Survival effects of erythropoiesis-stimulating agents (ESAs) in patients with breast cancer: A meta-analysis.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 120-120 ◽  
Author(s):  
Brian Leyland-Jones ◽  
Matti S. Aapro ◽  
Volker Moebus ◽  
Ulrike Nitz ◽  
Joyce O'Shaughnessy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Random Effects ◽  
Literature Search ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Mortality Data ◽  
Published Data ◽  
Epoetin Alfa ◽  
Treatment Results ◽  
Mixed Stage

120 Background: New data are available from two trials of ESA use in patients with breast cancer receiving chemotherapy. We conducted a meta-analysis of trials of ESA use in this population. Methods: A literature search identified reports from 1997-2012 that included mortality data from controlled ESA trials (epoetin alfa, epoetin beta, darbepoetin alfa, biosimilars) in patients with breast cancer receiving chemotherapy. We used data from company databases for Amgen Inc. or Janssen Products LP studies and published data for other studies. Random-effects odds ratios (OR) were calculated to compare results for patients randomized to ESA to patients randomized to control. Analyses were stratified by metastatic stage; mixed stage or treatment; and adjuvant/neoadjuvant treatment. Results: We analyzed 9 studies (N = 4,713; ESA n = 2,346, control n = 2367) (Table).The overall stratified random-effects OR for death was 1.17 (95% confidence interval, 0.99-1.39). Details are presented in the Table. Conclusions: Overall survival OR remains consistent with prior data after including recent results. [Table: see text]

Survival effects of erythropoiesis-stimulating agents (ESAs) in patients with breast cancer: A meta-analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20616-e20616
Author(s):  
Brian Leyland-Jones ◽  
Matti S. Aapro ◽  
Volker Moebus ◽  
Ulrike Nitz ◽  
Joyce O'Shaughnessy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Random Effects ◽  
Literature Search ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Mortality Data ◽  
Published Data ◽  
Epoetin Alfa ◽  
Treatment Results ◽  
Mixed Stage

e20616 Background: New data are available from two trials of ESA use in patients with breast cancer receiving chemotherapy. We conducted a meta-analysis of trials of ESA use in this population. Methods: A literature search identified reports from 1997-2012 that included mortality data from controlled ESA trials (epoetin alfa, epoetin beta, darbepoetin alfa, biosimilars) in patients with breast cancer receiving chemotherapy. We used data from company databases for Amgen Inc. or Janssen Products LP studies and published data for other studies. Random-effects odds ratios (OR) were calculated to compare results for patients randomized to ESA to patients randomized to control. Analyses were stratified by metastatic stage; mixed stage or treatment; and adjuvant/neoadjuvant treatment. Results: We analyzed 9 studies (N = 4713; ESA n = 2346, control n = 2367) (Table).The overall stratified random-effects OR for death was 1.17 (95% confidence interval, 0.99-1.39). Details are presented in the Table. Conclusions: Overall survival OR remains consistent with prior data after including recent results. [Table: see text]

Pulmonary toxicity of cytotoxic agents: A meta-analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19573-19573
Author(s):  
Y. Takiguchi ◽  
Y. Tada ◽  
K. Kurosu ◽  
S. Sakao ◽  
K. Tatsumi ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Comparative Studies ◽  
Pulmonary Toxicity ◽  
Literature Search ◽  
Meta Analysis ◽  
Best Supportive Care ◽  
Cytotoxic Agents ◽  
Published Data ◽  
Toxicity Data ◽  
Anti Cancer

19573 Background: Pulmonary toxicity is one of the most serious adverse effects of cytotoxic agents, and affected patients require discontinuation of the anti-cancer therapy, and it even proves fatal in many cases. Its incidence, however, may be considerably biased, as it may be influenced by many factors such as intercurrent medications or co-morbidities. The purpose of our study was to evaluate the incidences of pulmonary toxicity by cytotoxic agents in published data relating to prospective randomized comparative studies. Methods: A Medline literature search was conducted to extract prospective randomized comparative studies (either phase II or III) that included docetaxel, paclitaxel, irinotecan, vinorelbine and gemcitabine. Comparisons had to be performed between regimens with and without one of these agents, in addition to best supportive care with or without other common agent(s), so as to be able to clearly attribute the toxicity to the agent. Reports lacking detailed toxicity data were excluded. Results: The table below summarizes the results of the finally evaluated 47 studies (5 to 12 per agent) fulfilling the criteria. As many studies showed no pulmonary toxicity, standard statistical methods for meta-analysis were not applicable. Conclusions: The present study analyzing data in prospective randomized comparative studies might minimize bias of the relative incidence of pulmonary toxicity. Pulmonary toxicity was rarely encountered in randomized comparative studies. No increase in frequency was shown by the inclusion of any of the five cytotoxic agents. [Table: see text] No significant financial relationships to disclose.

