The use of quantitative cytology in identifying high-risk oral lesions in community practice

2012 ◽  
Vol 114 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Samson P. Ng ◽  
Indervir S. Mann ◽  
Christopher Zed ◽  
Alexei Doudkine ◽  
Jasenka Matisic
Keyword(s):  
High Risk ◽  
Oral Lesions ◽  
Community Practice ◽  
Quantitative Cytology

scholarly journals Differential expression of miRNAs in the serum of patients with high-risk oral lesions

2012 ◽  
Vol 1 (2) ◽  
pp. 268-274 ◽  
Author(s):  
Sara Ann MacLellan ◽  
James Lawson ◽  
Jonathan Baik ◽  
Martial Guillaud ◽  
Catherine Fang-Yeu Poh ◽  
...  
Keyword(s):  
High Risk ◽  
Differential Expression ◽  
Oral Lesions

Investigation of gastrointestinal stromal tumor (GIST) care management in GIST patients (pts) receiving short-term versus long-term imatinib (IM) adjuvant therapy: A chart review analysis.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 195-195
Author(s):  
Anthony Paul Conley ◽  
Annie Guérin ◽  
Medha Sasane ◽  
Geneviève Gauthier ◽  
Frances Schwiep ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Profile ◽  
Prescribing Patterns ◽  
Community Practice ◽  
Short Term ◽  
Online Data ◽  
Kit Mutation ◽  
Nccn Guidelines

195 Background: Although optimal duration of adjuvant IM therapy in Kit+ GIST pts is unknown, the NCCN guidelines recommend treatment for ≥36 months in high-risk pts based on clinical trials showing reduced risk of recurrence and mortality in pts receiving long-term adjuvant IM. The objective of this study was to investigate clinicians’ recurrence risk assessment and GIST management in patients receiving adjuvant IM for short- (6-12 months) vs. long-term (≥24 months) in community practice. Methods: GIST-related and treatment characteristic information on adult pts with primary resectable Kit+ GIST initiating IM ≤84 days after surgery (short-term: 411 pts; long-term: 408 pts) was collected from 320 U.S. oncologists using an online data collection form. In addition, physician prescribing patterns and perception of risk assessment and IM duration were collected. Results: Indicators of risk (tumor size, mitotic count, and tumor location) were significantly associated with IM treatment duration. Tumor rupture status did not impact IM duration, except when unknown, in which case pts had longer IM duration. About 50% of pts had not been tested for Kit mutation; 31% of physicians reported that it would not have changed therapy/management or were not aware of how results should have impacted GIST management. Among short-term pts for whom physicians reported a reason for IM discontinuation, main reasons included non-severe adverse events, completion of the 1-year treatment scheduled, economic constraint/health plan coverage change, and pts’ preference. Overall, 77.8% of surveyed physicians reported that pt risk profile drove their decision of continuing IM over an extended period of time. However, in practice 39.9% of the short-term pts and 48.8% of the long-term pts had a high risk profile as assessed by Fletcher classification; suggesting a lack of consistency between treatment related opinions and practice. Conclusions: These observed discrepancies highlight the need for standardization of risk assessment practices and education among community oncologists and pts.

scholarly journals Real World Assessment of Treatment Patterns and Outcomes Among Multiple Myeloma Patients across Different Risk Stratification Criteria in the United States: A Retrospective Cohort Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1640-1640
Author(s):  
Motiur Rahman ◽  
Christopher Kim ◽  
Jazmine Mateus ◽  
Alissa Keegan
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Real World ◽  
Treatment Initiation ◽  
Treatment Patterns ◽  
Community Practice ◽  
Newly Diagnosed ◽  
The Us ◽  
Standard Risk

