Inter- and intra-country variations in the use of trastuzumab in Norway, Spain and Sweden

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1069-1069
Author(s):  
N. Wilking ◽  
J. Bergh ◽  
U. Wilking ◽  
B. Jönsson
Keyword(s):  
Breast Cancer ◽  
Regional Differences ◽  
Treatment Time ◽  
Breast Cancer Mortality ◽  
Metastatic Breast ◽  
International Agency ◽  
Mortality Data ◽  
Global Comparison ◽  
Comparison Results ◽  
Incidence And Mortality

1069 Background: Breast cancer mortality is similar in Norway, Spain and Sweden (14–16/100,000 Age Standardized Rate). There are only small regional differences in incidence and mortality within the countries. Trastuzumab (T) was approved for metastatic breast cancer (MBC) in Norway, Spain and Sweden in second half of year 2000. T represents a unique new treatment for MBC that delays disease progression and improves survival. HER2 over expression (H+) is used to identify patients eligible for trastuzumab treatment (T). Methods: This study use sales data from IMS Health and incidence and mortality data from regional and national cancer registries as well as data from International Agency for Research on Cancer. We examines the variation in the use of T in different health care regions of Norway (4 regions), Spain (19 regions) and Sweden (6 regions) as well as differences in use between the countries. These results were also put into a global comparison. Results: There are marked differences in both the rate and level of uptake between the countries. Three years after approval the Spanish uptake was close to 90 % and twice the Swedish and 3–4 times the Norwegian uptake. The regional variations within the countries are of the same magnitude, a factor 2–3. Based on an assumed H+ rate of 25% and a treatment time of 38 weeks we estimate the proportion of H+ MBC patients that have been treated with T during the period 2000–2005 to be 24% in Norway; 66% in Spain and 44% in Sweden. In all countries there has been an increase in the use during the second half of 2005, indicating a use also in the adjuvant situation. T was approved for adjuvant treatment of BC in Europe in April 2006. Conclusions: Access of trastuzumab to patients with MBC in Norway, Spain and Sweden has been very variable. Spanish MBC patients have had earlier access to T than Swedish patients. Norwegian patients have had the lowest access. Regional differences in the use are in the magnitude of a factor 2–3. On a global level the Spanish uptake is in line with the uptake in the USA, Switzerland and Austria; the Swedish uptake is at an average European level and the Norwegian uptake is at a low level, similar to Czech Republic, Hungary, New Zealand, Poland and the UK. No significant financial relationships to disclose.

Regional differences in the use of trastuzumab in Sweden

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16019-16019
Author(s):  
U. Wilking ◽  
J. Bergh ◽  
N. Wilking ◽  
B. Jönsson
Keyword(s):  
Breast Cancer ◽  
Regional Differences ◽  
Treatment Time ◽  
Breast Cancer Mortality ◽  
Metastatic Breast ◽  
New Drugs ◽  
Marketing Authorization ◽  
Mortality Data ◽  
Marketing Approval ◽  
National Board

16019 Background: The number of deaths due to metastatic breast cancer (MBC) in Sweden is around 1.500 patients/year. It is important that patients have access to new drugs that may delay disease progression and potentially improve survival. HER2 over expression (H+) is used to identify patients eligible for trastuzumab treatment (T). Between 15–30% of patients with MBC have H+ disease. Methods: This study uses sales data from the retail supplier in Sweden, as well as breast cancer mortality data from the National Board of Health and Welfare. Date of marketing approval for trastuzumab in Sweden is Oct 2000. The median treatment time used in this study, as reflected in the pivotal trials, has been set to 38 weeks. This study examines the variation of use in the six health care regions of Sweden (total population 9 millions). Results: The per capita use of T in patients with H+ MBC varies significantly across Sweden. In 2000 minor regional differences in usage were observed. These differences increased and in Q4 2004 usage (measured in sales) varied between 12.500 USD and 37000 USD per 100,000 inhabitants (regions with the lowest/highest sales). Only half (approx. 1100 patients) based on the estiamted prevalent 2200 patients (based on 25% H+ MBC patients) have received T. The first year after marketing authorization 9% of the prevalent population received T. Four years later 93% of the incident population received T. Conclusions: Access of T to patients with H+ MBC in Sweden varies significantly across the 6 Health Regions. Uptake has been slow and not all eligeble patients receive T, even 5 years after marketing authorization. [Table: see text]

