scholarly journals EPID-05. COMPARATIVE EFFICACY OF FIRST-LINE ALK-INHIBITORS IN ALK+ LUNG CANCER BRAIN METASTASES: A NETWORK META-ANALYSIS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii79-ii79
Author(s):  
Philip Haddad ◽  
Dalia Hammoud ◽  
Kevin Gallagher
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Alk Inhibitors ◽  
Molecular Abnormalities ◽  
Online Databases ◽  
Previously Treated

Abstract BACKGROUND Lung cancer has been the leading cause of cancer death for both men and women worldwide. Non-small-cell lung cancer (NSCLC) displays an array of molecular abnormalities most commonly involving ALK and EGFR pathways. NSCLC with ALK rearrangements comprises close to 5% of cases. Several ALK inhibitors (ALKI) have been approved with activity in brain metastases. However, there have been limited comparative studies exploring their relative efficacies. This meta-analysis was conducted to compare the relative efficacy of ALKIs against ALKI-naïve ALK+ lung cancer brain metastases. METHODS A review of the medical literature was conducted using online databases. Inclusion criteria consisted of English language; diagnosis of ALKI-naïve ALK+ lung cancer trials with brain metastases; treatment with Crizotinib (CRZ), Alectinib (ALC), Brigatinib (BRG), and Ceritinib (CER); and comparative studies reporting brain metastases specific responses/events. A Bayesian and a frequentists network meta-analysis were conducted using netmeta package and the random-effects model. RESULTS Eight studies comprising a total of 665 participants with ALKI-naive ALK+ lung cancer brain metastases were included. When compared pair-wise to CRZ, ALC (RR=0.49;95%CI:0.36–0.66), BRG (RR=0.39;95%CI:0.24–0.64), and CER (RR=0.36;95%CI:0.19–0.68) demonstrated significantly superior response rates in patients with untreated or previously treated lung cancer brain metastases. When the efficacy of each ALKI was compared to each other, BRG and CER were ranked the highest, followed by ALC and CRZ in decreasing order. CONCLUSIONS This network meta-analysis is the first to compare and rank approved ALKIs used in treating metastatic ALK+ lung cancer. It indicates that BRG, CER, and ALC are better therapeutic options for patients with ALK-naive ALK+ lung cancer brain metastases when compared to CRZ.

scholarly journals 22. COMPARATIVE EFFICACY OF ALK-INHIBITORS IN ALK INHIBITOR-NAIVE ALK+ LUNG CANCER BRAIN METASTASES: A NETWORK META-ANALYSIS

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii3-ii4
Author(s):  
Philip Haddad ◽  
Dalia Hammoud ◽  
Kevin Gallagher
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Alk Inhibitors ◽  
Molecular Abnormalities ◽  
Online Databases ◽  
Previously Treated

Abstract BACKGROUND Lung cancer has been the leading cause of cancer death for both men and women worldwide. Non-small-cell lung cancer (NSCLC) displays an array of molecular abnormalities most commonly involving ALK and EGFR pathways. NSCLC with ALK rearrangements comprises around 5% of cases. Over the years, several ALK inhibitors (ALKI) have been approved with notable activity in brain metastases. However, there have been limited comparative studies exploring their relative efficacies. This analysis was conducted to compare the relative efficacy of ALKIs against ALKI-naïve ALK+ lung cancer brain metastases. METHODOLOGY A review of the medical literature was conducted using online databases. Inclusion criteria consisted of English language; diagnosis of ALKI-naïve ALK+ lung cancer trials with brain metastases; treatment with Crizotinib (CRZ), Alectinib (ALC), Brigatinib (BRG), and Ceritinib (CER); and comparative studies reporting brain metastases specific responses/events. A Bayesian and a frequentists network meta-analysis were conducted using netmeta package and the random-effects model. RESULTS Eight studies comprising a total of 665 participants with ALKI-naive ALK+ lung cancer brain metastases were included. When compared pair-wise to CRZ, ALC (RR=0.49;95%CI:0.36–0.66), BRG (RR=0.39;95%CI:0.24–0.64), and CER (RR=0.36;95%CI:0.19–0.68) demonstrated significantly superior response rates in patients with untreated or previously treated lung cancer brain metastases. When the efficacy of each ALKI was compared to each other, BRG and CER were ranked the highest followed by ALC then CRZ in decreasing order. CONCLUSIONS This network meta-analysis is the first to compare and rank ALKIs used in treating metastatic ALK+ lung cancer. It indicates that BRG, CER, and ALC are better therapeutic options for patients with ALK-naive ALK+ lung cancer brain metastases when compared to CRZ.

