One‐Day Versus Three‐Day Dexamethasone in Combination with Palonosetron for the Prevention of Chemotherapy‐Induced Nausea and Vomiting: A Systematic Review and Individual Patient Data‐Based Meta‐Analysis

e21688 Background: Several clinical trials have evaluated the need for corticosteroid-containing antiemetic regimens on the days after the first 24 hours to control delayed chemotherapy-induced nausea and vomiting (CINV) during moderate emetogenic chemotherapy (MEC) or anthracycline and/or cyclophosphamide (AC)-containing chemotherapy. Methods:We conducted systematic review using research databases and trial registries for any randomized controlled trials reporting CINV outcomes for a single 1-day-dexamethasone (D1 group) containing antiemetic regimen in chemotherapy-naive adult patients scheduled to receive a MEC or AC-containing chemotherapy, compared with additional dexamethasone on days 2 and 3 (D3 group). We also gathered the individual patient data (IPD) from each study investigator. The primary endpoint was complete response (CR: no vomiting and no rescue antiemetics) in the 5-day study period. Secondary efficacy end points were CR rates in 0–24 h and CR rates in 24–120 h; complete control in the overall, acute, delayed periods. An IPD meta-analysis was conducted to quantify the pooled risk differences between D1 group and D3 group and its interaction with patient characteristics using a fixed effect model. Results: Of 887 articles screened, 5 eligible studies were identified comprising 1194 patients, all enrolled in the meta-analysis. Overall, D1 group was not significantly inferior to D3 group in CR rate as well as CC rate [pooled risk difference in CR rate -1.5%, 95% confidence interval (CI) -7.1–4.0%; in delayed CR rate -2.4%, 95% CI -7.7–2.9%]. There was no significant interaction between dexamethasone regimen and patient characteristics (sex, age category ( < 60 or 60 years), and alcohol consumption). Conclusions: These results strongly suggest that the dexamethasone-sparing regimen is not associated with a significant loss in overall antiemetic control in an adult patient undergoing MEC or AC-containing chemotherapy, irrespective of patient baseline characteristics. These data contribute to simplify antiemetic regimens and spare many patients from the potential side-effects of multiple-day corticosteroids.

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Delayed versus Early Renal Replacement Therapy for Severe Acute Kidney Injury: A Systematic Review and Individual Patient Data Meta-Analysis of Randomised Clinical Trials

SSRN Electronic Journal ◽

10.2139/ssrn.3526302 ◽

2020 ◽

Author(s):

Stephane Gaudry ◽

David Hajage ◽

Nicolas Benichou ◽

Khalil Chaïbi ◽

Saber Barbar ◽

...

Keyword(s):

Systematic Review ◽

Acute Kidney Injury ◽

Clinical Trials ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Individual Patient Data ◽

Meta Analysis ◽

Kidney Injury ◽

Patient Data ◽

Randomised Clinical Trials

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Sentinel Lymph Node Procedure in Colon Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data

SSRN Electronic Journal ◽

10.2139/ssrn.3582801 ◽

2020 ◽

Author(s):

Marjolein Ankersmit ◽

Martijn W. Heymans ◽

Otto Hoekstra ◽

Stijn L. Vlek ◽

Linda J. Schoonmade ◽

...

Keyword(s):

Systematic Review ◽

Colon Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Individual Patient Data ◽

Meta Analysis ◽

Patient Data ◽

Sentinel Lymph Node Procedure

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Genome-wide copy number variations as molecular diagnostic tool for cutaneous intermediate melanocytic lesions: a systematic review and individual patient data meta-analysis

Virchows Archiv ◽

10.1007/s00428-021-03095-5 ◽

2021 ◽

Author(s):

Chiel F. Ebbelaar ◽

Anne M. L. Jansen ◽

Lourens T. Bloem ◽

Willeke A. M. Blokx

Keyword(s):

Systematic Review ◽

Sensitivity And Specificity ◽

Copy Number ◽

Individual Patient Data ◽

Meta Analysis ◽

Copy Number Variations ◽

Patient Data ◽

Melanocytic Lesions ◽

Genome Wide ◽

Malignant Lesions

AbstractCutaneous intermediate melanocytic neoplasms with ambiguous histopathological features are diagnostically challenging. Ancillary cytogenetic techniques to detect genome-wide copy number variations (CNVs) might provide a valuable tool to allow accurate classification as benign (nevus) or malignant (melanoma). However, the CNV cut-off value to distinguish intermediate lesions from melanoma is not well defined. We performed a systematic review and individual patient data meta-analysis to evaluate the use of CNVs to classify intermediate melanocytic lesions. A total of 31 studies and 431 individual lesions were included. The CNV number in intermediate lesions (median 1, interquartile range [IQR] 0–2) was significantly higher (p<0.001) compared to that in benign lesions (median 0, IQR 0–1) and lower (p<0.001) compared to that in malignant lesions (median 6, IQR 4–11). The CNV number displayed excellent ability to differentiate between intermediate and malignant lesions (0.90, 95% CI 0.86–0.94, p<0.001). Two CNV cut-off points demonstrated a sensitivity and specificity higher than 80%. A cut-off of ≥3 CNVs corresponded to 85% sensitivity and 84% specificity, and a cut-off of ≥4 CNVs corresponded to 81% sensitivity and 91% specificity, respectively. This individual patient data meta-analysis provides a comprehensive overview of CNVs in cutaneous intermediate melanocytic lesions, based on the largest pooled cohort of ambiguous melanocytic neoplasms to date. Our meta-analysis suggests that a cut-off of ≥3 CNVs might represent the optimal trade-off between sensitivity and specificity in clinical practice to differentiate intermediate lesions from melanoma.

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