Serum Carboxypeptidase N1 Serves as a Potential Biomarker Complementing CA15-3 for Breast Cancer

2020 ◽  
Vol 20 (17) ◽  
pp. 2053-2065
Author(s):  
Ranliang Cui ◽  
Chaomin Wang ◽  
Qi Zhao ◽  
Yichao Wang ◽  
Yueguo Li
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Critical Concentration ◽  
Tumour Size ◽  
Clinical Stage ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Potential Biomarker ◽  
Incidence And Mortality ◽  
Combined Detection

Background: The incidence and mortality of breast cancer are increasing annually. Breast cancer seriously threatens women's health and quality of life. We aimed to measure the clinical value of CPN1, a new serum marker of breast cancer and to evaluate the efficacy of CPN1 in combination with CA15-3. Methods: Seventy samples of breast cancer with lymph node metastasis, seventy-three samples of nonmetastatic breast cancer and twenty-five samples of healthy human serum were collected. Serum CA15-3 concentration was determined by Roche Elecsys, and serum CPN1 concentration was determined by ELISA. Results: In breast cancer patients, serum CPN1 concentration was positively correlated with tumour size, clinical stage and CA15-3 concentration (r = 0.376, P<0.0001). ROC curve analysis showed that the optimal critical concentration of CPN1 for breast cancer diagnosis was 32.8pg/ml. The optimal critical concentration of CPN1 in the diagnosis of metastatic breast cancer was 66.121pg/ml. CPN1 has a greater diagnostic ability for breast cancer (AUCCA15-3=0.702 vs. AUCCPN1=0.886, P<0.0001) and metastatic breast cancer (AUCCA15-3=0.629 vs. AUCCPN1=0.887, P<0.0001) than CA15-3, and the combined detection of CA15-3 and CPN1 can improve the diagnostic efficiency for breast cancer (AUCCA15-3+CPN1=0.916) and for distinguishing between metastatic and non-metastatic breast cancer (AUCCA15-3+CPN1=0.895). Conclusion: CPN1 can be used as a new tumour marker to diagnose and evaluate the invasion and metastasis of breast cancer. The combined detection of CPN1 and CA15-3 is more accurate and has a certain value in clinical application.

scholarly journals Key Factor Regulating Inflammatory Microenvironment, Metastasis, and Resistance in Breast Cancer: Interleukin-1 Signaling

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Fengjie Liu ◽  
Lihong Li ◽  
Meng Lan ◽  
Tengteng Zou ◽  
Zhaodi Kong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Drug Resistance ◽  
Tumor Microenvironment ◽  
Interleukin 1 ◽  
Therapeutic Targets ◽  
Metastatic Breast ◽  
Receptor System ◽  
Inflammatory Infiltration ◽  
Inflammatory Microenvironment ◽  
Incidence And Mortality

Breast cancer is one of the top-ranked cancers for incidence and mortality worldwide. The biggest challenges in breast cancer treatment are metastasis and drug resistance, for which work on molecular evaluation, mechanism studies, and screening of therapeutic targets is ongoing. Factors that lead to inflammatory infiltration and immune system suppression in the tumor microenvironment are potential therapeutic targets. Interleukin-1 is known as a proinflammatory and immunostimulatory cytokine, which plays important roles in inflammatory diseases. Recent studies have shown that interleukin-1 cytokines drive the formation and maintenance of an inflammatory/immunosuppressive microenvironment through complex intercellular signal crosstalk and tight intracellular signal transduction, which were found to be potentially involved in the mechanism of metastasis and drug resistance of breast cancer. Some preclinical and clinical treatments or interventions to block the interleukin-1/interleukin-1 receptor system and its up- and downstream signaling cascades have also been proven effective. This study provides an overview of IL-1-mediated signal communication in breast cancer and discusses the potential of IL-1 as a therapeutic target especially for metastatic breast cancer and combination therapy and current problems, aiming at enlightening new ideas in the study of inflammatory cytokines and immune networks in the tumor microenvironment.

