المؤلفون: Raquel Aguiar-Ibáñez, Emilie Scherrer, Dmitri Grebennik, John Cook, Shalini Bagga, Baanie Sawhney, Anvi Khandelwal, Scott A. Soefje

المصدر: BMC Health Services Research, Vol 23, Iss 1, Pp 1-10 (2023)

مصطلحات موضوعية: Immunotherapies, Pembrolizumab, Nivolumab, Survey, Productivity loss, Infusion visit, Public aspects of medicine, RA1-1270

الوصف: Abstract Introduction A new dosing schedule for the oncology immunotherapy pembrolizumab, every 6 weeks (Q6W), has been approved by the U.S. FDA, reducing the frequency of visits to infusion centers. We quantified the time spent by oncologists, nurses, patients, and caregivers per melanoma-related immunotherapy infusion visit to evaluate its potential impact. Methods Surveys were self-completed by 100 oncologists, 101 oncology nurses, and 100 patients with melanoma across the U.S. to quantify the time spent per infusion visit with pembrolizumab (Q3W or Q6W), nivolumab (Q2W or Q4W), or nivolumab+ipilimumab (nivolumab in combination: Q3W; nivolumab maintenance: Q2W or Q4W). Time measures included traveling, waiting, consultation, infusion, post-treatment observation, and caregiving. Respondents were also surveyed regarding the impact of the COVID-19 pandemic on infusion treatments. Results Responses deemed valid were provided by 89 oncologists, 93 nurses, and 100 patients. For each new [returning] patient treated with pembrolizumab, nivolumab or nivolumab+ipilimumab, oncologists reported to spend an average of 90 [64], 87 [60] and 101 [69] minutes per infusion visit (p-value for between-group difference = 0.300 [0.627]). For first [subsequent] treatment cycles, nurses reported spending 160 [145] average minutes per visit for nivolumab+ipilimumab, versus roughly 120 [110] for the single agents (p-value for between-group difference = 0.018 [0.022]). Patients reported to spend an average of 263, 382, and 224 minutes per visit at the center for pembrolizumab (N = 47), nivolumab (n = 34), and nivolumab+ipilimumab (n = 15) respectively (p-value for between-group difference = 0.0002). Patients also reported that their unpaid (N = 20) and paid caregivers (N = 41) spent with them an average of 966 and 333 minutes, respectively, from the day before to the day after the infusion visit. Conclusion Less frequent immunotherapy infusion visits may result in substantial time savings for oncologists, nurses, patients, and caregivers.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1472-6963Test

الوصول الحر: https://doaj.org/article/a95b3147d0cb47f7912515827ebe0e3eTest

المؤلفون: Xiang-Lin Tan, Amy Le, Emilie Scherrer, Huilin Tang, Nick Kiehl, Jiali Han, Ruixuan Jiang, Scott J. Diede, Irene M. Shui

المصدر: Frontiers in Oncology, Vol 12 (2022)

مصطلحات موضوعية: melanoma, brain metastasis, immunotherapy, targeted therapy, radiosurgery, prognostic factors, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: BackgroundMore than 60% of all stage IV melanoma patients develop brain metastases, while melanoma brain metastases (MBM) is historically difficult to treat with poor prognosis.ObjectivesTo summarize clinical outcomes and prognostic factors in MBM patients.MethodsA systematic review with meta-analysis was conducted, and a literature search for relevant studies was performed on November 1, 2020. Weighted average of median overall survival (OS) was calculated by treatments. The random-effects model in conducting meta-analyses was applied.ResultsA total of 41 observational studies and 12 clinical trials with our clinical outcomes of interest, and 31 observational studies addressing prognostic factors were selected. The most common treatments for MBM were immunotherapy (IO), MAP kinase inhibitor (MAPKi), stereotactic radiosurgery (SRS), SRS+MAPKi, and SRS+IO, with median OS from treatment start of 7.2, 8.6, 7.3, 7.3, and 14.1 months, respectively. Improved OS was observed for IO and SRS with the addition of IO and/or MAPKi, compared to no IO and SRS alone, respectively. Several prognostic factors were found to be significantly associated with OS in MBM.ConclusionThis study summarizes pertinent information regarding clinical outcomes and the association between patient characteristics and MBM prognosis.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fonc.2022.1025664/fullTest; https://doaj.org/toc/2234-943XTest

الوصول الحر: https://doaj.org/article/4829faf92aa94029b9b665b8fe8a7746Test

المؤلفون: Emilie Scherrer, Ashley Kang, Lisa M. Bloudek, Vadim S. Koshkin

المصدر: Frontiers in Oncology, Vol 12 (2022)