Surgical Management of Craniopharyngiomas in Children: Meta-analysis and Comparison of Transcranial and Transsphenoidal Approaches

Neurosurgery ◽  
2011 ◽  
Vol 69 (3) ◽  
pp. 630-643 ◽  
Author(s):  
Robert E Elliott ◽  
John A Jane ◽  
Jeffrey H Wisoff
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Outcome Data ◽  
Inclusion Criteria ◽  
Lateral Extension ◽  
Increased Intracranial Pressure ◽  
Online Databases ◽  
Neurological Morbidity ◽  
Vascular Structures ◽  
Lower Morbidity

Abstract BACKGROUND: Controversy persists regarding the optimal treatment of pediatric craniopharyngiomas. OBJECTIVE: We performed a meta-analysis of reported series of transcranial (TC) and transsphenoidal (TS) surgery for pediatric craniopharyngiomas to determine whether comparisons between the outcomes in TS and TC approaches are valid. METHODS: Online databases were searched for English-language articles reporting quantifiable outcome data published between 1990 and 2010 pertaining to the surgical treatment of pediatric craniopharyngiomas. Forty-eight studies describing 2955 patients having TC surgery and 13 studies describing 373 patients having TS surgery met inclusion criteria. RESULTS: Before surgery, patients who had TC surgery had less visual loss, more frequent hydrocephalus and increased intracranial pressure, larger tumors, and more suprasellar disease. After surgery, patients in the TC group had lower rates of gross total resection (GTR), more frequent recurrence after GTR, higher neurological morbidity, more frequent diabetes insipidus, less improvement, and greater deterioration in vision. There was no difference in operative mortality, obesity/hyperphagia, or overall survival percentages. CONCLUSION: Directly comparing outcomes after TC and TS surgery for pediatric craniopharyngiomas does not appear to be valid. Baseline differences in patients who underwent each approach create selection bias that may explain the improved rates of disease control and lower morbidity of TS resection. Although TS approaches are becoming increasingly used for smaller tumors and those primarily intrasellar, tumors more amenable to TC surgery include large tumors with significant lateral extension, those that engulf vascular structures, and those with significant peripheral calcification.

scholarly journals RADT-37. THE IMPACT OF POSTOPERATIVE RADIATION THERAPY (PORT) AND EXTENT OF SURGERY ON CLINICAL OUTCOMES OF ATYPICAL MENINGIOMA (AM): A META-ANALYSIS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii189-ii189
Author(s):  
Philip Haddad ◽  
Furqan Akhtar ◽  
Kevin Gallagher
Keyword(s):  
Clinical Outcomes ◽  
Comparative Studies ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Subtotal Resection ◽  
Recurrence Rates ◽  
Postoperative Radiation Therapy ◽  
Extent Of Surgery ◽  
The Impact

Abstract BACKGROUND Although meningiomas are among the most prevalent types of brain tumors, AMs account for around 4% of all meningiomas. AMs tend to be more aggressive with relatively higher rates of recurrence and mortality. Gross total resection (GTR) has been the standard of care when possible. However, GTR itself is not always enough to prevent the recurrence of AMs. The role of PORT remains controversial in AM as the comparative studies to support its use have provided conflicting RESULTS: The purpose of this meta-analysis is to evaluate the impact of PORT on clinical outcomes according to the extent of resection in AMs. METHODS A review of the medical literature was conducted using online databases. Inclusion criteria consisted of AM diagnosis, English language, Simpson graded resections, and comparative studies reporting recurrence rates (RcR), Progression-Free Survival (PFS), and Overall Survival (OS) with hazard ratios (HR) or Kaplan-Meier curves. A meta-analysis was conducted using an inverse variance method with a random-effects model. RESULTS Twenty-two comparative studies with a total of 5,129 patients were included and analyzed. When GTR was attained, PORT was associated with improved RcR (HR =0.72, 95%CI:0.59-0.86) and PFS (HR=0.77, 95%CI:0.65-0.90), but not OS (HR=0.93, 95%CI:0.83-1.04). When subtotal resection (STR) was attained, PORT was associated with improved PFS (HR=0.35, 95%CI:0.26-0.48) as well as OS (HR=0.70, 95%CI:0.54-0.89). The extent of surgery also impacted AM outcomes as GTR demonstrated superior PFS (HR=0.45, 95%CI:0.31-0.65) and OS (HR=0.30, 95%CI:0.13-0.72). CONCLUSIONS This is the first meta-analysis to show that PORT is associated with PFS benefit in AMs with GTR and STR. Moreover, PORT significantly improved OS of AMs that underwent STR but had no impact on OS when GTR was achieved. In the absence of randomized clinical trials, this meta-analysis represents the most compelling data supporting the use of PORT in this patient population.

