Evaluating the Consistency of Patient Preference Estimates: Systematic Variation in Survival—Adverse Event Trade-Offs in Patients with Cancer or Cardiovascular Disease

2021 ◽  
Author(s):  
Kevin Marsh ◽  
Nicolas Krucien
Keyword(s):  
Cardiovascular Disease ◽  
Adverse Event ◽  
Patient Preference ◽  
Systematic Variation ◽  
Patients With Cancer ◽  
Trade Offs

scholarly journals Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2

2021 ◽  
Author(s):  
Lewis Au ◽  
◽  
Annika Fendler ◽  
Scott T. C. Shepherd ◽  
Karolina Rzeniewicz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adverse Event ◽  
Checkpoint Inhibitors ◽  
Temporal Association ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Vaccination Programs ◽  
Patients With Cancer ◽  
Related Adverse Event ◽  
Pd1 Blockade

AbstractPatients with cancer are currently prioritized in coronavirus disease 2019 (COVID-19) vaccination programs globally, which includes administration of mRNA vaccines. Cytokine release syndrome (CRS) has not been reported with mRNA vaccines and is an extremely rare immune-related adverse event of immune checkpoint inhibitors. We present a case of CRS that occurred 5 d after vaccination with BTN162b2 (tozinameran)—the Pfizer-BioNTech mRNA COVID-19 vaccine—in a patient with colorectal cancer on long-standing anti-PD-1 monotherapy. The CRS was evidenced by raised inflammatory markers, thrombocytopenia, elevated cytokine levels (IFN-γ/IL-2R/IL-18/IL-16/IL-10) and steroid responsiveness. The close temporal association of vaccination and diagnosis of CRS in this case suggests that CRS was a vaccine-related adverse event; with anti-PD1 blockade as a potential contributor. Overall, further prospective pharmacovigillence data are needed in patients with cancer, but the benefit–risk profile remains strongly in favor of COVID-19 vaccination in this population.

scholarly journals IN-HOSPITAL OUTCOMES AMONG COVID-19 PATIENTS WITH CANCER AND CARDIOVASCULAR DISEASE

2021 ◽  
Vol 77 (18) ◽  
pp. 3064
Author(s):  
David Tehrani ◽  
Asim Rafique ◽  
Xiaoyan Wang ◽  
Pooja Desai ◽  
Alicia Morgans ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Hospital Outcomes ◽  
Patients With Cancer

Cardiovascular disease burden in adult patients with cancer: An 11-year nationwide population-based cohort study

2020 ◽  
Vol 317 ◽  
pp. 167-173 ◽  
Author(s):  
Jong-Chan Youn ◽  
Woo-Baek Chung ◽  
Justin A. Ezekowitz ◽  
Jung Hwa Hong ◽  
Hyewon Nam ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Disease Burden ◽  
Population Based ◽  
Adult Patients ◽  
Patients With Cancer

scholarly journals Outcomes of COVID-19 in Patients With a History of Cancer and Comorbid Cardiovascular Disease

2020 ◽  
pp. 1-10
Author(s):  
Sarju Ganatra ◽  
Sourbha S. Dani ◽  
Robert Redd ◽  
Kimberly Rieger-Christ ◽  
Rushin Patel ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mechanical Ventilation ◽  
Severe Disease ◽  
Multivariable Analysis ◽  
Supplemental Oxygen ◽  
Adverse Outcomes ◽  
Patients With Cancer ◽  
Vulnerable Patient ◽  
History Of ◽  
Secondary Endpoints

Background: Cancer and cardiovascular disease (CVD) are independently associated with adverse outcomes in patients with COVID-19. However, outcomes in patients with COVID-19 with both cancer and comorbid CVD are unknown. Methods: This retrospective study included 2,476 patients who tested positive for SARS-CoV-2 at 4 Massachusetts hospitals between March 11 and May 21, 2020. Patients were stratified by a history of either cancer (n=195) or CVD (n=414) and subsequently by the presence of both cancer and CVD (n=82). We compared outcomes between patients with and without cancer and patients with both cancer and CVD compared with patients with either condition alone. The primary endpoint was COVID-19–associated severe disease, defined as a composite of the need for mechanical ventilation, shock, or death. Secondary endpoints included death, shock, need for mechanical ventilation, need for supplemental oxygen, arrhythmia, venous thromboembolism, encephalopathy, abnormal troponin level, and length of stay. Results: Multivariable analysis identified cancer as an independent predictor of COVID-19–associated severe disease among all infected patients. Patients with cancer were more likely to develop COVID-19–associated severe disease than were those without cancer (hazard ratio [HR], 2.02; 95% CI, 1.53–2.68; P<.001). Furthermore, patients with both cancer and CVD had a higher likelihood of COVID-19–associated severe disease compared with those with either cancer (HR, 1.86; 95% CI, 1.11–3.10; P=.02) or CVD (HR, 1.79; 95% CI, 1.21–2.66; P=.004) alone. Patients died more frequently if they had both cancer and CVD compared with either cancer (35% vs 17%; P=.004) or CVD (35% vs 21%; P=.009) alone. Arrhythmias and encephalopathy were also more frequent in patients with both cancer and CVD compared with those with cancer alone. Conclusions: Patients with a history of both cancer and CVD are at significantly higher risk of experiencing COVID-19–associated adverse outcomes. Aggressive public health measures are needed to mitigate the risks of COVID-19 infection in this vulnerable patient population.

