scholarly journals P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Soham Bandyopadhyay
Keyword(s):  
Cohort Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Multivariate Logistic Regression Analysis ◽  
Global Health Research ◽  
Cancer Outcomes ◽  
Paediatric Cancer ◽  
Cancer Management ◽  
Anti Cancer ◽  
The Impact

Abstract Introduction Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short to medium term impacts on childhood cancer outcomes. Methods and analysis This is a multicentre, international, cohort study that will use routinely collected hospital data in a de-identified and anonymised form. Patients will be recruited consecutively into the study, with a 12 -month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. Ethics and dissemination At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally, and internationally. The results will be submitted for publication in a peer reviewed journal.

scholarly journals Impact of the COVID-19 pandemic on paediatric patients with cancer in low-income, middle-income and high-income countries: protocol for a multicentre, international, observational cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045679
Author(s):  
Noel Peter ◽  
Soham Bandyopadhyay ◽  
Kokila Lakhoo
Keyword(s):  
Cohort Study ◽  
Childhood Cancer ◽  
Low Income ◽  
High Income ◽  
Global Health Research ◽  
Multivariable Logistic Regression Analysis ◽  
Cancer Outcomes ◽  
Middle Income ◽  
Cancer Management ◽  
Anticancer Treatment

IntroductionChildhood cancers are a leading cause of non-communicable disease deaths for children around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases is currently undertaking the first international cohort study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short-term to medium-term impacts on childhood cancer outcomes.Methods and analysisThis is a multicentre, international cohort study that will use routinely collected hospital data in a deidentified and anonymised form. Patients will be recruited consecutively into the study, with a 12-month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anticancer treatment for the following cancers: acute lymphoblastic leukaemia, Burkitt lymphoma, Hodgkin lymphoma, Wilms tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas and neuroblastomas. Patients must be newly presented or must be undergoing active anticancer treatment from 12 March 2020 to 12 December 2020. The primary objective of the study was to determine all-cause mortality rates of 30 days, 90 days and 12 months. This study will examine the factors that influenced these outcomes. χ2 analysis will be used to compare mortality between low-income and middle-income countries and high-income countries. Multilevel, multivariable logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors.Ethics and disseminationAt the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally and internationally. The results will be submitted for publication in a peer-reviewed journal.

scholarly journals Celecoxib Analogues for Cancer Treatment: An Update on OSU-03012 and 2,5-Dimethyl-Celecoxib

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1049
Author(s):  
Cyril Sobolewski ◽  
Noémie Legrand
Keyword(s):  
Cancer Treatment ◽  
Metabolic Diseases ◽  
Catalytic Site ◽  
Antitumor Effects ◽  
Anti Cancer ◽  
Cox 2 ◽  
Cox 2 Inhibitors ◽  
The Impact ◽  
Important Enzyme ◽  
Specific Inhibitors

Cyclooxygenase-2 (COX-2) is an important enzyme involved in prostaglandins biosynthesis from arachidonic acid. COX-2 is frequently overexpressed in human cancers and plays a major tumor promoting function. Accordingly, many efforts have been devoted to efficiently target the catalytic site of this enzyme in cancer cells, by using COX-2 specific inhibitors such as celecoxib. However, despite their potent anti-tumor properties, the myriad of detrimental effects associated to the chronic inhibition of COX-2 in healthy tissues, has considerably limited their use in clinic. In addition, increasing evidence indicate that these anti-cancerous properties are not strictly dependent on the inhibition of the catalytic site. These findings have led to the development of non-active COX-2 inhibitors analogues aiming at preserving the antitumor effects of COX-2 inhibitors without their side effects. Among them, two celecoxib derivatives, 2,5-Dimethyl-Celecoxib and OSU-03012, have been developed and suggested for the treatment of viral (e.g., recently SARS-CoV-2), inflammatory, metabolic diseases and cancers. These molecules display stronger anti-tumor properties than celecoxib and thus may represent promising anti-cancer molecules. In this review, we discuss the impact of these two analogues on cancerous processes but also their potential for cancer treatment alone or in combination with existing approaches.

scholarly journals The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

2021 ◽  
Author(s):  
Ahmed M Badheeb ◽  
Mohamed A Badheeb ◽  
Hamdi A Alhakimi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Saudi Arabia ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Cancer Center ◽  
Anti Cancer ◽  
Before And After ◽  
The Difference ◽  
The Impact

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.

scholarly journals Adherence to childhood cancer treatment: a prospective cohort study from Northern Vietnam

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026863
Author(s):  
Bui Ngoc Lan ◽  
Anders Castor ◽  
Thomas Wiebe ◽  
Jacek Toporski ◽  
Christian Moëll ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Model ◽  
Secondary Outcome ◽  
Northern Vietnam ◽  
Family Decision ◽  
Treatment Abandonment

