scholarly journals Wilms' tumor 1 (WT1) expression and prognosis in solid cancer patients: a systematic review and meta-analysis

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Xiao-wei Qi ◽  
Fan Zhang ◽  
Hong Wu ◽  
Jun-lan Liu ◽  
Bei-ge Zong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Wilms Tumor ◽  
Meta Analysis ◽  
Solid Cancer ◽  
Wilms Tumor 1

scholarly journals A Systematic Review and Meta- Analysis of Randomized Controlled Trials on Primary Ambulatory Thromboprophylaxis (PATP) in Patients with Gastrointestinal Cancers Receiving Chemotherapy

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3679-3679
Author(s):  
Kyaw Zin Thein ◽  
Donald P. Quick ◽  
Thein Hlaing Oo
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Cancer Patients ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Control Group ◽  
Number Needed To Treat ◽  
Solid Cancer ◽  
Gastrointestinal Cancers

Introduction: PATP in solid cancer patients remains uncertain and is not routinely recommended although thrombosis is shown to be the second leading cause of death in cancer patients. Many studies failed to demonstrate in solid cancer outpatients improvement in overall survival despite decreasing venous thromboembolism (VTE) rates by PATP. We conducted a systematic review and meta-analysis of RCTs to determine the benefit and risk of PATP with low-molecular weight heparins (LMWHs) and direct oral anticoagulants (DOACs) in patients with gastrointestinal cancers receiving chemotherapy. Methods: We performed a comprehensive literature search using MEDLINE and EMBASE databases through June 30, 2019. The references of all potential studies were also reviewed for any additional relevant studies. The RCTs with reduction in VTE as a primary or secondary endpoint and the major bleeding (MB) as a safety outcome were incorporated in the analysis. The primary meta- analytic approach was a fixed effects model using the Mantel-Haenszel (MH) method. It was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI). Heterogeneity was assessed with Cochran's Q- statistic. Results: A total of 1,932 patients with gastric, gastroesophageal junctional (GEJ) and colorectal cancers from a subgroup of three RCTs were included in our meta-analysis. The prophylactic doses of LMWHs and DOAC (rivaroxaban) were used in the studies. The duration of LMWH and DOAC ranged from 3 to 6 months. The randomization ratio was 2 to 1 in PROTECHT study and 1 to 1 in all other studies. The I2 statistic for heterogeneity was 0, suggesting homogeneity among RCTs. The VTE incidence was 13 (1.26%) in PATP group and 23 (2.55%) in control group with a RR of 0.49 (95% CI: 0.25 to 0.96, P = 0.04). The absolute RD in VTE was -0.01 (95% CI: -0.03 to -0.00, P 0.04) with an estimate of the number needed to treat (NNT) of 78 to prevent one VTE event. In a subset of patients with gastric and GEJ cancers (n=587), the VTE incidence was 4 (1.37%) in PATP group and 10 (3.40%) in control group with a RR of 0.40 (95% CI: 0.13 to 1.24, P = 0.11). Conclusions: In our study, the relative risk reduction is 48% with a NNT of 78 to prevent one VTE in ambulatory patients with gastrointestinal cancers. Nevertheless, there is no statistically significant reduction in VTE events in a subset of gastric and GEJ cancers which are considered high risk in Khorana score. Based on the findings, PATP is not recommended in patients with gastrointestinal cancers on chemotherapy at this time. Further studies are necessary to define high risk subsets of gastrointestinal cancer patients receiving chemotherapy who may benefit from PATP. Disclosures Oo: Medical Education Speakers Network: Honoraria; Janssen and Janssen: Other: site co-investigator.

A Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCT) in Ambulatory Thromboprophylaxis (ATP) in Patients with Lung Cancer Receiving Chemotherapy

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3825-3825
Author(s):  
Kyaw Zin Thein ◽  
Sai-Ching J Yeung ◽  
Thein H. Oo
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Cancer Patients ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Control Group ◽  
Number Needed To Treat ◽  
Solid Cancer ◽  
Fixed Effects Model ◽  
Bleeding Events

Abstract Introduction: Lung cancer (LC) is the commonest cause of cancer mortality in USA. Thromboembolism (TE) is the second leading cause of death in cancer patients. The ambulatory thromboprophylaxis (ATP) in solid cancer patients remains uncertain. However, LC is at least an intermediate risk for TE according to Khorana scoring system. We conducted a systematic review and meta-analysis of RCTs to determine the benefit and risk of ATP with low-molecular weight heparins (LMWH) in LC patients receiving chemotherapy. Methods: We performed a comprehensive literature search using MEDLINE and EMBASE databases through June 30, 2016. The RCTs with reduction in TE as a primary or secondary endpoint and the major bleeding (MB) as a safety outcome were included in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI). Fixed effects model was applied. Results: A total of 4315 patients with LC from 4 RCTs and a subgroup of another 2 RCTs were included in our analysis. The prophylactic doses of dalteparin, nadroparin, certoparin, semuloparin and bemiparin were used in the studies. The ATP duration ranged from 3 to 6 months. The randomization ratio was 2 to 1 in PROTECHT study and 1 to 1 in other studies. The TE incidence was 89 (4.007%) in ATP group and 166 (7.927%) in control group with a RR of 0.510 (95% CI: 0.397 to 0.654, P < 0.001). The absolute RD was -0.039 (95% CI: -0.053 to -0.025, P < 0.001) with an estimated number needed to treat (NNT) of 25 to prevent one TE event. MB events were 24 (1.506%) in ATP group compared to 15 (1.019%) in control group according to an analysis of 4 RCTs. The pooled RR for MB was statistically nonsignificant at 1.468 (95% CI: 0.785 to 2.746, P = 0.229). Clinically relevant nonmajor (CRNM) bleeding events were 80 (5.571%) in ATP group and in 24 (1.674%) in control group on an analysis of 4 RCTs. The RR for CRNM bleeding was statistically significant at 3.253 (95% CI: 2.092 to 5.059, P < 0.001). Conclusions: In our study, the relative risk reduction for TE is 49% with a NNT of 25 to prevent one TE without increasing MB. Nevertheless, CRNM bleeding episodes were significant at a ratio of 3.253. Based on the findings, selection of LC patients who are at high TE risk is important. Further studies are necessary to define a subset of LC patients who may benefit from ATP. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Oo: Daiichi Sankyo: Research Funding.

scholarly journals The Effect of Diffuse Liver Diseases on the Occurrence of Liver Metastases in Cancer Patients: A Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2246
Author(s):  
Filippo Monelli ◽  
Giulia Besutti ◽  
Olivera Djuric ◽  
Laura Bonvicini ◽  
Roberto Farì ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Metastases ◽  
Viral Hepatitis ◽  
Cancer Patients ◽  
Liver Diseases ◽  
Lower Risk ◽  
Meta Analysis ◽  
Solid Cancer ◽  
Cross Sectional ◽  
Diffuse Liver Diseases

This systematic review with meta-analysis aimed to assess the effect of diffuse liver diseases (DLD) on the risk of synchronous (S-) or metachronous (M-) liver metastases (LMs) in patients with solid neoplasms. Relevant databases were searched for systematic reviews and cross-sectional or cohort studies published since 1990 comparing the risk of LMs in patients with and without DLD (steatosis, viral hepatitis, cirrhosis, fibrosis) in non-liver solid cancer patients. Outcomes were prevalence of S-LMs, cumulative risk of M-LMs and LM-free survival. Risk of bias (ROB) was assessed using the Newcastle-Ottawa Scale. We report the pooled relative risks (RR) for S-LMs and hazard ratios (HR) for M-LMs. Subgroup analyses included DLD, primary site and continent. Nineteen studies were included (n = 37,591 patients), the majority on colorectal cancer. ROB appraisal results were mixed. Patients with DLD had a lower risk of S-LMs (RR 0.50, 95% CI 0.34–0.76), with a higher effect for cirrhosis and a slightly higher risk of M-LMs (HR 1.11 95% CI, 1.03–1.19), despite a lower risk of M-LMs in patients with vs without viral hepatitis (HR 0.57, 95% CI 0.40–0.82). There may have been a publication bias in favor of studies reporting a lower risk for patients with DLD. DLD are protective against S-LMs and slightly protective against M-LMs for viral hepatitis only.

