP and a different third-order polynomial after the FMP. We assumed sine and cosine functions for month of the year. RESULTS Five to 10 years before the FMP, ∼20% of women reported hot flashes and night sweats, whereas ∼40% reported trouble sleeping. Prevalence rose ∼4 years before the FMP with a sharp jump in hot flash (∼60%) and night sweats (∼40%) prevalence coincident with the FMP. Peaks in hot flashes and trouble sleeping were observed in July with troughs in January. The peak and trough in night sweats occurred about 1 month earlier. Odds of hot flashes, night sweats, and trouble sleeping were 66%, 50%, and 24% greater, respectively, at the seasonal peak versus the seasonal minimum. CONCLUSION Menopausal symptoms exhibit seasonal variation associated with the summer and winter equinoxes. Seasonal increases in night sweats precede increases in hot flashes. Prospectively recorded monthly symptom data demonstrate that hot flashes and night sweats increase notably coincident with the FMP. : Video Summary:http://links.lww.com/MENO/A476.
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Affiliation(s)
- Siobán D Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | | | - Irina Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
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Gerber DE, Horn L, Boyer M, Sanborn R, Natale R, Palmero R, Bidoli P, Bondarenko I, Germonpre P, Ghizdavescu D, Kotsakis A, Lena H, Losonczy G, Park K, Su WC, Tang M, Lai J, Kallinteris NL, Shan JS, Reck M, Spigel DR. Randomized phase III study of docetaxel plus bavituximab in previously treated advanced non-squamous non-small-cell lung cancer. Ann Oncol 2019; 29:1548-1553. [PMID: 29767677 DOI: 10.1093/annonc/mdy177] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Bavituximab is a monoclonal antibody that targets phosphatidylserine in the presence of β2 glycoprotein 1 (β2GP1) to exert an antitumor immune response. This phase III trial determined the efficacy of bavituximab combined with docetaxel in patients with previously treated advanced non-small-cell lung cancer (NSCLC). Patients and methods Key eligibility criteria included advanced non-squamous NSCLC with disease progression after treatment with platinum-based doublet chemotherapy, evidence of disease control after at least two cycles of first-line therapy, presence of measurable disease, ECOG performance status 0 or 1, adequate bone marrow and organ function, and no recent history of clinically significant bleeding. Eligible patients were randomized 1 : 1 to receive up to six 21-day cycles of docetaxel plus either weekly bavituximab 3 mg/kg or placebo until progression or toxicity. The primary end point was overall survival (OS). Results A total of 597 patients were enrolled. Median OS was 10.5 months in the docetaxel + bavituximab arm and was 10.9 months in the docetaxel + placebo arm (HR 1.06; 95% CI 0.88-1.29; P = 0.533). There was no difference in progression-free survival (HR 1.00; 95% CI 0.82-1.22; P = 0.990). Toxicities were manageable and similar between arms. In subset analysis, among patients with high baseline serum β2GP1 levels ≥200 µg/ml, a nonsignificant OS trend favored the bavituximab arm (HR 0.82; 95% CI 0.63-1.06; P = 0.134). Among patients who received post-study immune checkpoint inhibitor therapy, OS favored the bavituximab arm (HR 0.46; 95% CI 0.26-0.81; P = 0.006). Conclusions The combination of bavituximab plus docetaxel is not superior to docetaxel in patients with previously treated advanced NSCLC. The addition of bavituximab to docetaxel does not meaningfully increase toxicity. The potential benefit of bavituximab observed in patients with high β2GP1 levels and in patients subsequently treated with immune checkpoint inhibitors requires further investigation. Clinical trial number NCT01999673.
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Affiliation(s)
- D E Gerber
- Division of Hematology-Oncology, Department of Internal Medicine, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, USA.