Meta-analysis of the effects on safety of front-loading (FL), every-2-week (Q2W), and Q3W dosing of darbepoetin alfa (DA) in patients (pts) with chemotherapy-induced anemia (CIA).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19511-e19511
Author(s):  
John A. Glaspy ◽  
Dusan Kotasek ◽  
Jean-Luc Canon ◽  
Dianne Tomita ◽  
Helen Collins ◽  
...  
Keyword(s):  
Adverse Events ◽  
Active Control ◽  
Random Effects ◽  
Darbepoetin Alfa ◽  
Comparison Group ◽  
Meta Analysis ◽  
Rapid Rate ◽  
Thromboembolic Events ◽  
Epoetin Alfa ◽  
Safety Risks

e19511 Background: Several studies evaluated if alternate dosing could decrease the time to hemoglobin (Hb) response. With recent safety concerns, this is now of limited interest; however, these studies may contribute to the understanding of safety risks. This study-level meta-analysis examined effects of FL, Q2W, and Q3W dosing of DA vs epoetin alfa (EA) and weekly DA dosing on safety in pts with CIA. Methods: Data from 11 studies (4 FL, 5 Q2W, 1 Q3W, 1 Q2W/Q3W) conducted between 1999 and 2006 in which the comparison group received 3-times-per-week (TIW) or once-weekly (QW) EA or QW DA were included in the meta-analysis. FL dosing differed between the studies and was defined as DA 4.5 mcg/kg or 300 mg QW for 4 or 5 weeks or until Hb > 12 g/dL followed by either DA 4.5 mcg/kg Q3W or a lower QW dose. Endpoints included deaths on study; disease progression (PD); embolic, thrombotic, and thromboembolic events; and rapid Hb rise (1 g/dL within 14 days). Random effects odds ratios (ORs) are provided comparing FL, Q2W, or Q3W arms to either TIW or QW active control arms. Heterogeneity was assessed using I2 statistic. Results: No differences in ORs for death, PD, embolic, thrombotic, and thromboembolic events or evidence of a more rapid rate of Hb rise were observed in FL, Q2W, and Q3W arms compared with controls (table). Conclusions: Results of this meta-analysis suggested that these adverse events were not related to FL, Q2W, or Q3W dosing of DA. [Table: see text]

scholarly journals Short-term Anteroposterior Treatment Effects of Functional Appliances and Extraoral Traction on Class II Malocclusion

2007 ◽  
Vol 77 (5) ◽  
pp. 907-914 ◽  
Author(s):  
Gregory Stylianos Antonarakis ◽  
Stavros Kiliaridis
Keyword(s):  
Literature Search ◽  
Meta Analysis ◽  
Class Ii ◽  
Published Data ◽  
Class Ii Malocclusion ◽  
Random Effects Model ◽  
Block Group ◽  
Short Term ◽  
Twin Block ◽  
Functional Appliances

Abstract Objective: To evaluate the anteroposterior short-term skeletal and dental effects on Class II malocclusion in growing patients following treatment with functional appliances (activators or twin block), extraoral traction, or combination appliances (appliances with both functional and extraoral traction components), based on published data. Materials and Methods: A literature search was carried out identifying a total of nine prospective clinical trials. The data provided in the publications underwent meta-analysis using the random effects model with regard to SNA, SNB, ANB, and overjet. Results: All appliance groups showed an improvement in sagittal intermaxillary relationships (decrease in ANB) when compared to untreated subjects. Activators and twin block appliances accomplish this mainly by acting on the mandible (increases in SNB) while twin block appliances also seem to act on the maxilla (decrease in SNA). Extraoral traction appliances achieve this by acting on the maxilla (decreases in SNA). Combination appliances mainly act on the mandible (increase in SNB). Activators, twin block, and combination appliances also reveal a decrease in overjet, which is not the case in the singular use of extraoral traction. Conclusions: Intermaxillary changes being present in all appliance groups, anteroposterior treatment response following the use of functional appliances and/or extraoral traction in growing class II malocclusion patients is most evident in one of the two jaws (mandible for activators and combination appliances and maxilla for extraoral traction) except for the twin block group, which shows changes on both jaws.

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 Heart Failure Therapies for the Prevention of HER2-Monoclonal Antibody-Mediated Cardiotoxicity: A Systematic Review and Meta-Analysis of Randomized Trials

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5527
Author(s):  
Lauren J. Brown ◽  
Thomas Meredith ◽  
Jie Yu ◽  
Anushka Patel ◽  
Bruce Neal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Monoclonal Antibodies ◽  
Active Treatment ◽  
Randomized Trials ◽  
Prophylactic Treatment ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Published Data ◽  
Her2 Positive