Evaluation of the Effect on Breast Cancer Mortality of Population Based Mammography Screening Programmes

1994 ◽  
Vol 1 (3) ◽  
pp. 184-187 ◽  
Author(s):  
Sven Törnberg ◽  
John Carstensen ◽  
Timo Hakulinen ◽  
Per Lenner ◽  
Thomas Hatschek ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Screening Programme ◽  
Breast Cancer Mortality ◽  
Time Lag ◽  
Statistical Modelling ◽  
Population Based ◽  
Mortality Data ◽  
Full Effect

To evaluate, by analysis of breast cancer mortality data from all the 26 Swedish counties for the years 1971 to 1990, whether the effect of the introduction of mammography screening in Sweden can be assessed by observation from existing mortality data. A Poisson regression model was used to study whether a decrease in breast cancer mortality among women aged 50–74 years was associated with the extent of mammography screening in different counties and periods. In regions where mammography screening had been introduced, breast cancer mortality tended to be decreased, on average, compared with regions with-'out screening. If a 10 year time lag between the start of screening and its full effect on mortality is assumed then the estimated reduction in breast cancer mortality associated with introduction of screening was 19% with a 95% confidence interval ranging from 3% to 37%. The results suggest that the effect of mammography screening may be studied using existing routine mortality data and appropriate statistical modelling. This way of assessing the outcome of the screening is valuable when continuously monitoring a screening programme that has become a public health routine.

Mechanisms of bone metastasis (BM) growth in patients with metastatic breast cancer (MBC): An exploratory study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1102-1102 ◽  
Author(s):  
W. S. Ooi ◽  
S. Popovic ◽  
M. Kalina ◽  
K. Harriette ◽  
G. Singh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Strategies ◽  
Bone Destruction ◽  
Metastatic Breast ◽  
Treated Group ◽  
Normal Breast ◽  
Primary Cancer ◽  
Comparison Results ◽  
Skeletal Related Events ◽  
Novel Treatment Strategies

1102 Background: The benefits of bisphosphonates (BPs) in reducing or delaying skeletal related events (SREs) in patients with BM have been attributed to their potent osteoclast (OC) inhibiting effect. However, despite the use of modern systemic anti-cancer therapy including potent BPs, many patients with BM continue to suffer from the consequences of their bone disease. An improved understanding of the basic mechanisms of bone destruction would allow further appropriate targeted treatment strategies to be developed. Methods: Archival paraffin embedded BM specimens from patients with MBC were examined for expression of OCs, receptor activator of nuclear factor kappa B (RANK), RANK Ligand (RANKL) and Osteoprotegerin (OPG). Histological specimens were also available for primary breast cancer, lymph node (LN) metastasis, normal breast and bone tissues for comparison. Results: BM specimens were available for 20 BP naïve pts and 2 pts treated with BP. OCs were significantly increased in the BM of the BP naive group compared to controls. There were no OCs seen in the BP treated group. RANK was expressed on tumor cells (TCs) in the both bone and nodal metastases but not on the primary cancer cells. It is also expressed on the OCs which were present in both BM and normal bone. While RANKL was absent in TCs, it was strongly expressed in all stromal cells (SCs) in all specimens and in osteoblasts. The OPG, while present in TCs of the BM and LN metastases, is not detected in the primary cancer. Conclusion: The mechanism of bone destruction in MBC are not fully understood and are clearly multifactorial. OCs may not be the singular obligatory factor for osteolysis in BM. Further investigation of various inhibitors of the RANK/RANKL/OPG pathways, may allow novel treatment strategies to be developed. No significant financial relationships to disclose.