مصطلحات موضوعية: urothelial carcinoma, HER2, ErbB2, targeted therapy, systematic literature search, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: BackgroundUrothelial carcinoma (UC) is a common malignancy with significant associated mortality. Recent clinical trials suggest an emerging role for HER2-targeted therapy. Testing for HER2 expression in UC is not part of current routine clinical practice. In consequence, the prevalence of HER2 expression in UC is not well defined.MethodsA systematic literature review (SLR) was conducted to characterize HER2 expression in both locally advanced unresectable or metastatic (LA/mUC) and earlier stage UC, classified as HER2+, HER2-low, HER2-. HER2+ was defined as an immunohistochemistry (IHC) score of 3+ or IHC 2+ and ISH/FISH+. HER2-low was defined as an IHC score of 2+ and ISH/FISH- or IHC 1+. HER2- was defined as an IHC score of 0. Weighted averages were calculated to generate an estimate of the population prevalence.ResultsA total of 88 studies were identified, with 45, 30, and 13 studies investigating LA/mUC, earlier stage UC, and mixed stage/unspecified, respectively. The most common assays used were Dako HercepTest and Ventana Pathway anti-HER2/neu (4B5) for IHC to assess HER2 protein expression; Abbott PathVysion HER-2 DNA Probe Kit, FoundationOne CDx, and Guardant360 CDx for assessing HER2 gene amplification. The most frequently cited scoring guidelines were ASCO/CAP guidelines for breast cancer and gastric cancer, though most studies defined their own criteria for HER2 expression. Using the pre-specified definition, HER2+ prevalence ranged from 6.7% to 37.5% with a weighted average of 13.0% in LA/mUC. Only 1 study presented data that could be classified as HER2+ based on pre-specified criteria in earlier stage UC patients, and this study represented a likely outlier, at 76.0%.ConclusionThe results from this SLR help to shed light on HER2 expression in UC, a potentially clinically relevant biomarker-driven subpopulation for emerging HER2-directed regimens. Results of this SLR illuminate the variability in how HER2+ status expression levels are being assessed and how HER2+ is defined. Consensus on standardized HER2 testing and scoring criteria is paramount to better understand the clinical relevance in patients with UC.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fonc.2022.1011885/fullTest; https://doaj.org/toc/2234-943XTest

الوصول الحر: https://doaj.org/article/209403f10bd94a99abbc0f28e2230f74Test

المؤلفون: Xiang-Lin Tan, Amy Le, Fred C. Lam, Emilie Scherrer, Robert G. Kerr, Anthony C. Lau, Jiali Han, Ruixuan Jiang, Scott J. Diede, Irene M. Shui

المصدر: Frontiers in Oncology, Vol 12 (2022)

مصطلحات موضوعية: melanoma, brain metastasis, immunotherapy, targeted therapy, treatment guidelines, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: BackgroundUp to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines.ObjectiveTo summarize current treatments and compare worldwide guidelines for the treatment of MBM.MethodsReview of global consensus treatment guidelines for MBM patients.ResultsSubstantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios.ConclusionWorldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fonc.2022.885472/fullTest; https://doaj.org/toc/2234-943XTest

الوصول الحر: https://doaj.org/article/3d136fcfb90e48cda5455a82cce40bd0Test

المؤلفون: Charles L. Cowey, Marley Boyd, Kathleen M. Aguilar, April Beeks, Clemens Krepler, Emilie Scherrer

المصدر: Cancer Medicine, Vol 9, Iss 21, Pp 7863-7878 (2020)

مصطلحات موضوعية: biomarkers, immunology, survival, target therapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Abstract Introduction Anti‐PD‐1 monotherapies (aPD‐1) and BRAF/MEK inhibitors (BRAF/MEKi) changed the BRAF‐mutant advanced melanoma treatment landscape. This study aimed to improve the understanding of real‐world treatment patterns and optimal treatment sequence. Methods This was a retrospective study of BRAF‐mutant advanced melanoma patients who initiated 1L aPD‐1 or BRAF/MEKi in the US Oncology Network between 1 January 2014 and 31 December 2017, followed through 31 December 2018. Patient and treatment characteristics were assessed descriptively, with Kaplan‐Meier methods used for time‐to‐event endpoints. As the primary analysis, overall survival (OS) and physician‐assessed progression‐free survival (rwPFS) were evaluated with Cox proportional hazard regression models and propensity score matching (n = 49). Results A total of 224 patients were included (median age 61 years, 62.9% male, 89.7% white): 36.2% received aPD‐1 and 63.8% BRAF/MEKi. Median OS and rwPFS were longer among aPD‐1 vs BRAF/MEKi patients (OS: not reached vs 13.9 months, log‐rank P = .0169; rwPFS: 7.6 vs 6.5 months, log‐rank P = .0144). Receipt of aPD‐1 was associated with improved OS (HR = 0.602 vs BRAF/MEKi [95%CI 0.382‐0.949]; P = .0287). Among patients without an event within 6 months of 1L initiation, receipt of aPD‐1 was associated with a decreased risk of progression or death from 6 months onwards (HR = 0.228 [95%CI 0.106‐0.493]; P = .0002). This association was not observed among patients within 6 months of 1L initiation (HR = 1.146; 95% CI 0.755‐1.738). Results from the propensity score‐matched pairs were consistent with these trends. Conclusion These results suggest a clinical benefit of 1L aPD‐1 compared to BRAF/MEKi after 6 months of treatment for BRAF‐mutant advanced melanoma. Future research should explore factors associated with early progression and their relationship with clinical outcomes.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-7634Test

