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Reynolds KA, Schlessinger DI, Yanes AF, Godinez-Puig V, Chen BR, Kurta AO, Cotseones JK, Chiren SG, Iyengar S, Ibrahim SA, Kang BY, Worley B, Behshad R, DeHoratius DM, Denes P, Drucker AM, Dzubow LM, Etzkorn JR, Harwood CA, Kim JYS, Lawrence N, Lee EH, Lissner GS, Marghoob AA, Guminiski A, Matin RN, Mattox AR, Mittal BB, Thomas JR, Zhou XA, Zloty D, Hughes BGM, Nottage MK, Green AC, Testori AAE, Argenziano G, Longo C, Zalaudek I, Lebbe C, Malvehy J, Saiag P, Cernea SS, Schmitt J, Kirkham JJ, Poon E, Sobanko JF, Cartee TV, Maher IA, Alam M. Development of a core outcome set for cutaneous squamous cell carcinoma trials: identification of core domains and outcomes. Br J Dermatol 2021; 184:1113-1122. [PMID: 33236347 DOI: 10.1111/bjd.19693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND The lack of uniformity in the outcomes reported in clinical studies of the treatment of cutaneous squamous cell carcinoma (cSCC) complicates efforts to compare treatment effectiveness across trials. OBJECTIVES To develop a core outcome set (COS), a minimum set of agreed-upon outcomes to be measured in all clinical trials of a given disease or outcome, for the treatment of cSCC. METHODS One hundred and nine outcomes were identified via a systematic literature review and interviews with 28 stakeholders. After consolidation of this long list, 55 candidate outcomes were rated by 19 physician and 10 patient stakeholders, in two rounds of Delphi exercises. Outcomes scored 'critically important' (score of 7, 8 or 9) by ≥ 70% of patients and ≥ 70% of physicians were provisionally included. At the consensus meeting, after discussion and voting of 44 international experts and patients, the provisional list was reduced to a final core set, for which consensus was achieved among all meeting participants. RESULTS A core set of seven outcomes was finalized at the consensus meeting: (i) serious or persistent adverse events, (ii) patient-reported quality of life, (iii) complete response, (iv) partial response, (v) recurrence-free survival, (vi) progression-free survival and (vii) disease-specific survival. CONCLUSIONS In order to increase the comparability of results across trials and to reduce selective reporting bias, cSCC researchers should consider reporting these core outcomes. Further work needs to be performed to identify the measures that should be reported for each of these outcomes.
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Affiliation(s)
- K A Reynolds
- Department of Dermatology, Northwestern University, Chicago, IL, USA.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - D I Schlessinger
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - A F Yanes
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - V Godinez-Puig
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - B R Chen
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - A O Kurta
- Department of Dermatology, Saint Louis University, St Louis, MO, USA
| | - J K Cotseones
- Medical & Cosmetic Dermatology Service, Northwestern Medicine Regional Medical Group, Naperville, IL, USA
| | - S G Chiren
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - S Iyengar
- Department of Dermatology, West Virginia University, Morgantown, WV, USA
| | - S A Ibrahim
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - B Y Kang
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - B Worley
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - R Behshad
- Department of Dermatology, Saint Louis University, St Louis, MO, USA
| | - D M DeHoratius
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P Denes
- Division of Cardiology, Northwestern University, Chicago, IL, USA
| | - A M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | | | - J R Etzkorn
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C A Harwood
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, UK.,Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - J Y S Kim
- Division of Plastic and Reconstructive Surgery, Northwestern University, Chicago, IL, USA
| | - N Lawrence
- Division of Dermatologic Surgery, Cooper University Hospital, Camden, NJ, USA
| | - E H Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - G S Lissner
- Department of Ophthalmology, Northwestern University, Chicago, IL, USA
| | - A A Marghoob
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - A Guminiski
- Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, Australia
| | - R N Matin
- Department of Dermatology, Churchill Hospital, Oxford, UK
| | - A R Mattox
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - B B Mittal
- Department of Radiation Oncology, Northwestern University, Chicago, IL, USA
| | - J R Thomas
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, IL, USA
| | - X A Zhou
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - D Zloty
- Department of Dermatology & Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - B G M Hughes
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Department of Medical Oncology, The Prince Charles Hospital, Brisbane, QLD, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - M K Nottage
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - A C Green
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,CRUK Manchester Institute and University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - A A E Testori