scholarly journals Intangible assets in the process of internationalization

2020 ◽  
Vol 56 (1) ◽  
pp. 63-78
Author(s):  
Łukasz Bryl
Keyword(s):  
English Language ◽  
Intangible Assets ◽  
Meta Analysis ◽  
Strong Relationship ◽  
Valuable Insight ◽  
Internationalization Process ◽  
Journal Articles ◽  
Employee Education ◽  
Current State ◽  
Online Databases

AbstractThe aim of this article is to determine the current state of impact of various forms of intangible assets on the internationalization process. For the purpose of the paper meta-analysis was adopted as a method of the study. English-language peer-reviewed journal articles were analyzed only with the help of: EBSCOhost, ScienceDirect, Emerald, JSTOR, ProQuest and Wiley Online databases. The search was aimed at newest papers (after 2012), however some older articles (with regard to their value) were included in the analysis as well. Based on the conducted analysis, there was observed a significant and positive link between the level of employee education and internationalization probability and extent. The effect of the wages on internationalization is stage dependent. Under certain assumptions there is a positive and strong relationship between R&D intensity and internationalization. Advertising spending do not foster the process of internationalization. The practical contribution of this research is twofold. First, it provides valuable insight for practitioners which intangible assets and how foster various modes of the internationalization process. Second, it describes upon which conditions the interrelation between firm intangible assets and internationalization is significant and positive.

scholarly journals Information Needs of Cancer Patients are Influenced by Time Since Diagnosis, Stage of Cancer, Patients’ Age, and Preferred Role in Treatment-related Decisions

2006 ◽  
Vol 1 (3) ◽  
pp. 80 ◽  
Author(s):  
John Loy
Keyword(s):  
Cancer Patients ◽  
Information Seeking ◽  
Information Needs ◽  
English Language ◽  
Meta Analysis ◽  
Active Role ◽  
Post Treatment ◽  
Inclusion Criteria ◽  
Information Need ◽  
Need For Information

A review of: Kalyani, Ankem. “Factors Influencing Information Needs Among Cancer Patients: A Meta-Analysis.” Library & Information Science Research; 28.1 (2006) 7-23. Objective – The author aims to study the aggregate influence of demographic and situational variables on the information needs of cancer patients, in order to inform the provision of information to those patients. Design – Meta-analysis. Setting – Research articles published in the MEDLINE and CINAHL databases. Subjects – English language studies published between 1993 and 2003. An initial search set of 196 studies from MEDLINE and 283 studies from CINAHL were identified. Following rigorous assessment, 12 studies met the inclusion criteria. Methods – A comprehensive search of the databases was conducted, initially combining “neoplasm” with “cancer patients” using the Boolean “or”. These results were then combined with five separate searches using the following terms; information need(s), information seeking, information seeking behaviour, information source(s) and information resource(s). This identified in total 479 English language articles. Based on a review of titles and abstracts, 110 articles were found covering information resources or the information needs of cancer patients. These articles were then subjected to the further inclusion criteria and limited to studies which included: analysis of information needs and/or information sources of cancer patients; adults as subjects of the research; and application of quantitative research methods and relevant statistics. This eliminated a further 35 papers. Twelve of the remaining 75 studies were selected for meta-analysis based on their use of the same variables measured consistently in comparable units. The final 12 studies included various forms of cancer, and no distinction was made among them. All 12 studies appeared in peer-reviewed journals. Main results – The meta-analysis found there was consistently no difference between the information needs of men and women. Five subsets were identified within the meta-analysis, and findings for each can be stated as follows: The younger the age of the patient, the greater their overall need for information was likely to be. During treatment, the time elapsed from the diagnosis to the information need was not significant. Once identified, the information need remained constant. During treatment and post-treatment phases, the time elapsed from the diagnosis to the information need made no significant difference, with the information need remaining constant and continuing into the post-treatment phase. The stage of cancer made no difference to the need for information. Those patients in the advanced stages of cancer required an equal amount of information to those in the early stages of cancer. The individual patient’s preferred role in treatment-related decisions made a difference to the information need. Patients who took an active role in treatment-related decisions had a greater need for information than those who did not take an active role. Conclusion – Findings from this meta-analysis can be used to guide information provision to cancer patients, specifically taking patient age and preferred role in treatment decision-making into consideration. Further research into the reasons behind the lower information needs among older patients is called for by the author.