Monoclonal antibodies including trastuzumab, pertuzumab, and antibody-drug conjugates, form the backbone of HER2-positive breast cancer therapy. Unfortunately, an important adverse effect of these agents is cardiotoxicity, occurring in approximately 10% of patients. There is increasing published data regarding prevention strategies for cardiotoxicity, though seldom used in clinical practice. We performed a systematic review and meta-analysis of randomized-controlled trials to evaluate pharmacotherapy for the prevention of monoclonal HER2-directed antibody-induced cardiotoxicity in patients with breast cancer. Online databases were queried from their inception until October 2021. Effects were determined by calculating risk ratios (RRs) and 95% confidence intervals (CI) or mean differences (MD) using random-effects models. We identified five eligible trials. In the three trials (n = 952) reporting data on the primary outcome of cardiotoxicity, there was no clear effect for patients assigned active treatment compared to control (RR = 0.90, 95% CI 0.63 to 1.29, p = 0.57). Effects were similar for ACE-I/ARB and beta-blockers (p homogeneity = 0.50). Active treatment reduced the risk of HER2 therapy interruptions (RR = 0.57, 95% CI 0.43 to 0.77, p < 0.001) with similar findings for ACE-I/ARB and beta-blockers (p homogeneity = 0.97). Prophylactic treatment with ACE-I/ARB or beta-blocker therapy may be of value for cardio-protection in patients with breast cancer prescribed monoclonal antibodies. Further, adequately powered randomized trials are required to define the role of routine prophylactic treatment in this patient group.

scholarly journals Genetic associations between CYP24A1 polymorphisms and predisposition of cancer: A meta-analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 71-79
Author(s):  
Guoqiang Zhang ◽  
Maohe Jin
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Literature Search ◽  
Web Of Science ◽  
Meta Analysis ◽  
Genetic Associations ◽  
Asian Ethnicity ◽  
Cancer Breast ◽  
Comprehensive Literature Search

Background: CYP24A1 polymorphisms may affect predisposition of cancer, but the results of published studies remain inconclusive. Therefore, the authors conducted this meta-analysis to more robustly assess relationships between CYP24A1 polymorphisms and the predisposition of cancer by pooling the findings of published studies. Materials and methods: A comprehensive literature search of PubMed, Embase, Web of Science, Wanfang, and CNKI was endorsed by the authors to identify eligible studies; 17 studies were finally found to be eligible for pooled meta-analysis. Results: The pooled meta-analysis results showed that genotypic frequencies of the rs4809960 polymorphism among cancerous patients and controls of Caucasian ethnicity differed significantly, and genotypic frequencies of the rs6022999 polymorphism among cancerous patients and controls of Asian ethnicity also differed significantly. Moreover, we found that genotypic frequencies of the rs2585428 polymorphism among patients with prostate cancer and controls differed significantly, and genotypic frequencies of the rs6068816 polymorphism among patients with prostate cancer/breast cancer and controls also differed significantly. Conclusions: This meta-analysis suggests that the rs4809960 polymorphism may affect the predisposition of cancer in Caucasians, and the rs6022999 polymorphism may affect the predisposition of cancer in Asians. Moreover, the rs2585428 polymorphism may affect the predisposition of prostate cancer, while the rs6068816 polymorphism may affect the predisposition of prostate cancer and breast cancer.

Impact of trainee involvement in esophagectomy on clinical outcomes: a narrative systematic review of the literature

2019 ◽  
Vol 32 (10) ◽  
pp. 1-8
Author(s):  
P Prasad ◽  
M Navidi ◽  
A Immanuel ◽  
S M Griffin OBE ◽  
A W Phillips
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Neoadjuvant Treatment ◽  
Length Of Hospital Stay ◽  
High Volume ◽  
Cochrane Library ◽  
Published Data ◽  
Meta Analyses ◽  
The Impact

SUMMARY Changes in the structure of surgical training have affected trainees’ operative experience. Performing an esophagectomy is being increasingly viewed as a complex technical skill attained after completion of the routine training pathway. This systematic review aimed to identify all studies analyzing the impact of trainee involvement in esophagectomy on clinical outcomes. A search of the major reference databases (Cochrane Library, MEDLINE, EMBASE) was performed with no time limits up to the date of the search (November 2017). Results were screened in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and study quality assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Four studies that included a total of 42 trainees and 16 consultants were identified, which assessed trainee involvement in open esophagogastric resectional surgery. A total of 1109 patients underwent upper gastrointestinal procedures, of whom 904 patients underwent an esophagectomy. Preoperative characteristics, histology, neoadjuvant treatment, and overall length of hospital stay were comparable between groups. One study found higher rates of anastomotic leaks in procedures primarily performed by trainees as compared to consultants (P &lt; 0.01)—this did not affect overall morbidity or survival; however, overall anastomotic leak rates from the published data were 10.4% (trainee) versus 6.3% (trainer) (P = 0.10). A meta-analysis could not be performed due to the heterogeneity of data. The median MINORS score for the included studies was 13 (range 11–15). This study demonstrates that training can be achieved with excellent results in high-volume centers. This has important implications on the consent process and training delivered, as patients wish to be aware of the risks involved with surgery and can be reassured that appropriately supervised trainee involvement will not adversely affect outcomes.

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