- Division of Dermatology, Fondazione IRCCS, Policlinico san Matteo, Pavia, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - I Zalaudek
- Department of Dermatology, Medical University of Trieste, Trieste, Italy
| | - C Lebbe
- APHP Department of Dermatology, Saint-Louis Hospital, INSERM U976, Université de Paris, Paris, France
| | - J Malvehy
- Department of Dermatology, Hospital Clinic of Barcelona, IDIBAPS and CIBER de Enfermedades Raras, Barcelona, Spain
| | - P Saiag
- University Department of Dermatology, Université de Versailles-Saint Quentin en Yvelines, APHP, Boulogne, France
| | - S S Cernea
- Dermatology Department of Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil
| | - J Schmitt
- Center for Evidence-Based Healthcare, Medical Faculty, Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - J J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - E Poon
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - J F Sobanko
- Department of Dermatology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,Division of Dermatologic Surgery, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - T V Cartee
- Department of Dermatology, Penn State College of Medicine, Hershey, PA, USA
| | - I A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - M Alam
- Department of Dermatology, Northwestern University, Chicago, IL, USA.,Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, IL, USA.,Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Edwards BJ, Gradishar WJ, Smith ME, Pacheco JA, Holbrook J, McKoy JM, Nardone B, Tica S, Godinez-Puig V, Rademaker AW, Helenowski IB, Bunta AD, Stern PH, Rosen ST, West DP, Guise TA. Elevated incidence of fractures in women with invasive breast cancer. Osteoporos Int 2016; 27:499-507. [PMID: 26294292 DOI: 10.1007/s00198-015-3246-3] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/08/2015] [Indexed: 01/13/2023]
Abstract
UNLABELLED This study evaluates the incidence of bone fractures in women with BC.We found that women with invasive breast cancer are at an increased risk for bone fractures, with fractures most commonly occurring at lower extremity and vertebral sites. The risk is further increased in women undergoing cancer therapy. INTRODUCTION Bone loss and fractures in breast cancer have generally been attributed to aromatase inhibitor use. This study assessed the incidence of fractures after invasive breast cancer diagnosis and evaluated bone density and FRAX risk calculation at time of fracture occurrence. METHODS Retrospective cohort study of women with invasive breast cancer [June 2003-December 2011] who participated in an academic hospital based genetic biobank. Demographic and clinical characteristics were abstracted from the electronic medical record (EMR). RESULTS A total of 422 women with invasive breast cancer were assessed; 79 (28 %) sustained fractures during the observation period; fractures occurred at multiple skeletal sites in 27 cases (116 fractures). The incidence of fractures was 40 per 1000 person-years. Women who sustained fractures were mostly white and had a family history of osteoporosis (36.9 %, p = 0.03) or history of a prior fracture (6/79, p = 0.004). Fractures occurred 4.0 years (range 0-12 years) after cancer diagnosis. Fracture cases had femoral neck bone mineral density (BMD) of 0.72 + 0.12 g/cm(2), T-score of -1.2, that is, within the low bone mass range. Fractures most commonly occurred in lower extremities, vertebral, and wrist sites. Hip fractures accounted for 11 % of fractures, occurring at a median age of 61 years. CONCLUSIONS Fractures occur shortly after commencing cancer therapy. Rapid bone loss associated with cancer therapy may precipitate fractures. Fractures occur at relatively higher BMD in BC. Occurrence of fractures in invasive breast cancer raises the possibility of cancer-induced impairment in bone quality.
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Affiliation(s)
- B J Edwards
- Department of General Internal Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe, unit 1465, Houston, TX, 77030, USA.
| | - W J Gradishar
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M E Smith
- NUgene Project, Center for Genetic Medicine, Northwestern University, Chicago, IL, USA
| | - J A Pacheco
- NUgene Project, Center for Genetic Medicine, Northwestern University, Chicago, IL, USA
| | - J Holbrook
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - J M McKoy
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - B Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Tica
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - V Godinez-Puig
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A W Rademaker
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - I B Helenowski
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A D Bunta
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - P H Stern
- Department of Molecular Pharmacology and Biological Chemistry, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S T Rosen
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D P West
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - T A Guise
- Department of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
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