scholarly journals Investigating a Correlation between Chemoradiotherapy Schedule Parameters and Overall Survival in a real-life LD SCLC Patient Cohort

2016 ◽  
Vol 7 (14) ◽  
pp. 2012-2017
Author(s):  
Farkhad Manapov ◽  
Chukwuka Eze ◽  
Maximilian Niyazi ◽  
Olarn Roengvoraphoj ◽  
Minglun Li ◽  
...  
Keyword(s):  
Overall Survival ◽  
Real Life ◽  
Patient Cohort ◽  
Sclc Patient

scholarly journals Impact of performance status on overall survival in patients with relapsed and/or refractory multiple myeloma: Real‐life outcomes of daratumumab treatment

2020 ◽  
Vol 105 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Garbriel Afram ◽  
Charlotte Gran ◽  
Johanna Borg Bruchfeld ◽  
Arnika Kathleen Wagner ◽  
Alamdar Hussain ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Performance Status ◽  
Real Life ◽  
Life Outcomes ◽  
Refractory Multiple Myeloma

scholarly journals Development of a Predictive Immune-Related Gene Signature Associated With Hepatocellular Carcinoma Patient Prognosis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482097711
Author(s):  
Jiasheng Lei ◽  
Dengyong Zhang ◽  
Chao Yao ◽  
Sheng Ding ◽  
Zheng Lu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Cox Regression ◽  
R Package ◽  
Gene Signature ◽  
Differentially Expressed ◽  
Related Gene ◽  
Patient Cohort ◽  
Immune Related Gene ◽  
Related Risk

Background: Hepatocellular carcinoma (HCC) remains the third leader cancer-associated cause of death globally, but the etiological basis for this complex disease remains poorly clarified. The present study was thus conceptualized to define a prognostic immune-related gene (IRG) signature capable of predicting immunotherapy responsiveness and overall survival (OS) in patients with HCC. Methods: Five differentially expressed IRG associated with HCC were established the immune-related risk model through univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Patients were separated at random into training and testing cohorts, after which the association between the identified IRG signature and OS was evaluated using the “survival” R package. In addition, maftools was leveraged to assess mutational data, with tumor mutation burden (TMB) scores being calculated as follows: (total mutations/total bases) × 106. Immune-related risk term abundance was quantified via “ssGSEA” algorithm using the “gsva” R package. Results: HCC patients were successfully stratified into low-risk and high-risk groups based upon a signature composed of 5 differentially expressed IRGs, with overall survival being significantly different between these 2 groups in training cohort, testing cohort and overall patient cohort ( P = 1.745e-06, P = 1.888e-02, P = 4.281e-07). No association was observed between TMB and this IRG risk score in the overall patient cohort ( P = 0.461). Notably, 19 out of 29 immune-related risk terms differed substantially in the overall patient dataset. These risk terms mainly included checkpoints, human leukocyte antigens, natural killer cells, dendritic cells, and major histocompatibility complex class I. Conclusion: In summary, an immune-related prognostic gene signature was successfully developed and used to predict survival outcomes and immune system status in patients with HCC. This signature has the potential to help guide immunotherapeutic treatment planning for patients affected by this deadly cancer.

scholarly journals Prevalence and impact of risk factors for poor asthma outcomes in a large, specialist-managed patient cohort: a real-life study

2019 ◽  
Vol Volume 12 ◽  
pp. 297-307 ◽  
Author(s):  
Gábor Tomisa ◽  
Alpár Horváth ◽  
Zsuzsanna Szalai ◽  
Veronika Müller ◽  
Lilla Tamási
Keyword(s):  
Risk Factors ◽  
Real Life ◽  
Life Study ◽  
Patient Cohort ◽  
Asthma Outcomes ◽  
Real Life Study

Azacitidine Has Limited Activity in Patients with MDS and AML

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5057-5057
Author(s):  
Karen Yee ◽  
Symron Bansal ◽  
Joseph Brandwein ◽  
Mark D. Minden ◽  
Aaron Schimmer ◽  
...  
Keyword(s):  
Overall Survival ◽  
Myeloproliferative Neoplasm ◽  
Organ Transplant ◽  
Real Life ◽  
Dose Schedule ◽  
Median Number ◽  
Intensive Chemotherapy ◽  
Princess Margaret Hospital ◽  
Limited Efficacy ◽  
Best Response