ObjectivesGlobal incidence and attention to childhood cancer is increasing and treatment abandonment is a major cause of treatment failure in low- and middle-income countries. The purpose of this study was to gain an understanding of factors contributing to non-adherence to treatment.DesignA prospective cohort study with 2 year follow-up of incidence, family-reported motives and risk factors.SettingThe largest tertiary paediatric oncology centre in Northern Vietnam.ParticipantsAll children offered curative cancer treatment, from January 2008 to December 2009.Primary and secondary outcome measuresFamily decision to start treatment was analysed with multivariable logistic regression, and family decision to continue treatment was analysed with a multivariable Cox model. This assessment of non-adherence is thereby methodologically consistent with the accepted definitions and recommended practices for evaluation of treatment abandonment.ResultsAmong 731 consecutively admitted patients, 677 were eligible for treatment and were followed for a maximum 2 years. Almost half the parents chose to decline curative care (45.5%), either before (35.2%) or during (10.3%) the course of treatment. Most parents reported perceived poor prognosis as the main reason for non-adherence, followed by financial constraints and traditional medicine preference. The odds of starting treatment increased throughout the study-period (OR 1.04 per month (1.01 to 1.07), p=0.002), and were independently associated with prognosis (OR 0.51 (0.41 to 0.64), p=<0.0001) and travel distance to hospital (OR 0.998 per km (0.996 to 0.999), p=0.004). The results also suggest that adherence to initiated treatment was significantly higher among boys than girls (HR 1.69 (1.05 to 2.73), p=0.03).ConclusionsNon-adherence influenced the prognosis of childhood cancer, and was associated with cultural and local perceptions of cancer and the economic power of the affected families. Prevention of abandonment is a prerequisite for successful cancer care, and a crucial early step in quality improvements to care for all children with cancer.

scholarly journals 1608P The impact of COVID-19 on the delivery of systemic anti-cancer treatment at Guy’s Cancer Centre

2021 ◽  
Vol 32 ◽  
pp. S1149
Author(s):  
S. Dolly ◽  
B. Russell ◽  
C.L. Moss ◽  
E. Tsotra ◽  
C. Gousis ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Centre ◽  
Anti Cancer ◽  
The Impact

scholarly journals The Impact of COVID-19 on the Delivery of Systemic Anti-Cancer Treatment at Guy’s Cancer Centre

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 266
Author(s):  
Beth Russell ◽  
Charlotte Moss ◽  
Eirini Tsotra ◽  
Charalampos Gousis ◽  
Debra Josephs ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Clinical Decision Making ◽  
Stage Iv ◽  
Clinical Decision ◽  
Study Data ◽  
Real World Data ◽  
Cancer Centre ◽  
Treatment Type ◽  
Anti Cancer ◽  
The Impact

Background: This study aimed to assess the outcome of cancer patients undergoing systemic anti-cancer treatment (SACT) at our centre to help inform future clinical decision-making around SACT during the COVID-19 pandemic. Methods: Patients receiving at least one episode of SACT for solid tumours at Guy’s Cancer Centre between 1 March and 31 May 2020 and the same period in 2019 were included in the study. Data were collected on demographics, tumour type/stage, treatment type (chemotherapy, immunotherapy, biological-targeted) and SARS-CoV2 infection. Results: A total of 2120 patients received SACT in 2020, compared to 2449 in 2019 (13% decrease). From 2019 to 2020, there was an increase in stage IV disease (62% vs. 72%), decrease in chemotherapy (42% vs. 34%), increase in immunotherapy (6% vs. 10%), but similar rates of biologically targeted treatments (37% vs. 38%). There was a significant increase in 1st and 2nd line treatments in 2020 (68% vs. 81%; p < 0.0001) and reduction in 3rd and subsequent lines (26% vs. 15%; p = 0.004) compared to 2019. Of the 2020 cohort, 2% patients developed SARS-CoV2 infections. Conclusions: These real-world data from a tertiary Cancer Centre suggest that despite the challenges faced due to the COVID-19 pandemic, SACT was able to be continued without any significant effects on the mortality of solid-tumour patients. There was a low rate (2%) of SARS-CoV-2 infection which is comparable to the 1.4%-point prevalence in our total cancer population.

scholarly journals The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease

2020 ◽  
Author(s):  
Jing Lin ◽  
Yanxia Qian ◽  
Xin Wu ◽  
Qiushi Chen ◽  
Qiang Ding ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Pregnant Women ◽  
Multivariate Logistic Regression Analysis ◽  
Structural Heart Disease ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Multivariate Logistic Regression ◽  
Premature Ventricular Contractions ◽  
The Impact

Abstract Objective: To investigate the outcomes of fetuses or neonates of pregnant women with premature ventricular contractions (PVCs). Study design: 6, 148 pregnant women were prospectively enrolled in the study. Of these women, 103 with a PVC burden >0.5% were divided into two groups based on the presence or absence of adverse fetal or neonatal events. The adverse outcomes were compared between the groups to assess the impact of PVCs on pregnancy. Results: A total of 17 adverse events (12 cases) occurred among 103 pregnant women with PVCs, which was significantly higher than that among women without PVCs (11.65% vs. 2.93%, p<0.01). The median PVC burden among pregnant women with PVCs was 2.84% (1.02% to 6.1%). Furthermore, compared with that of the women without adverse events, the median PVC burden of women with adverse fetal or neonatal outcomes was significantly higher (9.02% vs. 2.30%, p<0.01). Multivariate logistic regression analysis demonstrated that PVC burden was associated with adverse fetal or neonatal outcomes among pregnant women with PVCs (OR: 1.34, 95% CI (1.11-1.61), p<0.01). Conclusions: Frequent PVCs have adverse effects on pregnancy, and the PVC burden might be an important factor associated with adverse fetal and neonatal outcomes among pregnant women with PVCs. Our cohort study indicated that the higher the PVC burden is, the higher the likelihood of adverse events would be.