| | - L Horn
- Division of Hematology and Oncology, Department of Internal Medicine, Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - M Boyer
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - R Sanborn
- Robert W. Franz Cancer Research Center, Earle A. Chiles Research Institute, Providence Cancer Center, Portland; USA
| | - R Natale
- Department of Internal Medicine (Hematology-Oncology), Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - R Palmero
- Medical Oncology Service, Institut Català d'Oncologia -L'Hospitalet, Barcelona, Spain
| | - P Bidoli
- Department of Oncology, ASST di Monza - Azienda Ospedaliera San Gerardo, Monza, Italy
| | - I Bondarenko
- State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk, Ukraine
| | - P Germonpre
- Department of Pneumology, AZ Maria Middelares, Gent, Belgium
| | - D Ghizdavescu
- Department of Oncology, Ploiesti Municipal Hospital, Ploiesti, Romania
| | - A Kotsakis
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece
| | - H Lena
- Pneumology Service, Hôspital Pontchaillou, Rennes, France
| | - G Losonczy
- Pulmonology Clinic, Semmelweis Egyetem, Budapest, Hungary
| | - K Park
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, Korea
| | - W-C Su
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - M Tang
- Peregrine Pharmaceuticals, Inc., Tustin, USA
| | - J Lai
- Peregrine Pharmaceuticals, Inc., Tustin, USA
| | | | - J S Shan
- Peregrine Pharmaceuticals, Inc., Tustin, USA
| | - M Reck
- Department of Thoracic Oncology, German Center for Lung research (DZL), Lungen Clinic Grosshansdorf, Grosshansdorf, Germany
| | - D R Spigel
- Lung Cancer Clinical Research Program, Sarah Canon Research Institute, Nashville, USA
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Xu B, Zhang Q, Sun T, Li W, Teng Y, Hu X, Bondarenko I, Adamchuk H, Li Y, Shan B, Cheng J, Peng T, Wang X, Chen Y, Jiang W, Liu S, Zhang X, Liu E, Luk A, Wang Q. First China-manufactured trastuzumab biosimilar HLX02 global phase III trial met primary endpoint in breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, Larkin J, Garbe C, Jouary T, Hauschild A, Chiarion-Sileni V, Lebbe C, Mandalá M, Millward M, Arance A, Bondarenko I, Haanen JBAG, Hansson J, Utikal J, Ferraresi V, Mohr P, Probachai V, Schadendorf D, Nathan P, Robert C, Ribas A, Davies MA, Lane SR, Legos JJ, Mookerjee B, Grob JJ. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol 2019; 30:1848. [PMID: 31406976 PMCID: PMC6927319 DOI: 10.1093/annonc/mdz221] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Martin M, Campone M, Bondarenko I, Sakaeva D, Krishnamurthy S, Roman L, Lebedeva L, Vedovato JC, Aapro M. Randomised phase III trial of vinflunine plus capecitabine versus capecitabine alone in patients with advanced breast cancer previously treated with an anthracycline and resistant to taxane. Ann Oncol 2019; 29:1195-1202. [PMID: 29447329 DOI: 10.1093/annonc/mdy063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background Capecitabine is an approved standard therapy for anthracycline- and taxane-pretreated locally advanced or metastatic breast cancer (BC). Vinflunine has demonstrated single-agent activity in phase II studies in this setting and activity and tolerability when combined with capecitabine. We compared the combination of vinflunine plus capecitabine (VC) with single-agent capecitabine. Patients and methods Patients with locally recurrent/metastatic BC previously treated or resistant to an anthracycline and resistant to taxane therapy were randomly assigned to either vinflunine (280 mg/m2, day 1) plus oral capecitabine [825 mg/m2 twice daily (b.i.d.), days 1-14] every 3 weeks (q3w) or single-agent oral capecitabine (1250 mg/m2 b.i.d., days 1-14) q3w. The primary end point was progression-free survival (PFS) assessed by an independent review committee. The study had 90% power to detect a 30% improvement in PFS. Results Overall, 770 patients were randomised. PFS was significantly longer with VC than with capecitabine alone [hazard ratio, 0.84, 95% confidence interval (CI), 0.71-0.99; log-rank P = 0.043; median 5.6 versus 4.3 months, respectively]. Median overall survival was 13.9 versus 11.7 months with VC versus capecitabine alone, respectively (hazard ratio, 0.98; 95% CI, 0.83-1.15; log-rank P = 0.77). No difference in quality of life was observed between the two treatment arms. The most common adverse events (NCI CTCAE version 3.0) in the combination arm were haematological and gastrointestinal. Grade 4 neutropenia was more frequent with VC (12% versus 1% with capecitabine alone); febrile neutropenia occurred in 2% versus 0.5%, respectively. Hand-foot syndrome was less frequent with VC (grade 3: 4% versus 19% for capecitabine alone). Peripheral neuropathy was uncommon in both arms (grade 3: 1% versus 0.3%). Conclusions Vinflunine combined with capecitabine demonstrated a modest improvement in PFS and an acceptable safety profile compared with capecitabine alone in patients with anthracycline- and taxane-pretreated locally recurrent/metastatic BC. ClinicalTrials.gov NCT01095003.