scholarly journals Research Synthesis

2019 ◽  
Vol 83 (3) ◽  
pp. 598-626 ◽  
Author(s):  
Caroline Roberts ◽  
Emily Gilbert ◽  
Nick Allum ◽  
Léïla Eisner
Keyword(s):  
Data Quality ◽  
English Language ◽  
Survey Methodology ◽  
Future Research ◽  
Journal Articles ◽  
Inclusion Criteria ◽  
Response Error ◽  
Response Strategies ◽  
Online Databases ◽  
Different Types

Abstract Herbert Simon’s (1956) concept of satisficing provides an intuitive explanation for the reasons why respondents to surveys sometimes adopt response strategies that can lead to a reduction in data quality. As such, the concept rapidly gained popularity among researchers after it was first introduced to the field of survey methodology by Krosnick and Alwin (1987), and it has become a widely cited buzzword linked to different forms of response error. In this article, we present the findings of a systematic review involving a content analysis of journal articles published in English-language journals between 1987 and 2015 that have drawn on the satisficing concept to evaluate survey data quality. Based on extensive searches of online databases, and an initial screening exercise to apply the study’s inclusion criteria, 141 relevant articles were identified. Guided by the theory of survey satisficing described by Krosnick (1991), the methodological features of the shortlisted articles were coded, including the indicators of satisficing analyzed, the main predictors of satisficing, and the presence of main or interaction effects on the prevalence of satisficing involving indicators of task difficulty, respondent ability, and respondent motivation. Our analysis sheds light on potential differences in the extent to which satisficing theory holds for different types of response error, and highlights a number of avenues for future research.

Early palliative care in haematological patients: a systematic literature review

2020 ◽  
Vol 10 (4) ◽  
pp. 395-403
Author(s):  
Silvia Tanzi ◽  
Francesco Venturelli ◽  
Stefano Luminari ◽  
Franco Domenico Merlo ◽  
Luca Braglia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Early Palliative Care ◽  
Study Results ◽  
Registration Number ◽  
Integrated Or ◽  
The Impact

BackgroundEarly palliative care together with standard haematological care for advanced patients is needed worldwide. Little is known about its effect. The aim of the review is to synthesise the evidence on the impact of early palliative care on haematologic cancer patients’ quality of life and resource use.Patients and methodsA systematic review was conducted. The search terms were early palliative care or simultaneous or integrated or concurrent care and haematological or oncohaematological patients. The following databases were searched: PubMed, Embase, Cochrane, CINHAL and Scopus. Additional studies were identified through cross-checking the reference articles. Studies were in the English language, with no restriction for years. Two researchers independently reviewed the titles and abstracts, and one author assessed full articles for eligibility.ResultsA total of 296 studies titles were reviewed. Eight articles were included in the synthesis of the results, two controlled studies provided data on the comparative efficacy of PC interventions, and six one-arm studies were included. Since data pooling and meta-analysis were not possible, only a narrative synthesis of the study results was performed. The quality of the two included comparative studies was low overall. The quality of the six non-comparative studies was high overall, without the possibility of linking the observed results to the implemented interventions.ConclusionsStudies on early palliative care and patients with haematological cancer are scarce and have not been prospectively designed. More research on the specific population target, type and timing of palliative care intervention and standardisation of collected outcomes is required.PROSPERO registration numberCRD42020141322.

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