scholarly journals Delivering Systemic Anti-Cancer Treatment Via Another Route of Administration As an Option to Reduce Exposure to COVID-19 in Patients with Multiple Myeloma in the UK

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 12-13
Author(s):  
Holly Cranmer ◽  
Tanja Podkonjak ◽  
Eugene Benson ◽  
Jonathon Dabora ◽  
Graham H Jackson
Keyword(s):  
Multiple Myeloma ◽  
Cancer Treatment ◽  
Cost Savings ◽  
Route Of Administration ◽  
Treatment Pathway ◽  
Scenario Analyses ◽  
Anti Cancer ◽  
The Uk ◽  
The Impact ◽  
At Home

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a strain of coronavirus that causes a respiratory illness known as COVID-19. COVID-19 is a pandemic affecting many countries globally.(1) As of 23rd July 2020, there have been 297,146 lab-confirmed cases of COVID-19 in the UK and 45,554 people who tested positive for the virus have died.(2) Patients with multiple myeloma (MM) are at a higher risk of contracting the virus and experiencing more severe outcomes.(3-6) The higher risk is driven by a compromised immune system, the use of immunosuppressive agents and patient characteristics aligning with key risk factors - patients with MM are often elderly and have multiple co-morbidities.(7) In light of the COVID-19 outbreak, NHS England and NICE have issued guidance to modify usual care to reduce patient exposure to COVID-19. For patients with cancer, NICE recommend delivering systemic anti-cancer treatment in different and less immunosuppressive regimens, different locations (ideally at home) or via another (less invasive and/or less resource intensive) route of administration where possible.(8)(9) The objective of this analysis is to explore the impact of switching patients from intravenous (IV) treatments requiring hospital administrations to subcutaneous (SC) or oral alternatives which can be administered at home or in an outpatient setting which reduces the patient's potential exposure to COVID-19. Methods: A decision tree model was developed in Microsoft Excel® (Figure 1). Patients enter the model and are assigned a probability of being treated; those that are treated are then assigned a probability of IV, SC or oral-based therapy. Based on the route of administration, patients are assigned a probability of contracting COVID-19 and, for those patients that do contract the virus, a probability of death from the virus is estimated. The model compares the outcomes from two identical decision trees: one informed by the pre-COVID-19 treatment pathway and one informed by the post-COVID-19 pathway. Model inputs, including COVID-19 inputs (e.g., number of active and diseased COVID-19 cases among patients with MM), have been informed by the literature and clinical opinion. Costs reflected in the model include: treatment of COVID-19, treatment for MM and administration of MM treatments. Scenario analyses explore lower and upper bounds for key inputs. Results are presented from a UK perspective and a 1-year time horizon (from model entry) is considered. Results: Per the model, treating patients with oral therapies is shown to reduce the number of COVID-19 cases and the number of COVID-19 deaths in patients with MM compared with IV- and SC-delivered therapies. These outcomes translate into cost savings driven by costs avoided in treating COVID-19. There was a limited difference in the costs of treating the underlying MM despite the switch. However, there were additional cost savings demonstrated through avoiding expensive and resource intensive administration appointments associated with IV therapies, and to a lesser extent SC therapies. The use of oral therapies has also aided the increase in telemedicine for routine appointments - scenarios exploring this demonstrate further savings. These results are driven by the perceived risk attached to each of the different routes of administration - scenario analyses demonstrated that assuming even the lower bound risk (an assumed additional risk of 10%) for IV therapies vs. oral therapies, a significant number of COVID-19 cases and deaths were avoided, and costs reduced. Conclusions: Changes to the treatment pathway for patients with MM in light of the COVID-19 pandemic aim to reduce the exposure to the virus for these patients. The model demonstrates that simply switching the route of administration can reduce the number of COVID-19 cases and deaths . This has important implications in avoiding severe outcomes, decreasing the spread of the virus and reducing the cost and resource use burden to the healthcare system. In addition, the model reflects potential efficiencies which may extend beyond the COVID-19 pandemic (e.g. telemedicine) to optimize clinical practice for patients with MM in the longer-term. Disclosures Cranmer: Takeda: Current Employment. Podkonjak:Takeda: Current Employment. Benson:Takeda: Current Employment. Dabora:Takeda: Current Employment. Jackson:Merck Sharp and Dohme: Honoraria; Chugai: Honoraria; Amgen: Honoraria; Janssen: Honoraria; Celgene: Honoraria; Takeda: Honoraria; Roche: Honoraria.

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