scholarly journals The Impact of Limited Cancer Health Literacy on Patient Preference for Shared Care

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 106s-106s ◽  
Author(s):  
C.M.H. Chan ◽  
N.A. Taib ◽  
L.H. Wee ◽  
D. Blanch-Hartigan ◽  
E. Krupat ◽  
...  
Keyword(s):  
Health Literacy ◽  
Cancer Patients ◽  
Patient Preference ◽  
Shared Care ◽  
Cancer Outcomes ◽  
Limited Health Literacy ◽  
Patients With Cancer ◽  
Cancer Literacy ◽  
Limited Health ◽  
The Impact

Background: Patient are increasingly expected to engage in their own care. However, patients with limited health literacy often struggle with this. The expectation of patients' engagement in health care decisions by their healthcare providers likely increases the burden that cancer patients are already experiencing following a life-changing diagnosis. Involving patients with cancer in medical decision-making requires them to have an adequate understanding their disease and treatment options. Limited health literacy poses a barrier to patient engagement in their own care, contributing to health disparities and poorer cancer outcomes. Aim: Our primary objective was to determine levels of health literacy among patients with cancer and the extent of its association with patient preference for care. We also sought to identify sociodemographic and clinical characteristics associated with limited cancer health literacy. Methods: As part of a larger prospective cohort study, N = 345 adult cancer patients attending a large, university-affiliated outpatient oncology clinic were recruited using consecutive sampling. Face to face interviews were conducted using questionnaires. Instruments used included the 30-item Cancer Health Literacy Test (CHLT-30), and the Patient-Practitioner Orientation Scale (PPOS) to determine patient preference for shared care. The relationship between cancer health literacy and patient preference for shared care was examined using bivariate analysis, with logistic regression used to identify predictors. Results: Mean patient age was 60.0 ± 11.6 years. A greater female preponderance was observed (69.4%), with over half of patients indicating secondary school completion (51.6%). Up to 79.3% of patients reported a monthly household income of less than RM 4000 (approximately USD 1000), placing them in the bottom 40% of household incomes in Malaysia. A total of 59.1% of patients (n = 204) in this sample were found to have limited cancer health literacy, with an average score of 14.40 ± 4.04 out of a full score of 30. Patients with limited cancer literacy were 1.69 times (95% CI 1.42-2.03) less likely to prefer active participation in their care. Conclusion: Rates of limited cancer literacy in this sample (59.1%) appear to be at least three times higher than prevailing rates in high resource countries with established cancer control programs such as the United States (18%). One out of every two patients with cancer in this study were found to possess limited health literacy, making this a significant issue particularly given its association with lesser patient preference for shared care. This study marks an important first step toward increasing health literacy among patients with cancer and empowering patients to participate in their care, which may help mitigate the impact of disparities such as lower educational and socioeconomic levels traditionally associated with poorer cancer outcomes.

Serum copper and zinc concentrations in serum from patients with cancer and cardiovascular disease

1997 ◽  
Vol 204 (1) ◽  
pp. 27-35 ◽  
Author(s):  
F. Martín-Lagos ◽  
M. Navarro-Alarcón ◽  
C. Terrés-Martos ◽  
H. López-G de la Serrana ◽  
M.C. López-Martínez
Keyword(s):  
Cardiovascular Disease ◽  
Serum Copper ◽  
Patients With Cancer ◽  
Copper And Zinc ◽  
Zinc Concentrations

An Overview of Chemotherapy-Induced Peripheral Neuropathy

2008 ◽  
Vol 21 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Jose R. Murillo ◽  
James E. Cox ◽  
Michael S. Oholendt
Keyword(s):  
Adverse Event ◽  
Peripheral Neuropathy ◽  
Positive Impact ◽  
Chemotherapeutic Agents ◽  
Patient Specific ◽  
Drug Discontinuation ◽  
Neurologic Complication ◽  
Patients With Cancer ◽  
Neurological Adverse Event

Peripheral neuropathy remains a major limitation of chemotherapeutic agents used in cancer treatment. This neurologic complication from chemotherapy occurs frequently and can be debilitating. Although difficult to predict, both chemotherapeutic and patient-specific risk factors may contribute to this adverse event. Symptoms of peripheral neuropathy may appear acutely after treatment or persist chronically upon drug discontinuation. The taxanes, vinca alkaloids, and immunomodulatory drugs commonly cause peripheral nervous system toxicity. Prompt recognition and evaluation of this neurological adverse event by those who provide care to patients with cancer can prove to have a positive impact on the quality of life of those patients.

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