scholarly journals Esophageal cancer: comparative effectiveness of treatment options

2016 ◽  
pp. 1 ◽  
Author(s):  
Steven Lin ◽  
Cai Xu
Keyword(s):  
Esophageal Cancer ◽  
Comparative Effectiveness ◽  
Treatment Options

scholarly journals Targeting the Microenvironment in Esophageal Cancer

2021 ◽  
Vol 9 ◽  
Author(s):  
Lei Wang ◽  
Huiqiong Han ◽  
Zehua Wang ◽  
Litong Shi ◽  
Mei Yang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Adverse Reactions ◽  
Radical Surgery ◽  
Treatment Options ◽  
Antiangiogenic Therapy ◽  
Common Type ◽  
New Drugs ◽  
Limited Efficacy ◽  
Important Therapeutic Target

Esophageal cancer (EC) is the eighth most common type of cancer and the sixth leading cause of cancer-related deaths worldwide. At present, the clinical treatment for EC is based mainly on radical surgery, chemotherapy, and radiotherapy. However, due to the limited efficacy of conventional treatments and the serious adverse reactions, the outcome is still unsatisfactory (the 5-year survival rate for patients is less than 25%). Thus, it is extremely important and urgent to identify new therapeutic targets. The concept of tumor microenvironment (TME) has attracted increased attention since it was proposed. Recent studies have shown that TME is an important therapeutic target for EC. Microenvironment-targeting therapies such as immunotherapy and antiangiogenic therapy have played an indispensable role in prolonging survival and improving the prognosis of patients with EC. In addition, many new drugs and therapies that have been developed to target microenvironment may become treatment options in the future. We summarize the microenvironment of EC and the latest advances in microenvironment-targeting therapies in this review.

Comparative effectiveness research in renal cell carcinoma: Lenvatinib with everolimus as a potential new treatment option.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 27-27 ◽  
Author(s):  
Gabriel Tremblay ◽  
Corey Pelletier ◽  
Unnati Majethia ◽  
Anna Forsythe
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Comparative Effectiveness ◽  
Treatment Options ◽  
Progression Free Survival ◽  
Treatment Comparison ◽  
Hazard Ratios ◽  
New Treatment ◽  
Comparative Effectiveness Analysis

27 Background: Renal cell carcinoma (RCC) is the most common type of kidney cancer and represents about 90% of all kidney cancers. As comprehensive comparison of the efficacy associated with mRCC treatments is not available, the goal of this research was to provide a comparative effectiveness analysis including overall survival (OS) and progression free survival (PFS) for first and second line treatments. Methods: Systematic literature review yielded the following randomized active-controlled studies: lenvatinib + everolimus (LEN+EVE) versus everolimus (EVE), axinitib (AXI) versus sorafenib (SOR), cabozantinib (CAB) versus EVE, nivolumab (NIV) versus EVE, and pazopanib (PAZ) versus sunitinib (SUN). In addition, placebo-controlled studies were identified for EVE, PAZ, and SOR. An indirect treatment comparison (ITC) was performed on OS and PFS hazard ratios (HR). Results: Scenario A presents the HR and confidence intervals (95% CI) generated with ITC of all treatments against EVE. In scenario B, the HR of LEN + EVE are compared to all treatment options. Only LEN + EVE and CAB demonstrated significance against EVE for both OS and PFS. LEN + EVE proved to be significant against EVE, PAZ, SOR, SUN, AXI and NIV for PFS and against EVE, SOR and AXI for OS. The use of crossover trials in the network for the treatment compared to placebo remains a potential bias in the results. Conclusions: Even if limitations exist regarding the use of ITC, the option of LEN+EVE demonstrated a strong comparative effectiveness profile for both OS and PFS. [Table: see text]

scholarly journals Esophageal Cancer After Bariatric Surgery: Increasing Prevalence and Treatment Strategies

2021 ◽  
Author(s):  
Victor D. Plat ◽  
Anne Kasteleijn ◽  
Jan Willem M. Greve ◽  
Misha D. P. Luyer ◽  
Suzanne S. Gisbertz ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Esophageal Cancer ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Loss To Follow Up ◽  
Multicenter Cohort ◽  
Incidence And Mortality ◽  
Individualized Approach ◽  
Post Bariatric Surgery