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Affiliation(s)
- M Martin
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - M Campone
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - I Bondarenko
- Oncology and Medical Radiology Department, Dnipropetrovsk Medical Academy, City Multidisciplinary Clinical Hospital No. 4, Dnipropetrovsk, Ukraine
| | - D Sakaeva
- State Budgetary Healthcare Institution, Republican Clinical Oncology Dispensary of MoH of Bashkortostan Republic, Ufa, Russia
| | - S Krishnamurthy
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - L Roman
- Leningrad Regional Oncology Dispensary, St Petersburg
| | - L Lebedeva
- Department of Chemotherapy, Arkhangelsk Clinical Oncological Dispensary, Arkhangelsk, Russia
| | - J-C Vedovato
- Clinical Development Oncology, Oncology Innovation Unit, Institut de Recherche Pierre Fabre, Toulouse, France
| | - M Aapro
- Cancer Center, Clinique de Genolier, Genolier, Switzerland
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Katz SJ, Bondarenko I, Ward KC, Hamilton AS, Morrow M, Kurian AW, Hofer TP. Association of Attending Surgeon With Variation in the Receipt of Genetic Testing After Diagnosis of Breast Cancer. JAMA Surg 2019; 153:909-916. [PMID: 29971344 DOI: 10.1001/jamasurg.2018.2001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance Genetic testing after diagnosis of breast cancer is common, but little is known about the influence of the surgeon on the variation in testing. Objectives To quantify and explain the association of attending surgeon with rates of genetic testing after diagnosis of breast cancer. Design, Setting, and Participants This population-based study identified 7810 women with stages 0 to II breast cancer treated between July 1, 2013, and August 31, 2015, through the Surveillance, Epidemiology, and End Results registries for the state of Georgia, as well as Los Angeles County, California. Surveys were sent approximately 2 months after surgery. Also surveyed were 488 attending surgeons identified by the patients. Main Outcomes and Measures The study examined the association of surgeon with variation in the receipt of genetic testing using information from patient and surgeon surveys merged to Surveillance, Epidemiology, and End Results and genetic testing data obtained from 4 laboratories. Results In total, 5080 women (69.6%) of 7303 who were eligible (mean [SD] age, 61.4 [0.8] years) and 377 surgeons (77.3%) of 488 (mean [SD] age, 53.8 [10.7] years) responded to the survey. Approximately one-third (34.5% [1350 of 3910] of patients had an elevated risk of mutation carriage, and 27.0% (1056 of 3910) overall had genetic testing. Surgeons had practiced a mean (SE) of 20.9 (0.6) years, and 28.9% (107 of 370) treated more than 50 cases of new breast cancer per year. The odds of a patient receiving genetic testing increased more than 2-fold (odds ratio, 2.48; 95% CI, 1.85-3.31) if she saw a surgeon with an approach 1 SD above that of a surgeon with the mean test rate. Approximately one-third (34.1%) of the surgeon variation was explained by patient volume and surgeon attitudes about genetic testing and counseling. If a patient with higher pretest risk saw a surgeon at the 5th percentile of the surgeon distribution, she would have a 26.3% (95% CI, 21.9%-31.2%) probability of testing compared with 72.3% (95% CI, 66.7%-77.2%) if she saw a surgeon at the 95th percentile. Conclusions and Relevance In this study, the attending surgeon was associated with the receipt of genetic testing after a breast cancer diagnosis. Variation in surgeon attitudes about genetic testing and counseling may explain a substantial amount of this association.
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Affiliation(s)
- Steven J Katz
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.,Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor
| | - Irina Bondarenko
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Kevin C Ward
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ann S Hamilton
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Monica Morrow
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Allison W Kurian
- Department of Medicine, Stanford University, Stanford, California.,Department of Health Research and Policy, Stanford University, Stanford, California
| | - Timothy P Hofer
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.,Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
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