Abstract Background: Despite the development of highly active novel agents, high risk (HR) multiple myeloma (MM) patients continue to demonstrate relatively poor prognosis. Limited data is published on how treatment patterns with risk stratification systems have changed over time. Moreover, real world studies using electronic health records (EHRs) have not evaluated the performance of risk stratification systems with real world outcomes. This study aims to evaluate the ability to implement three different risk stratification systems - international staging system (ISS), revised ISS (R-ISS), and high-risk chromosomal abnormalities (HRCA, defined as presence of del(17)p, t(4;14) and/or t(4;16)) [Palumbo et al. 2015] - to characterize treatment patterns and associated outcomes [real world overall survival (rwOS) and real world progression free survival (rwPFS)] among newly diagnosed MM (NDMM) patients in the US community practice. Methods: This study used Flatiron Enhanced MM EHR de-identified database (New York, NY). Newly diagnosed MM patients (≥ 18 years) were diagnosed from January 2015 through June 2020 (cohort 1 - for studying treatment distribution) with follow-up through December 2020, and from January 2015 through December 2018 (cohort 2 - for rwOS and rwPFS), with follow-up through December 2020. Patients with malignancies other than MM were excluded. Proportion of rwOS was measured from treatment initiation until death, and median rwPFS was measured from treatment initiation until death, progression, or start of new line of therapy using Kaplan-Meier method. Results: A total of 1,979 and 1,382 patients were eligible in cohorts 1 and 2, respectively. In both the cohorts, approximately 18% (cohort 1: N=367, cohort 2: N=248), 41% (cohort 1: N=805, cohort 2: N=566), and 37% (cohort 1: N=738, cohort 2: N=508) were HR patients according to the R-ISS, ISS, and HRCA criteria, respectively. Approximately half of the HR patients were ≥70 years old (52% for R-ISS III and ISS III, and 47% for HRCA), with chronic kidney disease stage ≥3 by eGFR for 54% R-ISS III and ISS III, and 34% high risk CA, and ECOG score ≥2 for 18% R-ISS III, 19% ISS III, and 14% HRCA patients. Triplets were the most frequent treatment regimens (62% for R-ISS III and II, and 66% for R-ISS I; 59% for ISS III, and 65% for ISS II and I; 65% for HRCA and 61% for standard risk CA(SRCA) with proteasome inhibitors (PIs) / immunomodulatory agents (IMiDs) / dexamethasone being most common regimen across all the risk stratification criteria. Quadruplet agent use was higher in R-ISS III and ISS III categories (6.8% vs. 3.3% for R-ISS III vs. I; 6.3% vs. 2.8% for ISS III vs. I). The median rwPFS in HR patients were shorter than the lower risk subgroups (R-ISS III: 8.8 months [95% CI 7.1 - 11.0], R-ISS II: 12.1 months [95% CI 10.7 - 13.6], R-ISS I: 23.5 months [95% CI 13.8 - .]; ISS III: 10.4 months [95% CI 8.5 - 11.5], ISS II: 12.7 months [95% CI 10.7 - 14.3], ISS I: 16 months [95% CI 12.2 - 19.5]; HRCA: 10.1 months [95% CI 8.8 - 12.1], SRCA: 13.1 months [95% CI 11.3 - 14.8]). The 2-year rwOS was lower in the HR subgroups (R-ISS III: 0.65 [95% CI 0.59 - 0.70], R-ISS II: 0.79 [95% CI 0.76 - 0.81], R-ISS I: 0.91 [95% CI 0.85 - 0.95]; ISS III: 0.68 [95% CI 0.64 - 0.72], ISS II: 0.81 [95% CI 0.77 - 0.84], ISS I: 0.89 [95% CI 0.85 - 0.92]; HRCA: 0.75 [95% CI 0.71 - 0.79], SRCA: 0.79 [95% CI 0.76 - 0.81]). Discussion: This study found that median rwPFS and 2-year rwOS proportions were consistently lower among HR patients compared to the standard risk individuals. The majority of the HR patients were older, with decreased levels of physical functioning and worse indicators of end-organ damage including renal function, anemia, and hypercalcemia. Most patients received triplets with frequent use of PIs likely for aggressive disease control among HR patients. Some HR patients received more quads than lower risk patients suggesting treatment intensification, but HR patients also received stem cell transplants at a lower rate. Although a smaller proportion of patients have all the data collected needed for R-ISS classification, the consistent findings across treatment outcomes suggest that R-ISS is implementable in real world studies and has a greater discriminatory ability than ISS or HRCA alone. Overall, this study suggests that HR patients have relatively poor outcomes which calls for the study of risk-adapted implementation of novel therapies among this patient population in the US community practice settings. Figure 1 Figure 1. Disclosures Rahman: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Kim: Amgen: Current Employment, Current equity holder in publicly-traded company. Mateus: Amgen Inc.: Current Employment, Other: Work at Amgen as a contract employee through DOCS. Keegan: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company.

scholarly journals Expression of invadopodia markers can identify oral lesions with a high risk of malignant transformation

2020 ◽  
Vol 7 (1) ◽  
pp. 61-74
Author(s):  
Aiman Ali ◽  
Andresa Borges Soares ◽  
Denise Eymael ◽  
Marco Magalhaes
Keyword(s):  
High Risk ◽  
Malignant Transformation ◽  
Oral Lesions

scholarly journals Targeting of chemoprevention to high-risk potentially malignant oral lesions: Challenges and opportunities

Oral Oncology ◽  
2014 ◽  
Vol 50 (12) ◽  
pp. 1123-1130 ◽  
Author(s):  
Victor D. Martinez ◽  
Calum E. MacAulay ◽  
Martial Guillaud ◽  
Wan L. Lam ◽  
Lewei Zhang ◽  
...  
Keyword(s):  
High Risk ◽  
Oral Lesions ◽  
Challenges And Opportunities ◽  
Potentially Malignant

A single visit multidisciplinary model for managing patients with mutations in moderate and high-risk genes in a community practice setting

2017 ◽  
Vol 17 (1) ◽  
pp. 175-178
Author(s):  
Michael P. O’Leary ◽  
Bryan S. Goldner ◽  
Sridevi Abboy ◽  
Philip D. Mercado ◽  
Hong Yoon Plurad
Keyword(s):  
High Risk ◽  
Practice Setting ◽  
Community Practice ◽  
Risk Genes ◽  
Single Visit ◽  
Multidisciplinary Model
Sign in / Sign up

Export Citation Format

Share Document