scholarly journals EPID-22. NEWLY-DIAGNOSED BRAIN TUMORS IN PEDIATRIC PATIENTS: EPIDEMIOLOGY IN THE UNITED STATES

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi79-vi79
Author(s):  
Matthew Torre ◽  
Mustafa Ascha ◽  
Maya Harary ◽  
Timothy Smith ◽  
Ayal Aizer ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
The United States ◽  
Pineal Region ◽  
Intracranial Tumor ◽  
Astrocytic Tumors ◽  
Intracranial Tumors ◽  
Newly Diagnosed ◽  
Embryonal Tumors ◽  
Diffuse Gliomas ◽  
The U.S

Abstract INTRODUCTION Herein we examine the epidemiology across all pediatric intracranial tumors in the U.S. METHODS Pediatric patients (< 20yo) presenting between 2010–2015 with an intracranial tumor as the first evidence of cancer were queried from the National Cancer Database, which comprises >70% of cancers newly-diagnosed in the U.S. Tumor types were classified by WHO2016 ICD-O3. RESULTS 14,952 pediatric patients without a history of cancer presented with intracranial tumors between 2010–2015. Across all ages, these were comprised of 1) 22% diffuse astrocytic and oligodendroglial (n=3,328), 2) 17% sellar region (n=2,530), 3) 16% other astrocytic (n=2,378, 2,131 were pilocytic and pilomyxoid), 4) 13% embryonal (n=1,896; 1,092 were classic histology medulloblastomas), 5) 7% neuronal and mixed neuronal-glial (n=981), 6) 5% ependymal (n=752), 7) 4% GCTs (n=615), 8) 3% mesenchymal non-meningothelial (n=492), 9) 3% nerve sheath (n=428), and 10) ≤2% each of meningioma, choroid plexus, brain metastatic (44% from neuroblastoma), pineal region, hematologic, and other glioma tumors. Embryonal tumors predominated in neonates and infants (0-2yo), diffuse gliomas in childhood (3-11yo), and sellar tumors in adolescents (12-19yo). Females represented 49% of the cases, but sellar tumors predominated (23%, vs. only 11% in males); whereas in males diffuse gliomas predominated (23%; vs. 22% in females) overall and in pediatric patients older than 2yo. CONCLUSIONS In U.S. pediatric patients that present with a new intracranial tumor, embryonal tumors and diffuse gliomas predominate in infants ≤2yo, and continue to predominate in male children 3-11yo, whereas female children 3-11yo shifted towards a predominance by diffuse gliomas and other astrocytic tumors (e.g. pilocytic and pilomyxoid). In female adolescents 12-19yo, sellar tumors predominated, followed by diffuse gliomas; whereas in male adolescents diffuse gliomas predominated, followed by other astrocytic tumors and sellar tumors. Our findings demonstrate that newly-diagnosed intracranial masses in pediatric patients significantly vary by both age and sex.

scholarly journals EPID-21. THE NATIONAL SPECTRUM OF NEWLY-DIAGNOSED BRAIN TUMORS IN ADULT PATIENTS VARIES SIGNIFICANTLY BY PATIENT DEMOGRAPHICS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi79-vi79
Author(s):  
Matthew Torre ◽  
Mustafa Ascha ◽  
Maya Harary ◽  
Timothy Smith ◽  
Ayal Aizer ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Patient Characteristics ◽  
Intracranial Tumor ◽  
Adult Patients ◽  
Intracranial Tumors ◽  
Newly Diagnosed ◽  
Patient Demographics ◽  
Common Diagnosis ◽  
History Of ◽  
Tumor Types