Abstract Abstract 5057 Background: The multicenter, randomized AZA-001 trial demonstrated that azacitidine (AZA) significantly improved overall survival in patients with intermediate-2/high risk MDS (including patients with AML < 30 % marrow blasts), compared with conventional care regimens, including supportive care, low dose cytarabine (LDAC) and intensive chemotherapy (Lancet Oncol 2009;10:223–32). Recent data has suggested that AZA may have limited efficacy in the “real life” situation (Hematol Oncol 2011Mar8; Epub ahead of print). This retrospective analysis evaluates the responses and outcomes of patients with MDS and AML < 30% marrow blasts who received AZA at the Princess Margaret Hospital. Methods: Between July 2009 and July 2011, 87 patients received AZA at the Princess Margaret Hospital. This analysis is restricted to patients with MDS and AML < 30% marrow blasts (n = 60), excluding AML with > 30% blasts (n = 6), MDS/myeloproliferative neoplasm (n = 1), and patients previously treated with intensive chemotherapy and/or alloSCT within the last 5 years (n = 20). Azacitidine was planned to be administered subcutaneously at the dose-schedule of 75 mg/m2/d for 6 days every 28 days. However, 8 patients received subsequent cycles of AZA in local centers at the dose schedule of 75 mg/m2/d for 5 days, 2 days off, followed by 75 mg/m2/d for 2 days (AZA 5-2-2). Results: Median age was 73 (range, 43 to 87), and 63% were male. Twenty-three patients (38%) had secondary or therapy-related MDS or AML. Two patients had received a prior organ transplant (heart and liver). Forty-two patients (70%) had MDS (7 RCMD, 10 RAEB-1, 17 RAEB-2, 3 CMML-1, 5 CMML-2). Cytogenetic risk (by IPSS criteria) was good in 19 (32%), intermediate in 6 (10%), and poor in 33 (55%) patients, respectively. Karyotype analysis failed in 2 patients (3%). IPSS was intermediate-1 in 4 (7%), intermediate-2 in 32 (53%), and high in 24 (40%) of the patients. Median baseline hemoglobin level, absolute neutrophil count and platelet count were 90.5 g/L, 0.9 × 109/L, and 44.5 × 109/L, respectively. Median prior therapies was 0 (range, 0–2) with 5, 3, 1, and 1 patients having previously received erythropoiesis-stimulating agent, hydroxyurea, LDAC, and decitabine, respectively. The median number of AZA cycles administered was 5.5 (range, 0–19). The best response was CR in 4 (7%), marrow CR in 8 (13%), and hematologic improvements in platelets, neutrophils, and erythroid in 15 (25%), 9 (15%), and 5 (8%) patients, respectively. Fifteen patients remain on treatment. Treatment discontinuation was mostly due to disease progression, lack of response, and/or intercurrent illness/infection, with 7 (12%) patients stopping therapy to proceed to an alloSCT. Twenty patients have died. Median overall survival was 36.7 weeks (range, 4.4 weeks-86.6+ weeks). Conclusions: Azacitidine has limited efficacy in this group of patients. Optimal therapy for this patient population still needs to be determined. Disclosures: Yee: Celgene: Honoraria. Schuh:Celgene: Honoraria.

scholarly journals Treatment modalities and drug survival in a systemic sclerosis real-life patient cohort

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
S. Panopoulos ◽  
Κ. Chatzidionysiou ◽  
M. G. Tektonidou ◽  
V. K. Bournia ◽  
A. A. Drosos ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Real Life ◽  
Treatment Modalities ◽  
Patient Cohort ◽  
Drug Survival

scholarly journals Impact of Early Switching to Nilotinib As Second Line TKI in Patients with Chronic Myeloid Leukemia Who Were Intolerant to, Suboptimal to and Failed Imatinib: The Thai Multi-Centered Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4267-4267
Author(s):  
Pongtep Viboonjuntra ◽  
Arnuparp Lekhakula ◽  
Kanchana Chansung ◽  
Chittima Sirijerachai ◽  
Pimjai Niparuck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adverse Events ◽  
Real Life ◽  
Progression Free Survival ◽  
Second Line ◽  
Free Survival ◽  
Kaplan Meier ◽  
Grade 3 ◽  
The Impact