Risk of Bleeding from Primary Thromboprophylaxis (PTP) in Patients with Solid Cancer Receiving Chemotherapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCT)

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3820-3820
Author(s):  
Kyaw Zin Thein ◽  
Aung M Tun ◽  
Sai-Ching J Yeung ◽  
Thein H. Oo
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Bleeding Event ◽  
Bleeding Risk ◽  
Risk Difference ◽  
Control Group ◽  
Solid Cancer ◽  
Bleeding Events ◽  
Risk Of Bleeding

Abstract Introduction: Thrombosis is the second leading cause of death in cancer patients. Hypothetically, prognosis might be improved by preventing thrombotic events by PTP. PTP has to be outweighed with the bleeding risk from PTP benefit. Moreover, PTP in ambulatory cancer patients remains uncertain. We performed a systematic review and meta-analysis of RCTs to determine the risk of major bleeding (MB) and clinically relevant non-major (CRNM) bleeding from PTP with low-molecular weight heparins (LMWH) in solid cancer patients receiving chemotherapy. Methods: We systematically conducted a comprehensive literature search using MEDLINE and EMBASE databases through May 31, 2016. The RCTs with MB and CRNM bleeding as safety outcomes were included in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI). Random effects model was applied. Results: 12 RCTs with a total of 8643 patients were eligible for analysis. Dalteparin, nadroparin, certoparin, semuloparin and bemiparin were used in the studies. 9 studies utilized prophylactic doses, while one used intermediate doses and 2 employed therapeutic dose. The PTP duration was from 6 weeks to 6 months. MB events were reported in 67 (1.486%) patients on PTP compared to 46 (1.112%) in control group. The pooled RR for MB was statistically nonsignificant at 1.341 (95% CI: 0.917 to 1.960, P = 0.130). CRNM bleeding events were noted in 209 (4.637%) in PTP group and 106 (2.563%) in control group. The RR for CRNM bleeding was statistically significant at 1.729 (95% CI: 1.017 to 2.938, P = 0.043). The absolute RD in CRNM bleeding was 0.020 (95% CI: 0.004 to 0.035, P = 0.012) with an estimated number needed to harm (NNH) of 48 to cause one CRNM bleeding event. Conclusions: Approximately 60 patients are needed to be treated with PTP to prevent one symptomatic venous thrombosis among all ambulatory unselected cancer patients on chemotherapy in a previous meta-analysis. Our meta-analysis revealed that PTP contributed an increase in CRNM bleeding events with NNH of 48. The risk of bleeding should not be underestimated and more RCTs are required before making any recommendations. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Oo: Daiichi Sankyo: Research Funding.

scholarly journals Efficacy of COVID-19 vaccines in immunocompromised patients: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Ainsley Ryan Yan Bin Lee ◽  
Shi Yin Wong ◽  
Louis Yi Ann Chai ◽  
Soo Chin Lee ◽  
Matilda Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Risk Ratio ◽  
Data Extraction ◽  
Meta Analysis ◽  
Solid Cancer ◽  
Immunocompromised Patients ◽  
Medical Conditions ◽  
Transplant Recipients ◽  
Haematological Cancer