Abstract Purpose The number of bariatric procedures has increased exponentially over the last 20 years. On the background of ever-increasing incidence of esophageal malignancies, the altered anatomy after bariatric surgery poses challenges in treatment of these cancers. In this study, an epidemiological estimate is presented for the future magnitude of this problem and treatment options are described in a retrospective multicenter cohort. Methods The number of bariatric procedures, esophageal cancer incidence, and mortality rates of the general population were used for epidemiological estimates. A retrospective multicenter cohort was composed; patients were treated in three large oncological centers with a high upper gastrointestinal cancer caseload. Consecutive patients with preceding bariatric surgery who developed esophageal cancer between 2014 and 2019 were included. Results Approximately 3200 out of 6.4 million post bariatric surgery patients are estimated to have developed esophageal cancer between 1998 and 2018 worldwide. In a multicenter cohort, 15 patients with esophageal cancer or Barrett’s esophagus and preceding bariatric surgery were identified. The majority of patients had a history of Roux-en-Y gastric bypass (46.7%) and had an adenocarcinoma of the distal esophagus (60%). Seven patients received curative surgical treatment, five of whom are still alive at last follow-up (median follow-up 2 years, no loss to follow-up). Conclusion Based on worldwide data, esophageal cancer development following bariatric surgery has increased over the past decades. Treatment of patients with esophageal cancer after bariatric surgery is challenging and requires a highly individualized approach in which optimal treatment and anatomical limitations are carefully balanced. Graphical abstract

scholarly journals Critical appraisal and issues regarding generalisability of comparative effectiveness studies of NOACs in atrial fibrillation and their relation to clinical trial data: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042024
Author(s):  
Eveline M Bunge ◽  
Ben van Hout ◽  
Sylvia Haas ◽  
Georgios Spentzouris ◽  
Alexander Cohen
Keyword(s):  
Atrial Fibrillation ◽  
Comparative Effectiveness ◽  
Critical Appraisal ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Oral Anticoagulants ◽  
Treatment Options ◽  
Patient Registries ◽  
Effectiveness Studies ◽  
Unmeasured Confounders

ObjectiveTo critically appraise the published comparative effectiveness studies on non-vitamin K antagonist oral anticoagulants (NOACs) in non-valvular atrial fibrillation (NVAF). Results were compared with expectations formulated on the basis of trial results with specific attention to the patient years in each study.MethodsAll studies that compared the effectiveness or safety between at least two NOACs in patients with NVAF were eligible. We performed a systematic literature review in Medline and EMbase to investigate the way comparisons between NOACs were made, search date 23 April 2019. Critical appraisal of the studies was done using among others ISPOR Good Research Practices for comparative effectiveness research.ResultsWe included 39 studies in which direct comparison between at least two NOACs were made. Almost all studies concerned patient registries, pharmacy or prescription databases and/or health insurance database studies using a cohort design. Corrections for differences in patient characteristics was applied in all but two studies. Eighteen studies matched using propensity scores (PS), 8 studies weighted patients based on the inverse probability of treatment, 1 study used PS stratification and 10 studies applied a proportional hazards model. These studies have some important limitations regarding unmeasured confounders and channelling bias, even though the larger part of the studies were well conducted technically. On the basis of trial results, expected differences are small and a naïve analysis suggests trials with between 7200 and 56 500 patients are needed to confirm the observed differences in bleedings and between 51 800 and 7 994 300 to confirm differences in efficacy.DiscussionComparisons regarding effectiveness and safety between NOACs on the basis of observational data, even after correction for baseline characteristics, may not be reliable due to unmeasured confounders, channelling bias and insufficient sample size. These limitations should be kept in mind when results of these studies are used to decide on ranking NOAC treatment options.

Neoadjuvant therapy or upfront surgery? A systematic review and meta-analysis of T2N0 esophageal cancer treatment options

2018 ◽  
Vol 54 ◽  
pp. 176-181 ◽  
Author(s):  
F.C. Mota ◽  
I. Cecconello ◽  
F.R. Takeda ◽  
F. Tustumi ◽  
R.A.A. Sallum ◽  
...  
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Cancer Treatment ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Treatment Options

Comparative Effectiveness Analysis of Treatment Options for Single Brain Metastasis

2015 ◽  
Vol 84 (5) ◽  
pp. 1316-1332 ◽  
Author(s):  
Kristopher T. Kimmell ◽  
Emily LaSota ◽  
Robert J. Weil ◽  
Nicholas F. Marko
Keyword(s):  
Brain Metastasis ◽  
Comparative Effectiveness ◽  
Treatment Options ◽  
Effectiveness Analysis ◽  
Single Brain Metastasis ◽  
Comparative Effectiveness Analysis
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