Abstract Introduction : To date, the ELN recommendation and NCCN guidelines are the principle mile stones to follow up the treatment response and to make the decision of TKIs switching. However, in real life practice, many factors influence changing the real switching date from the date had an indication. This study aims to analyze the impact of early switching to second line TKI, nilotinib, in real life practice, for the CML patients who failed, had sub-optimal response or were intolerant to imatinib. Methods : This prospective study was conducted through 7 medical centers in Thailand between 1st of September 2009 and 31st of August 2011. Adult CML patients of age ≥ 18 years old, in chronic and accelerated phase, who had failure, suboptimal response or intolerance to imatinib, based on ELN 2009 guideline, were included and were eligible with nilotinib 400 mg twice daily. Prospective data collection for 24 months of each patient was performed. The main objective was to identify the impact of early switching to nilotinib on major molecular response (MMR). The other objectives were to observe the efficacy of nilotinib including overall survival, progression free survival and the safety. The survival results were presented as Kaplan-Meier survival curves. For the comparison of the treatment groups, the Kaplan-Meier estimator with the corresponding log-rank test for equality of survivor functions across treatment group was applied. Results : The final 108 cases were analysed. The median age was 47 (17-79) years with the proportion of male to female of 1.4:1 respectively. The median duration of the prior imatinib treatment was 18 months (2-142 months). The median duration between the date of indication and the date of real switching was 3.1 months (0-62.8 months) with 50% changing less than 3 months, 26.9% between 3 months and 12 months, and 23.1% changing longer than 12 months. The indication of switching included 63.6% failure to imatinib, 29% intolerance to imatinib and 7.4% suboptimal to imatinib. On the nilotinib switching, 70.4% completed 24 months follow-up, and 29.6% discontinued treatment mostly because of unsatisfactory results or adverse events. Evaluation was made every 3 months based on 2009 ELN recommendation. At 3 months, 57%, 20%, and 8% of the patients achieved CHR, CCyR and MMR, respectively. Those who did not achieve CHR at 3 months never achieved MMR, while 86 % of those who achieved CCyR at 3 months achieved MMR. All CML achieving MMR at 3 months had sustained MMR throughout the study period (24 months). Imatinib suboptimal response had better outcome than imatinib failure and imatinib intolerance groups. A preliminary analysis of BCR-ABL mutation was performed on 90 cases, and mutations were found on 21 cases. Two of them were T315I which were excluded from the study. The cases with mutation had poorer response to treatment than those without mutation. There was one case with initial G250E mutation developing T315I mutation after treatment with nilotinib. At 24 months, one case progressed to accelerated phase and 3 cases progressed to blastic transformation. The 2-year overall survival and 2-year progression-free survival and were 98.9% and 96.9% (figure 1 and 2), respectively. The interquatile analysis was done to identify the groups of cumulative MMR according to the duration between the date of indication and the date of real switching to nilotinib. The patients who switched to nilotinib within 12 months after date of indication could have a greater chance to achieved MMR than those who switched treatment later than 12 months (p(log-rank) = 0.002) (figure 3). Skin rash, musculoskeletal pain, and infection were the three most common non-hematologic adverse events, However, most of them were grade 1-2, except for 4 cases with grade 3-4 infections. Grade 3-4 hematologic adverse events included thrombocytopenia (12%), neutropenia (11%), anemia (5%) and leucopenia (4%), and most of them were manageable. Although biochemical abnormalities were commonly found, most of them were mild. Conclusions : Nilotinib, as a second line treatment showed excellent efficacy and tolerability. Indication for nilotinib treatment, initial mutation status and depth of response at 3 months after treatment can predict outcomes of the patients. However, the patients will have a greater chance to achieve MMR if they switched to nilotinib within 12 months after the date of indication for changing. Disclosures No relevant conflicts of interest to declare.