Abstract INTRODUCTION Herein we examine the epidemiology and outcomes of the entire spectrum of intracranial tumors in the contemporary era. METHODS Adult patients (≥20yo) presenting between 2010–2015 where the first evidence of cancer involves an intracranial tumor were queried from the National Cancer Database, which comprises >70% of cancers newly-diagnosed in the U.S. Tumor types were classified by WHO2016 ICD-O3, and stratified by patient characteristics. RESULTS 361,841 adults without a history of cancer presented with intracranial tumors between 2010–2015. Across all ages, these were comprised of 1) brain metastases (BMs; 25%: 29% in males vs. 23% in females); 2) meningiomas (25%: 15% in males, but 34% in females) including atypical (n=4,565) and anaplastic (n=833); 3) diffuse infiltrative gliomas (21%: 26% in males vs. 17% in females), mostly GBMs (14%); followed by 4) sellar (14%), 5) cranial nerve (6%), and PCNSL (3%) tumors. The remaining types each comprised ≤2 % of brain tumors, including mesenchymal non-meningothelial tumors (2%), intracranial ependymal (0.8%), mixed neuronal-glial (0.7%), circumscribed “other astrocytomas” (0.6%, mostly pilocytic astrocytomas n=1,307 and PXAs n=272), CNS embryonal (0.3%), pineal (0.2%), GCTs (0.1%), and choroid plexus (0.1%) tumors. In the 91,686 patients presenting with a BM, the most common primaries were lung adenocarcinoma (39%), lung SmallCC (14%), lung SqCC (8%), breast (8% of females), melanoma (3%), kidney (3%), colorectal (2%), and esophageal (1%). The distributions of brain tumor types differed significantly by age, sex, race/ethnicity, and insurance status. CONCLUSIONS In adult patients where the first manifestation of cancer includes an intracranial tumor, the most common diagnosis is either metastatic disease (predominantly from NSCLC) in males or benign meningiomas in females; but varies substantially by age group. Notably, our results adjust the traditional teaching that half of all new brain masses are BMs, which in fact represent only ~25% of new intracranial masses.

scholarly journals GERM-04. PRIMARY INTRACRANIAL GERM CELL TUMORS ARE MORE PREVALENT AMONG PEDIATRIC PATIENTS OF ASIAN/PACIFIC ISLANDER RACE/ETHNICITY IN THE UNITED STATES

2021 ◽  
Vol 23 (Supplement_1) ◽  
pp. i16-i17
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Pediatric Patients ◽  
Pacific Islander ◽  
Germ Cell Tumors ◽  
The United States ◽  
Asian Pacific Islander ◽  
Intracranial Germ Cell Tumors ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
The U.S

Abstract Introduction Primary intracranial germ cell tumors (GCTs) appear to be more prevalent among pediatric patients in eastern Asia than in the U.S. Herein we use cancer registry data to evaluate whether GCT prevalence differs by race/ethnicity among U.S. pediatric patients. Methods Pediatric patients (age≤14) presenting between 2004–2017 with a primary intracranial GCT were identified by ICD-O-3 histological and topographical coding from the National Cancer Database (comprising &gt;70% of cancers newly-diagnosed cancers in the U.S.), and categorized by NICHD age stages. Patients’ age, sex, race/ethnicity, and overall survival, and tumor location and size were evaluated. Results 889 pediatric patients with primary intracranial GCTs were identified, which were overwhelmingly male (64.8%) and pure germinomas (64.0%). Non-germinomatous (24.5%) and mixed (11.5%) tumor types were in the minority. Overall, primary GCTs comprised 4.9% of intracranial tumors in pediatric males and 2.9% of intracranial tumors in pediatric females. Asian/Pacific Islander pediatric patients in the U.S. had a notably higher prevalence of GCTs: among Asian/Pacific Islander males, 10.6% of all brain tumors were GCTs, compared to only 4.5% in White non-Hispanic patients, 2.8% in Black non-Hispanic patients, and 6.0% in Hispanic patients. Despite the much lower prevalence of GCTs among female patients overall, this predominance also persisted for Asian/Pacific Islander females, among whom 7.5% of brain tumors were GCTs, compared to only 2.5% in White non-Hispanic patients, 2.4% in Black non-Hispanic patients, and 4.1% in Hispanic patients. Overall, 9.4% of pediatric primary intracranial GCTs occurred in patients of Asian/Pacific Islander race/ethnicity, in contrast to 4.0% of diffuse astrocytic/oligodendroglial tumors, 2.8% of other astrocytic tumors, or 4.6% of embryonal tumors. Conclusions Primary intracranial GCTs affect a substantially larger proportion of both male and female pediatric patients of Asian/Pacific Islander race/ethnicity in the United States.

Emerging treatment patterns and checkpoint inhibitor (CPI) use among newly diagnosed Merkel cell carcinoma (MCC) patients in the United States veteran population.

