scholarly journals Clinical outcomes and dosing patterns of 2nd targeted therapy in metastatic renal carcinoma: a retrospective chart review in the EU

2016 ◽  
Vol 27 ◽  
pp. vi288
Author(s):  
D. Heng ◽  
J. Park ◽  
J.E. Signorovitch ◽  
H. Yang ◽  
J. Song ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Clinical Outcomes ◽  
Chart Review ◽  
Renal Carcinoma ◽  
Retrospective Chart Review ◽  
Dosing Patterns ◽  
The Eu

Outcomes of second targeted therapy in metastatic renal carcinoma: A retrospective chart review in the EU.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 558-558
Author(s):  
Daniel Yick Chin Heng ◽  
Jinhee Park ◽  
James E. Signorovitch ◽  
Hongbo Yang ◽  
Jinlin Song ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Chart Review ◽  
Data Entry ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Eligibility Criteria ◽  
Kaplan Meier ◽  
The Uk ◽  
Sites Of Metastases ◽  
The Eu

558 Background: This study describes the real-world outcomes of metastatic renal cell carcinoma (mRCC) patients treated with everolimus (EVE), sorafenib (SOR), and axitinib (AXI) as 2nd targeted therapy in the UK, Germany, and France. Methods: A retrospective chart review was conducted among oncologists and urologists in the UK, Germany and France. Charts were reviewed for adult mRCC patients satisfying the following eligibility criteria: 1) experienced disease progression on 1st targeted therapy with sunitinib or pazopanib; 2) initiated 2nd targeted therapy with EVE, AXI, or SOR between 10/2012 and 6/2013. Kaplan-Meier analysis was used to estimate overall survival (OS) after initiation of 2nd targeted therapy among all patients and stratified by type of 2nd targeted therapy. Results: A total of 281 charts were reviewed, with 99, 91, and 91 mRCC patients receiving EVE, AXI, and SOR as 2nd targeted therapy, respectively. Mean age was 60.6 years old at initial mRCC diagnosis and 65.5% were male. The majority of patients used sunitinib (79.4%), with the rest using pazopanib (20.6%) as 1st targeted therapy. Median duration of 1st targeted therapy was 9.7 months. At the initiation of 2nd targeted therapy, 91.8% of patients had an ECOG score ≤ 2. The most common sites of metastases were lung (71.2%), bone (53.0%), and lymph nodes (47.0%). Median OS from the initiation of 2nd targeted therapy among all patients was 21.8 months (95% CI: 16.5-26.2). The median OS was 23.0, 23.5, and 18.7 for EVE, AXI, and SOR respectively. The majority of patients (87.5%) initiated 2nd targeted therapy on the recommended dose. Patients receiving AXI had a higher rate of dose increase (13.2%), compared to EVE (1.0%) and SOR (0.0%), while patients on EVE had a higher rate of dose decrease (12.1%), compared to AXI (5.5%) and SOR (8.8%). Conclusions: In this retrospective chart review study of several EU countries, the observed median OS was numerically comparable for EVE and AXI, but rates of dose adjustment differed by treatments. Retrospective chart reviews may be subject to selection bias and errors in data entry, and further analysis is underway to address confounding effects of unobserved patient characteristics.

Outcomes of second-targeted therapy for mRCC: A retrospective chart review of community practices in the United States.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 424-424
Author(s):  
Eric Jonasch ◽  
James E. Signorovitch ◽  
Peggy L. Lin ◽  
Zhimei Liu ◽  
Kenneth W. Culver ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Targeted Therapies ◽  
Treatment Duration ◽  
Dose Adjustment ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Common Reason ◽  
Median Treatment ◽  
Median Treatment Duration ◽  
Imaging Test

424 Background: Sequential use of targeted therapies has become standard practice for the treatment of metastatic renal cell carcinoma (mRCC). This study describes treatment outcomes of the 2nd-targeted therapy among patients with mRCC treated in the community setting. Methods: A retrospective chart review and survey was conducted during May through June 2012 among community-based oncologists or hematologists. Charts were reviewed for adult mRCC patients initiated on 2nd -targeted therapy on or after January 1, 2010. Abstracted data included patient demographics, disease characteristics, treatment duration, dose adjustment, progression, mortality, and imaging test patterns. Kaplan-Meier analysis was used to estimate treatment duration, overall survival (OS) and progression-free survival (PFS) during 2nd-targeted therapy. Patients were censored at the most recent contact. Results: Charts were reviewed for 433 mRCC patients. Mean age was 63 years at initial mRCC diagnosis and 64% were male. The most commonly used 2nd targeted therapies were everolimus (36% of patients), temsirolimus (17%), pazopanib (15%), and sunitinib (14%). The median duration of 2nd -targeted therapy was 10.5 months (95% CI: 8.8-11.5). The majority of patients (73%) had no dose adjustment on 2nd-targeted therapy; the most common reason for adjustment was drug toxicity (70%). Among the 44% of patients who discontinued 2nd-targeted therapy, disease progression was the most common reason for discontinuation. The proportion of patients who received imaging test within 3, 6, and 12 months after 2nd-line treatment initiation was 57%, 92%, and 99%, respectively. Routine monitoring (83%) was the most common reason for imaging tests. Median durations of OS and PFS after initiation of the 2nd-targeted therapy were 30.4 months (95% CI: 23.5-not reached) and 10.7 months (95% CI: 8.4-12.2), respectively. Conclusions: In this large, retrospective chart review study, median treatment duration of 2nd -targeted therapy was 10.5 months, median OS was 30.4 months, and median PFS was 10.7 months. Median treatment duration in community practice was longer than in clinical trials for targeted therapies in mRCC.