scholarly journals Treatment Outcomes of Real Life Elderly Multiple Myeloma Patients:Â Analysis from Registry of Monoclonal Gammopathies (RMG)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2019-2019
Author(s):  
Jakub Radocha ◽  
Roman Hajek ◽  
Lucie Brozova ◽  
Ludek Pour ◽  
Ivan Spicka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Treatment Outcomes ◽  
Board Of Directors ◽  
Research Funding ◽  
Statistical Significance ◽  
Real Life ◽  
Advisory Committees ◽  
Monoclonal Gammopathies

Abstract Introduction: Multiple myeloma patients over the age of 65 represent the majority of myeloma population. The main goal was to evaluate treatment outcomes in terms of overall survival for elderly patients based on initial choice of anti-myeloma drugs, and to find potential factors affecting survival. Patients and Methods: This is a retrospective registry based analysis from the Registry of monoclonal gammopathies of the Czech Myeloma Group. Patients with multiple myeloma diagnosed between 2007-2016 over the age of 65 with symptomatic myeloma were included in the analysis. Basic demographic data and disease characteristics were obtained. The Kaplan-Meier estimates were completed by the Greenwood confidence interval. The log-rank test was used to estimate the statistical significance of the difference between the curves. The Cox proportional hazards model was performed to explore the univariate significance of risk factors. Results: Data from 1410 MM patients were obtained. Gender [HR 1.316 (1.124-1.541), p=0.001], age [above 75 vs. 66-75, HR 1.437 (1.221-1.692), p< 0.001], creatinine levels [at cutoff 152 µmol/L, HR 1.613 (1.365-1.905), p< 0.001] and ECOG performance status [0-1 vs. 2-4, 1.869 (1.594-2.191), p< 0.001] were found to significantly affect overall survival. Moreover these risk factors have cumulative effect on overall survival of the patients. Overall survival of patients regardless to above mentioned risk factors treated with upfront bortezomib (N = 880) was median OS 40.4 months (CI: 36.1-44.7), patients treated with upfront thalidomide (N = 370) had median OS 48.1 months (CI: 41.0-55.2), for lenalidomide (N = 64) median overall survival was 53.2 months (CI: 44.6-61.8) and for combination of bortezomib and thalidomide (N = 46) 32.2 months (CI: 26.6-37.8). When any of these risk factors was present the OS in each group shortened. In the group of patients with no risk factors (N = 255) the median OS for bortezomib (N = 126) was not reached, for thalidomide (N = 96) the median OS was 66.3 months (CI: 43.1-89.6), for lenalidomide (N = 17) 71.1 months (CI: 44.8-97.4) and for combination of bortezomib and thalidomide (N=8) was not reached. In the group of patients with 1 risk factor (N = 514) the median OS for bortezomib (N = 303) was 46.1 months (CI: 36.2-56.1), for thalidomide (N = 141) 56.2 months (CI: 47.5-64.9), for lenalidomide (N = 29) 49.0 months (CI: 9.7-88.2) and for combination of bortezomib and thalidomide (N=20) was not reached. In the group of patients with 2 risk factors (N = 420) the median OS for bortezomib (N = 288) was 34.0 months (CI: 24.7-43.4), for thalidomide (N = 87) 31.9 months (CI: 22.8-40.9), for lenalidomide (N = 14) 33.2 months (CI: 0.0-67.6) and for combination of bortezomib and thalidomide (N=20) 29.4 months (CI: 7.6-51.1). In the group of patients with 3-4 risk factors (N = 221) the median OS for bortezomib (N = 163) was 19.2 months (CI: 14.9-23.5), for thalidomide (N = 46) 18.9 months (CI: 13.0-24.7), for lenalidomide (N = 4) 6.1 months (CI: 0.0-63.0) and for combination of bortezomib and thalidomide (N=3) 14.3 months (CI:-). Conclusion: The overall survival of patients above the age of 65 shows promising results with the use of novel agents. The treatment outcomes seem to be generally affected by overall condition, age and gender of the patient rather than treatment modality used upfront. Figure. Figure. Disclosures Hajek: Amgen: Consultancy, Honoraria, Research Funding; Bristol Myers Squibb: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria, Research Funding; Novartis: Research Funding. Maisnar:Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees.

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