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 139-139
Author(s):  
Ying Zheng ◽  
Shivani Pandya ◽  
Ting Yu ◽  
Mairead Kearney ◽  
Sulena Shrestha ◽  
...  
Keyword(s):  
Median Duration ◽  
Systemic Therapy ◽  
Index Date ◽  
Checkpoint Inhibitors ◽  
The United States ◽  
Treatment Patterns ◽  
Veterans Health ◽  
Newly Diagnosed ◽  
Health Administration ◽  
The U.S

139 Background: MCC is a rare and aggressive skin cancer with annual incidence of 2,500 in the U.S. Checkpoint inhibitors (CPIs) demonstrated durable disease response historically not seen with chemotherapy among MCC patients in clinical trials. Avelumab, a PD-L1 antibody, became the first and only approved treatment for metastatic MCC by the U.S. FDA in March 2017. This study evaluated emerging treatment patterns among MCC patients using the US Veterans Health Administration (VHA) database. Methods: This retrospective study identified newly-diagnosed MCC patients who initiated ≥1 systemic therapy from Oct. 2013 to Jan. 2018 and had continuous enrollment from ≥6 months pre-initial MCC diagnosis date until ≥2 months post-index date with follow-up until the earliest of death, disenrollment, or study end. The index date was defined as the start date of first-line (1L) systemic therapy. A subsequent line of therapy (2L) was defined by the earliest of new therapy addition, regimen switch, or a new/existing regimen after a >60-day gap from the prior cycle end. Duration of 1L therapy was evaluated among patients treated with CPIs, National Cancer Comprehensive Network (NCCN)-recommended chemotherapy (recCTs), and other chemotherapy (oCTs). The median duration of therapy was estimated using the Kaplan Meier method. Results: Of the 120 MCC patients (72% pre-2017) with 1L systemic therapy, 17%, 45%, and 38% were treated with CPIs, recCTs and oCTs, respectively. More than 75% were white men aged ≥65 years with mean baseline Charlson comorbidity index scores ≥5. Carboplatin-etoposide (56%) and cisplatin-etoposide (26%) were the most commonly-used recCTs. The median duration of 1L therapy in patients treated with CPI, recCTs and oCTs was 300, 91, and 21 days, respectively. 2L therapy was initiated in 33% of all 1L patients. Conclusions: Among 1L MCC patients, CPIs treated patients appear to be on treatment longer than both recCTs and oCTs patients. These descriptive findings provide important insights into the emerging real-world treatment patterns amongst MCC patients in the VHA population.

scholarly journals Gap between pediatric and adult approvals of molecular targeted drugs

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Satoshi Nishiwaki ◽  
Yuichi Ando
Keyword(s):  
Pediatric Patients ◽  
Package Insert ◽  
The United States ◽  
Antineoplastic Drugs ◽  
Childhood Cancers ◽  
The European Union ◽  
Pediatric Cancers ◽  
The Status ◽  
Approved Drugs ◽  
The U.S

Abstract To clarify the approval status of molecular targeted antineoplastic drugs in the United States (U.S.), the European Union (E.U.), and Japan (JP), we checked the status of pediatric indications according to the package insert of each drug. A total of 103 drugs were approved for adult patients in at least one of the three regions whereas only 19 drugs were approved for pediatric patients. Sixty-six of 103 drugs (64.1%) had adult indications in the U.S., the E.U., and JP, whereas only three drugs had pediatric indications in all three regions. Abnormalities in six genes (NRAS, ABL1, JAK2, KIT, ALK and BRAF) were common in childhood cancers as well as adult cancers, for which at least one approved drug could be a potentially actionable drug. Although there were 16 candidate drugs that had adult indications for these abnormalities, only three drugs (18.8%) had pediatric indications. We confirmed that there were few molecular targeted antineoplastic drugs with pediatric indications in the U.S., the E.U., and JP compared with the number of approved drugs for adults. Drugs targeting genomic abnormalities which were common in both adult and pediatric cancers were considered to be good candidates for expansion of their indication for pediatric patients.

scholarly journals 824 Biologic Use in Pediatric Patients Newly Diagnosed With Ulcerative Colitis in the United States, 2010-2013 and 2014-2016

2019 ◽  
Vol 114 (1) ◽  
pp. S475-S475
Author(s):  
Geert R. D'Haens ◽  
April Naegeli ◽  
Malika Mahoui ◽  
Stuart Morton ◽  
Yan Dong ◽  
...  
Keyword(s):  
United States ◽  
Ulcerative Colitis ◽  
Pediatric Patients ◽  
The United States ◽  
Newly Diagnosed

scholarly journals 826 Biologic Use in Pediatric Patients Newly Diagnosed With Crohn’s Disease in the United States, 2010-2013 and 2014-2016