Double fascicular nerve transfer to the biceps and brachialis muscles after brachial plexus injury: clinical outcomes in a series of 29 cases

2011 ◽  
Vol 114 (6) ◽  
pp. 1520-1528 ◽  
Author(s):  
Wilson Z. Ray ◽  
Mitchell A. Pet ◽  
Andrew Yee ◽  
Susan E. Mackinnon
Keyword(s):  
Brachial Plexus ◽  
Clinical Outcomes ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Study Results ◽  
The Mean ◽  
Flexion Strength

Object The clinical outcomes of patients with brachial plexus injuries who underwent double fascicular transfer (DFT) using fascicles from the median and ulnar nerves to reinnervate the biceps and brachialis muscles were evaluated. Methods The authors conducted a retrospective chart review of 29 patients with brachial plexus injuries that were treated with DFT for restoration of elbow flexion. All patients underwent pre- and postoperative clinical evaluation using the Medical Research Council grading system. Results The mean patient age was 37 years (range 17–68 years), and there was a mean follow-up of 19 ± 12 months (range 8–68 months). At the most recent follow-up, all but 1 patient (97%) had regained elbow flexion. Eight patients recovered Grade M5, 15 patients recovered Grade M4, and 4 patients recovered Grade M3 elbow flexion strength. There was no evidence of functional deficit in the donor nerve distributions. Conclusions Study results demonstrated the reliable restoration of M4–M5 elbow flexion following double fascicular transfer in patients with brachial plexus injuries.

scholarly journals P019: What happens to John Doe? Unidentified patients in the emergency department: a retrospective chart review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S71-S71
Author(s):  
K. Tastad ◽  
J. Koh ◽  
D. Goodridge ◽  
J. Stempien ◽  
T. Oyedokun
Keyword(s):  
Emergency Department ◽  
Clinical Outcomes ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Inclusion Criteria ◽  
Identification Methods ◽  
Police Services ◽  
Admission Rates ◽  
Time Period ◽  
Minimal Research

Introduction: Patients who are not identified upon presentation to the emergency department (ED), commonly referred to as John or Jane Does (JDs), are a vulnerable population due to the sequelae associated with this lack of patient information. To date, there has been minimal research describing JDs. We aimed to characterize the JD population and determine if it differs significantly from the general ED population. Methods: We conducted a retrospective chart review of 114 JDs admitted to Saskatoon EDs from May 2018 to April 2019. Patients met inclusion criteria if they were provided a unique JD identification number at ED admission because their identities were unknown or unverifiable. Data regarding demographics, clinical presentation, ED course, mode of identification, and major clinical outcomes (i.e. admission rates, mortality rates) were gathered from electronic records. A second reviewer abstracted a random 21.0% sample of charts to ensure validity of the data. The JD population was then compared to the general population of ED patients that presented during the same time period. Results: Male JDs most commonly presented as trauma activations (85.7%) in contrast to female JDs who most commonly presented with issues related to substance abuse (51.4%). Compared to the general ED population, a greater percentage of JDs were categorized as CTAS 1 or 2 (85.8% vs 18.9%, p < 0.0001), more likely to be 44 years of age or younger (82.4% vs 58.5%, p < 0.0001), and more likely to be male (64.9% vs 49.1%, p < 0.0001). Descriptive statistics on the JD population demonstrated that most JDs received consults to inpatient services (58.8%). Of JDs who presented to the ED, 34.2% were admitted to hospital. The mortality of the JD population was 13.2% at 3 months. The ED average (SD) length of stay for JDs was 8.7 (9.0) hours. How JDs were ultimately identified was recorded only 70.2% of the time. Most frequently, JDs identified themselves (26.3%), other identification methods included police services (14.9%), family members (7.9%), registered nurses (6.1%), government-issued identification (5.3%), social work (4.4%) or other measures (5.4%). Conclusion: JD's represent a unique population in the ED. Both their presentations and clinical outcomes differ significantly from the generalized ED population. More research is needed to better identify strategies to improve the management and identification methods of these unique patients.

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