Objective To compare the efficacy of COVID 19 vaccines between those with immunocompromised medical conditions and those who are immunocompetent Design Systematic review and meta-analysis Data sources PubMed, EMBASE, CENTRAL, CORD-19 and WHO COVID-19 research databases were searched for eligible comparative studies published between 1st December 2020 and 3rd September 2021. ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched in August 2021 to identify registered yet unpublished or ongoing studies. Study selection Prospective observational studies which compared the efficacy of COVID-19 vaccination between those with immunocompromising medical conditions and those who were immunocompetent were included. Two reviewers independently screened for potentially eligible studies. Data extraction The primary outcomes of interest were cumulative incidence of seroconversion after first and second doses of COVID vaccination. Secondary outcomes included SARS-CoV-2 antibody titre level after first and second doses of COVID-19 vaccination. After duplicate data abstraction, a frequentist random effects meta-analysis was conducted. Risk of bias was assessed using the ROBINS-I tool. Certainty of evidence was assessed using the GRADE approach. Results After screening 3283 studies, 42 studies that met our inclusion criteria were identified. 18 immunocompromised cohorts from 17 studies reported seroconversion in immunocompromised patients compared to healthy controls after the first dose and 30 immunocompromised cohorts in 28 studies reporting data after the second dose. Among immunocompromised groups, in incremental order, transplant recipients had the lowest pooled risk ratio of 0.06 (95%CI: 0.04 to 0.09, I^2=0%, p=0.81) (GRADE=Moderate) followed by haematological cancer patients at 0.36 (95%CI: 0.21 to 0.62, I^2 = 89%, p<0.01) (GRADE=Moderate), solid cancer patients at 0.40 (95%CI: 0.31 to 0.52, I^2 = 63%, p=0.03) (GRADE=Moderate) and IMID patients at 0.66 (95%CI: 0.48 to 0.91, I^2=81%, p<0.01) (GRADE=Moderate). After the second dose, the lowest pooled risk ratio was again seen in transplant recipients at 0.29 (95%CI: 0.21 to 0.40, I^2=91%, p<0.01) (GRADE=Moderate), haematological cancer patients at 0.68 (95%CI: 0.57 to 0.80, I^2=68%, p=0.02) (GRADE=Low), IMID patients at 0.79 (95%CI: 0.72 to 0.786, I^2=87%, p<0.01) (GRADE=Low) and solid cancer at 0.92 (95%CI: 0.89 to 0.95, I^2=26%, p=0.25) (GRADE=Low). Conclusion Seroconversion rates and serological titres are significantly lower in immunocompromised patients with transplant recipients having the poorest outcomes. Additional strategies on top of the conventional 2-dose regimen will likely be warranted, such as a booster dose of the vaccine. Systematic review registration PROSPERO CRD42021272088

Coronavirus Disease (COVID-19) in Cancer Patients: A Systematic Review and Meta-Analysis to Evaluate Severity and Fatal Outcomes

2020 ◽  
Author(s):  
Abhijeet Ashok Salunke ◽  
Kunal Nandy ◽  
Subodh Kumar Pathak ◽  
Ketul Puj ◽  
Vikas Warikoo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Meta Analysis

Effectiveness of five-element music therapy in cancer patients: A systematic review and meta-analysis

2021 ◽  
pp. 101416
Author(s):  
Ting Yang ◽  
Shurui Wang ◽  
Ruirui Wang ◽  
Yuqi Wei ◽  
Yannan Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Music Therapy ◽  
Cancer Patients ◽  
Meta Analysis

Traditional Oriental Herbal Medicine and Natural Killer Cells for Cancer Patients: A Systematic Review and Meta-analysis

2017 ◽  
Vol 31 (4) ◽  
pp. 519-532 ◽  
Author(s):  
Kyeore Bae ◽  
Ji-hye Park ◽  
Jeehye Kim ◽  
Chong-kwan Cho ◽  
Byeongsang Oh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Natural Killer Cells ◽  
Herbal Medicine ◽  
Natural Killer ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Killer Cells
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