الوصول الحر: https://doaj.org/article/ee976dd75d584d12914c8df2bc5510e8Test

المؤلفون: Xiang-Lin Tan, Amy Le, Huilin Tang, Madeline Brown, Emilie Scherrer, Jiali Han, Ruixuan Jiang, Scott J. Diede, Irene M. Shui

المصدر: Cancers, Vol 14, Iss 24, p 6108 (2022)

مصطلحات موضوعية: melanoma, brain metastases, risk factors, proportion, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Melanoma can frequently metastasize to the brain with severe consequences. However, variation of melanoma brain metastases (MBM) development among populations is not well studied, and underlying mechanisms and risk factors for MBM development are not consistently documented. We conducted a systematic literature review (SLR) including a total of 39 articles to evaluate the proportion of melanoma patients who are diagnosed with, or develop, brain metastases, and summarize the risk factors of MBM. The average proportion of MBM was calculated and weighted by the sample size of each study. Meta-analyses were conducted for the selected risk factors using a random-effects model. The proportion of MBM at diagnosis was 33% (975 with MBM out of 2948 patients) among patients with cutaneous melanoma (excluding acral) and 23% (651/2875) among patients with cutaneous mixed with other types of melanoma. The proportion at diagnosis was lower among populations with mucosal (9/96, 9%) or uveal (4/184, 2%) melanoma and among populations outside the United States and Europe. Meta-analysis demonstrated that male vs. female gender and left-sided tumors vs. right-sided were significantly associated with increased risk of melanoma brain metastases. These data may help clinicians to assess an individual patient’s risk of developing melanoma brain metastases.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2072-6694/14/24/6108Test; https://doaj.org/toc/2072-6694Test

الوصول الحر: https://doaj.org/article/8f1d9dacb9624f47b04f2f8a0a62c1a4Test

المؤلفون: Peter Mohr, Emilie Scherrer, Chalid Assaf, Marc Bender, Carola Berking, Sheenu Chandwani, Thomas Eigentler, Imke Grimmelmann, Ralf Gutzmer, Sebastian Haferkamp, Jessica C. Hassel, Axel Hauschild, Rudolf Herbst, Ruixuan Jiang, Katharina C. Kähler, Clemens Krepler, Alexander Kreuter, Ulrike Leiter, Carmen Loquai, Friedegund Meier, Claudia Pföhler, Anja Rudolph, Dirk Schadendorf, Maximo Schiavone, Gaston Schley, Patrick Terheyden, Selma Ugurel, Jens Ulrich, Jochen Utikal, Carsten Weishaupt, Julia Welzel, Michael Weichenthal

المصدر: Cancers, Vol 14, Iss 7, p 1804 (2022)

مصطلحات موضوعية: advanced melanoma, surrogate endpoint, real-world evidence, overall survival (OS), time to next treatment (rwTtNT), pembrolizumab, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Knowledge on the real-world characteristics and outcomes of pembrolizumab-treated advanced melanoma patients in Germany and on the value of different real-world endpoints as surrogates for overall survival (OS) is limited. A sample of 664 pembrolizumab-treated patients with advanced melanoma from the German registry ADOReg was used. We examined OS, real-world progression-free survival (rwPFS), real-world time to next treatment (rwTtNT), and real-world time on treatment (rwToT). Spearman’s rank and iterative multiple imputation (IMI)-based correlation coefficients were computed between the OS and the rwPFS, rwTtNT, and rwToT and reported for the first line of therapy and the overall sample. The median OS was 30.5 (95%CI 25.0–35.4) months, the rwPFS was 3.9 months (95%CI 3.5–4.9), the rwTtNT was 10.7 months (95%CI 9.0–12.9), and the rwToT was 6.2 months (95%CI 5.1–6.8). The rwTtNT showed the highest correlation with the OS based on the IMI (rIMI = 0.83), Spearman rank correlations (rs = 0.74), followed by the rwToT (rIMI = 0.74 and rs = 0.65) and rwPFS (rIMI = 0.69 and rs = 0.56). The estimates for the outcomes and correlations were similar for the overall sample and those in first-line therapy. The median OS was higher compared to recent real-world studies, supporting the effectiveness of pembrolizumab in regular clinical practice. The rwTtNT may be a valuable OS surrogate, considering the highest correlation was observed with the OS among the investigated real-world endpoints.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2072-6694/14/7/1804Test; https://doaj.org/toc/2072-6694Test