scholarly journals Spatial Analysis of County-Level Breast Cancer Mortality in Texas

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Arvind B. Bambhroliya ◽  
Keith D. Burau ◽  
Ken Sexton
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Female Breast Cancer ◽  
Southern Region ◽  
Scan Statistics ◽  
Mortality Data ◽  
County Level ◽  
Northeastern Region ◽  
Female Breast

Objective. The objectives of the study were to detect high-risk areas and to examine how racial and ethnic status affect the geographic distribution of female breast cancer mortality in Texas. Analyses were based on county-level data for the years from 2000 to 2008.Materials and Methods. Breast cancer mortality data were obtained from the Texas Cancer Registry, and the Spatial Scan Statistics method was used to run Purely Spatial Analyses using the Discrete Poisson, Bernoulli, and Multinomial models.Results and Conclusions. Highest rates of female breast cancer mortality in Texas have shifted over time from southeastern areas towards northern and eastern areas, and breast cancer mortality at the county level is distributed heterogeneously based on racial/ethnic status. Non-Hispanic blacks were at highest risk in the northeastern region and lowest risk in the southern region, while Hispanics were at highest risk in the southern region along the border with Mexico and lowest risk in the northeastern region.

scholarly journals A DNA-Peptide Fusion as a Vaccine Candidate against Breast and Ovarian Cancer Metastasis: Consequent Benefit in Certain Lung Cancers

2020 ◽  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Ovarian Cancer ◽  
Cancer Mortality ◽  
In Silico ◽  
Breast Cancer Mortality ◽  
Mortality Data ◽  
Published Data ◽  
Lung Carcinogenesis ◽  
Breast And Ovarian Cancer

Cancer mortality data were obtained from the WHO Mortality Database. Lung cancer, with about 85% being non-small cell lung cancer is one of the most common malignant tumors, considered the leading cause of cancer-related death in both men and women (associated with breast and ovarian cancer in metastasis). From published data, we designed a preventive vaccine in Silico aimed to protect against breast and ovarian cancer involved in metastasis for lung cancer. The largest increases are expected for melanoma; cancers of the prostate, kidney, liver, and urinary bladder in males; and the lung, breast, uterus, ovarian, and thyroid in females. Among all women, lung cancer mortality rates have surpassed those for breast cancer around the world. This reflects the decline of breast cancer mortality due to screening access and effective treatment alongside entrance of certain countries lifestyle and behavior in which smoking has become more prevalent in women. One aim of this research paper is to provide a better understanding for the potential dormant repositories of outbreaks and potential metastasis of breast and ovarian cancer and its consequents in lung cancer. In this study, we present to the cDNA-peptide fusion a more stable anti-tumoral against breast and ovarian cancer. As a cDNA target, we used primers from Her2 gene fusion with peptides from Her2 and human PARP-1 proteins. Our analysis identified 16 cloning DNA (cDNA) with theorical fusion stability (FS) value among 49.30-62.41 range and theorical Exosome Affinity (EA) (cDNA-peptide and exosome) among 62.60-77.10 range. We proposed a cDNA-peptide with theorical fusion value stability FS=50.36 Cruz and exosome affinity EA=68.02 Ro. We have named the cDNA-peptide selection as: LCR_2020_B008-55. In addition, in Silico, this cDNA-peptide also manifests partial inhibiting activity on the methylated promoter genes in lung tumors, therefore, this chimera cDNA-peptide may achieve a higher representative antitumoral activity against lung cancer disease. According to the anti-tumoral monitoring after and before vaccination using the candidate LCR_2020_B008-55, we proposed exosomes as biomarkers of lung carcinogenesis after and before vaccination. Due to the cDNA-peptides, in Silico, manifesting high affinity with exosomes, where our proposed vaccine may reach high representative activity against breast, ovarian and lung cancer in a metastasis stage, we identified this chimera with a triple antitumoral action.

