scholarly journals Treatment Pattern and Outcomes with Systemic Therapy in Men with Metastatic Prostate Cancer in the Real-World Patients in the United States

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4951
Author(s):  
Umang Swami ◽  
Jennifer Anne Sinnott ◽  
Benjamin Haaland ◽  
Nicolas Sayegh ◽  
Taylor Ryan McFarland ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Real World ◽  
Comparative Effectiveness ◽  
Metastatic Prostate Cancer ◽  
Proportional Hazards Model ◽  
The United States ◽  
Cox Proportional Hazards Model ◽  
Real World Data ◽  
Hormonal Therapies

Background: Both novel hormonal therapies and docetaxel are approved for treatment of metastatic prostate cancer (mPC; in castration sensitive or refractory settings). Present knowledge gaps include lack of real-world data on treatment patterns in patients with newly diagnosed mPC, and comparative effectiveness of novel hormonal therapies (NHT) versus docetaxel after treatment with a prior NHT. Methods: Herein we extracted patient-level data from a large real-world database of patients with mPC in United States. Utilization of NHT or docetaxel for mPC and comparative effectiveness of an alternate NHT versus docetaxel after one prior NHT was evaluated. Comparative effectiveness was examined via Cox proportional hazards model with propensity score matching weights. Each patient’s propensity for treatment was modeled via random forest based on 22 factors potentially driving treatment selection. Results: The majority of patients (54%) received only androgen deprivation therapy for mPC. In patients treated with an NHT, alternate NHT was the most common next therapy and was associated with improved median overall survival over docetaxel (abiraterone followed by docetaxel vs. enzalutamide (8.7 vs. 15.6 months; adjusted hazards ratio; aHR 1.32; p = 0.009; and enzalutamide followed by docetaxel vs. abiraterone (9.7 vs. 13.2 months aHR 1.40; p = 0.009). Limitations of the study include retrospective design.

Comparative effectiveness of nab-paclitaxel plus gemcitabine versus FOLFIRINOX in metastatic pancreatic cancer: A nationwide chart review in the United States.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 376-376
Author(s):  
Sunnie S. Kim ◽  
James Signorovitch ◽  
Hongbo Yang ◽  
Oscar Patterson-Lomba ◽  
Cheryl Xiang ◽  
...  
Keyword(s):  
Real World ◽  
Medical Records ◽  
Proportional Hazards Model ◽  
Specific Treatment ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Real World Data ◽  
Significant Difference ◽  
Treatment Sequences

376 Background: nab-Paclitaxel plus gemcitabine ( nab-P+G) and FOLFIRINOX (FFX) are among the most common first-line (1L) therapies for metastatic adenocarcinoma of the pancreas (mPC), yet there is no head-to-head trial comparing their efficacy and real-world data is limited. As new second-line (2L) therapies become available, it is important to understand the real-world effectiveness associated with different treatment sequences. Methods: This retrospective cohort study compared the efficacy and safety of 1L nab-P+G vs. FFX, overall and under specific treatment sequences. Medical records were reviewed by 215 physicians across the US who provided information for mPC patients who initiated 1L with nab-P+G or FFX between 04/01/2015-12/31/2015. The outcomes of interest were overall survival (OS) and tolerability. OS was evaluated using Kaplan-Meier curves, and compared between cohorts using Cox proportional hazards model adjusting for baseline characteristics. Results: Medical records were reviewed for 654 patients receiving nab-P+G (n = 337) or FFX (n = 317) as 1L therapy for mPC. Patients in the nab-P+G cohort were older, less likely to have ECOG ≤ 1 and had more comorbidities than patients in the FFX cohort. There was no statistically significant difference in OS (adjusted HR = 0.99, p = 0.96), with median OS (mOS) being 12.1 and 13.8 months for nab-P+G and FFX, respectively. Among the subgroup of patients with ECOG ≤ 1, mOS was 14.1 and 13.7 months, respectively (adjusted HR = 1.00, p = 0.99). Among patients with 1L nab-P+G and FFX, 36.1% and 41.3% received 2L therapy and experienced mOS of 16.3 and 16.6 months, respectively (HR = 1.04, p = 0.76). Among commonly observed adverse events (AEs) (≥ 5% of patients in both cohorts), the rates of diarrhea, fatigue, mucositis, nausea and vomiting were higher in the FFX than nab-P+G cohort (all p < 0.05). Conclusions: In a nationwide sample of mPC patients, real-world survival outcomes were similar between patients receiving 1L nab-P+G or FFX. both overall and among patients who went on to receive active 2L treatments. In addition, nab-P+G was associated with significantly lower rates of common AEs compared with FFX.

Real-world evidence of treatment patterns and pharmacy costs among patients with metastatic castration-resistant prostate cancer (mCRPC) in a managed care population in the United States.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19319-e19319
Author(s):  
Kelvin A. Moses ◽  
Katrine Wallace ◽  
Adrienne Landsteiner ◽  
Scott Bunner ◽  
Nicole Engel-Nitz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Real World ◽  
Locally Advanced ◽  
The United States ◽  
Treatment Patterns ◽  
Administrative Claims ◽  
Castration Resistant Prostate Cancer ◽  
Real World Data ◽  
Entire Study