2019 ◽  
Vol 114 (1) ◽  
pp. S476-S478
Author(s):  
Geert R. D'Haens ◽  
April Naegeli ◽  
Malika Mahoui ◽  
Stuart Morton ◽  
Yan Dong ◽  
...  
Keyword(s):  
United States ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pediatric Patients ◽  
The United States ◽  
Newly Diagnosed

scholarly journals Tackling a Recurrent Pinealoblastoma

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Siddanna Palled ◽  
Sruthi Kalavagunta ◽  
Jaipal Beerappa Gowda ◽  
Kavita Umesh ◽  
Mahalaxmi Aal ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
High Dose Chemotherapy ◽  
Pineal Region ◽  
High Dose ◽  
Cell Transplant ◽  
Intracranial Tumors ◽  
Newly Diagnosed ◽  
Management Guidelines ◽  
Multimodality Approach

Pineoblastomas are rare, malignant, pineal region lesions that account for <0.1% of all intracranial tumors and can metastasize along the neuroaxis. Pineoblastomas are more common in children than in adults and adults account for <10% of patients. The management of pinealoblastoma is multimodality approach, surgery followed with radiation and chemotherapy. In view of aggressive nature few centres use high dose chemotherapy with autologus stem cell transplant in newly diagnosed cases but in recurrent setting the literature is very sparse. The present case represents the management of pinealoblastoma in the recurrent setting with reirradiation and adjuvant carmustine chemotherapy wherein the management guidelines are not definitive.

scholarly journals Utilization and Treatment Patterns of Disease-Modifying Therapy Among Pediatric Patients With Multiple Sclerosis in the United States

2020 ◽  
Author(s):  
Greenberg Benjamin ◽  
Scott Kolodny ◽  
Mengru Wang ◽  
Chinmay Deshpande
Keyword(s):  
Multiple Sclerosis ◽  
Index Date ◽  
Pediatric Patients ◽  
Treatment Options ◽  
The United States ◽  
Treatment Patterns ◽  
Considerable Proportion ◽  
Newly Diagnosed ◽  
Disease Modifying Therapy ◽  
Disease Modifying

Abstract Background: The current landscape and treatment patterns of disease-modifying therapy (DMT) use among pediatric patients with multiple sclerosis (MS) is not yet well understood. This study examined DMT utilization and treatment patterns among pediatric patients newly diagnosed with MS. Methods: Pediatric patients (&lt;18 years) with 2 MS diagnosis claims from January 1, 2010, to December 31, 2016, were identified from the MarketScan Commercial Database. Index date was defined as the date of first MS diagnosis and patients were followed up for 1-year post-index date. Outcomes evaluated included percentage of patients who initiated treatment after MS diagnosis, different DMTs initiated, treatment discontinuation, and switching treatment over the follow-up period. Results: Of the 182,057 newly diagnosed MS patients, 288 pediatric patients (mean age: 14 years; females: 61%) were identified. Within the first year of diagnosis, 188 patients (65.3%) did not receive any DMT. The most commonly first initiated treatments were interferons and glatiramer acetate (83%), but 28% of patients switched or discontinued from first initiated treatment within 6 months of treatment initiation. Conclusions: This study suggests that a considerable proportion of pediatric MS patients remain untreated within one year. Patients most commonly initiated injectables as their first DMT. Overall approximately 1 in 3 patients failed on therapy early. Thus, the study warrants urgency in treating these patients with currently approved treatment options.

Quality Control of Data in a Large-Scale Cancer Register Program

1966 ◽  
Vol 05 (02) ◽  
pp. 67-74 ◽  
Author(s):  
W. I. Lourie ◽  
W. Haenszeland
Keyword(s):  
United States ◽  
Quality Control ◽  
Cancer Patients ◽  
Large Scale ◽  
The United States ◽  
Newly Diagnosed ◽  
Related Data ◽  
Cancer Register ◽  
Independent Review ◽  
End Results

Quality control of data collected in the United States by the Cancer End Results Program utilizing punchcards prepared by participating registries in accordance with a Uniform Punchcard Code is discussed. Existing arrangements decentralize responsibility for editing and related data processing to the local registries with centralization of tabulating and statistical services in the End Results Section, National Cancer Institute. The most recent deck of punchcards represented over 600,000 cancer patients; approximately 50,000 newly diagnosed cases are added annually.Mechanical editing and inspection of punchcards and field audits are the principal tools for quality control. Mechanical editing of the punchcards includes testing for blank entries and detection of in-admissable or inconsistent codes. Highly improbable codes are subjected to special scrutiny. Field audits include the drawing of a 1-10 percent random sample of punchcards submitted by a registry; the charts are .then reabstracted and recoded by a NCI staff member and differences between the punchcard and the results of independent review are noted.

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