scholarly journals Thyroid cancer incidence and mortality in Latin America

2018 ◽  
Author(s):  
Fábia Cheyenne Gomes de Morais Fernandes ◽  
Dyego Leandro Bezerra de Souza ◽  
Maria Paula Curado ◽  
Isabelle Ribeiro Barbosa
Keyword(s):  
Latin America ◽  
Thyroid Cancer ◽  
Costa Rica ◽  
Cancer Incidence ◽  
World Health ◽  
International Agency ◽  
Mortality Data ◽  
Incidence Trends ◽  
Incidence And Mortality ◽  
Thyroid Cancer Incidence

This study analyzed trends in thyroid cancer incidence and mortality in countries of Latin America. Ecological study of time series, with incidence data extracted from the International Agency for Research on Cancer (IARC), in the 1990-2012 period and mortality data obtained from 16 countries of the World Health Organization (WHO), in the 1995-2013 period. The trend of incidence rate was analyzed by the Joinpoint regression. The average annual percentage change (AAPC) and the 95% confidence interval (CI 95%) were calculated for incidence and mortality. The average rate of thyroid cancer incidence was higher in Quito (Ecuador) between the ages of 40 to 59 years old, 42.2 new cases per 100,000 inhabitants, as well as mortality 4.8 deaths per 100,000 women inhabitants above 60 years old. There was an increase in thyroid cancer incidence trends in women, for all age groups, in Cali, Costa Rica and Quito and men in Costa Rica; there was stability above the age of 60 years old in Cali, Goiania, Quito and Valdivia in men, as well as women in Goiania and Valdivia. There was a trend of increasing mortality for females in three countries: Ecuador (AAPC= 3,28 CI 95% 1,36;5,24), Guatemala (AAPC= 6,14 CI 95% 2,81;9,58) and Mexico (AAPC= 0,67 CI 95% 0,16;1,18). Thyroid cancer in Latin America showed a high incidence, with increased incidence in women. Stability in mortality was observed for most countries of Latin America.

scholarly journals Prior Treatment Time Affects Survival Outcomes in Metastatic Breast Cancer

2020 ◽  
pp. 500-513 ◽  
Author(s):  
Gabrielle B. Rocque ◽  
Aidan Gilbert ◽  
Courtney P. Williams ◽  
Kelly M. Kenzik ◽  
Arie Nakhmani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Proportional Hazards ◽  
Treatment Time ◽  
Specific Treatment ◽  
Metastatic Breast ◽  
Clinical Trial Data ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Prior Treatment

PURPOSE Sequential drug treatments in metastatic breast cancer (MBC) are disparate. Clinical trial data includes limited reporting of treatment context, primarily including the number of prior therapies. This study evaluates the relationship between prior treatment time, prior lines of treatment, and survival using a novel visualization technique coupled with statistical analyses. PATIENTS AND METHODS This retrospective cohort study used a nationwide, de-identified electronic health record–derived database to identify women with hormone receptor–positive, human epidermal growth factor receptor 2–negative MBC diagnosed in 2014 who subsequently received paclitaxel. Images were created, with individual patients represented on the y-axis and time, on the x-axis. Specific treatments were represented by colored bars, with Kaplan-Meier curves overlaying the image. Separate images assessed progression-free survival and overall survival (OS). Hazard ratios (HRs) and 95% CIs from Cox proportional hazards models evaluated the association between prior treatment time and OS. RESULTS Of 234 patients, median survival from first paclitaxel administration was 20 months (interquartile range, 8-53 months). An inverse relationship was observed between OS after paclitaxel and timing of administration. In adjusted models, each year on treatment prior to paclitaxel was associated with a 16% increased hazard of death after paclitaxel (HR, 1.16; 95% CI, 1.05 to 1.29). CONCLUSION OS after a specific treatment is dependent on when a drug is given in the disease context, highlighting the potential for an overall OS benefit to be observed on the basis of treatment timing. Prior time on treatment should be considered as a stratifying factor in randomized trials and a confounding factor when examining survival in observational data.

Sign in / Sign up

Export Citation Format

Share Document