e19319 Background: Prostate cancer (PC) is the most common cancer among men in the United States. Once the disease progresses to mCRPC, initial castration modalities may not be sufficient. This real-world data study describes the treatment patterns and pharmacy costs of US-insured patients with mCRPC. Methods: Adult males in an administrative claims database who had ≥1 claim for PC (ICD-9: 185 or 233.4; ICD-10: C61 or D075), had undergone pharmacologic or surgical castration, and had a code for metastatic disease during the identification period were included in the analysis. A minimum of 6 months of continuous enrollment (CE) pre- and post-index date (first metastatic claim) was required. Patients with metastatic claims at baseline were excluded. Patients were followed until the earliest of death (unless prior to 6-month CE), end of study period, or disenrollment. Claims-based algorithms were used to identify locally advanced and distant mCRPC patients and lines of therapy (LOT). The entire study period (baseline period through follow-up) was January 2008-March 2018. Results: 3690 patients with mCRPC were identified, of which 3150 received at least one LOT; 85.4% had ≥1 LOT, 69.4% had ≥2 LOTs, and 50.7% had ≥3 LOTs following metastatic diagnosis (Table). The average duration of treatment was similar across groups: 83.8, 86.5, 71.7, and 70.2 days for LOTs 1–4, respectively. The five most common LOTs were leuprolide (36.6%), bicalutamide-leuprolide (6.6%), abiraterone (5.9%), bicalutamide (5.0%), and enzalutamide (4.7%). Mean monthly per-patient pharmacy costs increased with each LOT ($2683, $2654, $2911, $2924, $3611, for LOTs 1–5, respectively). Conclusions: This is the first study to examine treatment patterns and drug costs of patients with mCRPC. Given the large number of LOTs this population moves through and the increasing costs associated with each, the development of more efficacious novel therapies for use earlier in the metastatic treatment regimen to prolong life is warranted. [Table: see text]

Efficacy of abiraterone acetate in castration‐resistant metastatic prostate cancer: A real‐world data analysis

2020 ◽  
Author(s):  
Abdilkerim Oyman ◽  
Mustafa Başak ◽  
Melike Özçelik ◽  
Deniz Tataroğlu Özyükseler ◽  
Selver Işık ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Data Analysis ◽  
Real World ◽  
Metastatic Prostate Cancer ◽  
Abiraterone Acetate ◽  
Real World Data ◽  
World Data ◽  
Castration Resistant

scholarly journals Rare Paravertebral and Skull Base Metastases in Prostate Cancer

2016 ◽  
Vol 9 (3) ◽  
pp. 738-746 ◽  
Author(s):  
Gbeminiyi Samuel ◽  
Amir Isbell ◽  
Onyekachi Ogbonna ◽  
Hasan Iftikhar ◽  
Susmita Sakruti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Metastatic Prostate Cancer ◽  
Clinical Presentation ◽  
The United States ◽  
Unique Case ◽  
Skull Base Metastases ◽  
The Right ◽  
Upper Mediastinum ◽  
Paravertebral Mass

Prostate cancer is the most commonly diagnosed visceral cancer in the United States. A majority of cases exhibit an insidious course and nonaggressive tumor behavior. Prostate cancer can manifest as lesions which remain localized, regionally invading or metastasize to lymph nodes, bones, and lungs. Here, we report a unique case of metastatic prostate cancer to the right upper mediastinum, presenting as a paravertebral mass within 2 years of initial tissue diagnosis. Paravertebral spread has not been described for prostate cancer, and herein, we discuss the clinical presentation, diagnostic workup, and possible therapeutic options available in light of the literature.

scholarly journals Estimating the Population Benefits and Costs of Rituximab Therapy in the United States from 1998 to 2013 Using Real-World Data

Medical Care ◽  
2016 ◽  
Vol 54 (4) ◽  
pp. 343-349 ◽  
Author(s):  
Mark D. Danese ◽  
Carolina M. Reyes ◽  
Michelle L. Gleeson ◽  
Marc Halperin ◽  
Sandra L. Skettino ◽  
...  
Keyword(s):  
United States ◽  
Real World ◽  
The United States ◽  
Real World Data ◽  
World Data ◽  
Benefits And Costs

scholarly journals Incidence and Survival Changes in Patients with Esophageal Adenocarcinoma during 1984–2013

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Zhang Haiyu ◽  
Pei Xiaofeng ◽  
Mo Xiangqiong ◽  
Qiu Junlan ◽  
Zheng Xiaobin ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Esophageal Adenocarcinoma ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Potential Risk Factors

Purpose. The morbidity of esophageal adenocarcinoma (EAC) has significantly increased in Western countries. We aimed to identify trends in incidence and survival in patients with EAC in the recent 30 years and then analyzed potential risk factors, including race, sex, age, and socioeconomic status (SES). Methods. All data were collected from the Surveillance, Epidemiology, and End Results or SEER database. Kaplan–Meier analysis and the Cox proportional hazards model were conducted to compare the differences in survival between variables, including sex, race, age, and SES, as well as to evaluate the association of these factors with prognosis. Results. A total of 16,474 patients with EAC were identified from 1984 to 2013 in the United States. Overall incidence increased every 10 years from 1.8 to 3.1 to 3.9 per 100. Overall survival gradually improved (p<0.0001), which was evident in male patients ((hazard ratio (HR) = 1.111; 95% confidence interval (CI) (1.07, 1.15)); however, the 5-year survival rate remained low (20.1%). The Cox proportional hazards model identified old age, black ethnicity, and medium/high poverty as risk factors for EAC (HR = 1.018; 95% CI (1.017, 1.019; HR = 1.240, 95% CI (1.151,1.336), HR = 1.000, 95% CI (1.000, 1.000); respectively). Conclusions. The incidence of EAC in the United States increased over time. Survival advantage was observed in white patients and patients in the low-poverty group. Sex was an independent prognostic factor for EAC, but this finding has to be confirmed by further research.

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