الوصول الحر: https://doaj.org/article/bb3e4f856a0049c7af31270a7328f54bTest

المؤلفون: Xiaoyun Li, Xinyue Liu, Cathy Anne Pinto, Emilie Scherrer, Mizuho Kalabis

المصدر: Journal for ImmunoTherapy of Cancer, Vol 8, Iss Suppl 3 (2020)

مصطلحات موضوعية: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2051-1426Test

الوصول الحر: https://doaj.org/article/1bfc61267f7a45059e87b4fee703575bTest

المؤلفون: Irene M, Shui, Emilie, Scherrer, Andrew, Frederickson, Joyce W, Li, Anel, Mynzhassarova, Eric, Druyts, Hussein, Tawbi

المصدر: Melanoma Research. 32:393-404

مصطلحات موضوعية: Cancer Research, Skin Neoplasms, Oncology, Drug Resistance, Neoplasm, Programmed Cell Death 1 Receptor, Humans, Immunotherapy, Dermatology, Ipilimumab, Melanoma

الوصف: Nearly half of advanced melanoma patients do not achieve a clinical response with anti-programmed cell death 1 protein (PD1) therapy (i.e. primary resistance) or initially achieve a clinical response but eventually progress during or following further treatment (i.e. secondary resistance). A consensus definition for tumor resistance to anti-PD1 monotherapy was published by Society for Immunotherapy of Cancer Immunotherapy Resistance Taskforce (SITC) in 2020. A systematic literature review (SLR) of clinical trials and observational studies was conducted to characterize the proportions of advanced melanoma patients who have progressed on anti-PD1 therapies. The SLR included 55 unique studies and the SITC definition of primary resistance was applied to 37 studies that specified disease progression by best overall response. Median and range of patients with primary resistance in studies that specified first-line and second-line or higher anti-PD1 monotherapy was 35.50% (21.19-39.13%; n = 4 studies) and 41.54% (30.00-56.41%, n = 3 studies); median and range of patients with primary resistance in studies that specified first-line and second-line or higher combination therapy was 30.23% (15.79-33.33%; n = 6 studies), and 70.00% (61.10-73.33%; n = 3 studies). Primary resistance to anti-PD1 monotherapies and when in combination with ipilimumab are higher in patients receiving second-line or higher therapies, in patients with acral, mucosal, and uveal melanoma, and in patients with active brain metastases. The percentage of patients with primary resistance was generally consistent across clinical trials, with variability in resistance noted for observational studies. Limitations include applying the SITC definitions to combination therapies, where consensus definitions are not yet available. Future studies should highly consider utilizing the SITC definitions to harmonize how resistance is classified and facilitate meaningful context for clinical activity.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::24277db8ff02d4b150d4a28e6f90efe7Test
https://doi.org/10.1097/cmr.0000000000000850Test

المؤلفون: Rachael Miller, Sophie Walker, Irene Shui, Agnes Brandtmüller, Kevin Cadwell, Emilie Scherrer

المصدر: Melanoma Management, Vol 7, Iss 1 (2020)

مصطلحات موضوعية: adjuvant therapy, cancer, cutaneous melanoma, epidemiology, incidence, mortality, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Aim: Management of cutaneous melanoma (CM) is continually evolving with adjuvant treatment of earlier stage disease. The aim of this review was to identify published epidemiological data for stages II–III CM. Materials & methods: Systematic searches of Medline and Embase were conducted to identify literature reporting country/region-specific incidence, prevalence, survival or mortality outcomes in stage II and/or III CM. Screening was carried out by two independent reviewers. Results & conclusion: Of 41 publications, 14 described incidence outcomes (incidence rates per stage were only reported for US and Swedish studies), 33 reported survival or mortality outcomes and none reported prevalence data. This review summarizes relevant data from published literature and highlights an overall paucity of epidemiological data in stages II and III CM.

العلاقة: https://doaj.org/toc/2045-0885Test; https://doaj.org/toc/2045-0893Test; https://doaj.org/article/35e45945d96049ceb999513ef2ad683aTest

الإتاحة: https://doi.org/10.2217/mmt-2019-0022Test
https://doaj.org/article/35e45945d96049ceb999513ef2ad683aTest