scholarly journals Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020—Cohort Study Based on Administrative Data

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6150
Author(s):  
Thomas Datzmann ◽  
Jochen Schmitt ◽  
Saskia Fuhrmann ◽  
Martin Roessler ◽  
Friedegund Meier ◽  
...  
Keyword(s):  
Cohort Study ◽  
Metastatic Melanoma ◽  
Cox Model ◽  
Relative Survival ◽  
Distant Metastases ◽  
Routine Care ◽  
High Survival ◽  
Health Insurance Data ◽  
Real World Evidence ◽  
Survival Differences

(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance data of about two million individuals from Saxony, Germany, was conducted for the years 2010 to 2020. Only patients with an advanced stage, i.e., distant metastases were considered for the main analysis. Relative survival since metastasis and predicted survivor curves derived from a Cox model were used to assess potential differences in mortality. (4) Results: Relative survival was highest in the subgroup with sequential use of ICI and TT. All treatments except interferon had significant hazard ratios (HR) in the Cox model with time-dependent effects indicating a protective effect after treatment initiation (HR 0.01–0.146) but decreasing over time (HR 1.351–2.310). The predicted survivor curves revealed best survival under ICI-TT treatment and worst survival under TT treatment alone. (5) Conclusions: We found real-world evidence for survival benefits of patients with metastatic melanoma who received sequential ICI and TT treatment. It is conceivable that the observed high survival differences were overestimated due to bias, such as confounding by indication.

scholarly journals Implementation and Effectiveness of Novel Therapeutic Substances for Advanced Malignant Melanoma in Saxony, Germany, 2010–2020 - Cohort Study Based on Administrative Data

2021 ◽  
Author(s):  
Thomas Datzmann ◽  
Jochen Schmitt ◽  
Saskia Fuhrmann ◽  
Martin Roessler ◽  
Friedegund Meier ◽  
...  
Keyword(s):  
Cohort Study ◽  
Metastatic Melanoma ◽  
Cox Model ◽  
Relative Survival ◽  
Distant Metastases ◽  
Routine Care ◽  
High Survival ◽  
Health Insurance Data ◽  
Real World Evidence ◽  
Survival Differences

(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance data of about 2 million individuals from Saxony, Germany, was conducted for the years 2010 to 2020. Only patients with an advanced stage, i.e. distant metastases were considered for the main analysis. Relative survival since metastasis and predicted survivor curves derived from a Cox model were used to assess potential differences in mortality. (4) Results: Relative survival was highest in the subgroup with sequential use of ICI and TT. All treatments except interferon had significant hazard ratios (HR) in the Cox model with time-dependent effects indicating a protective effect after treatment initiation (HR 0.01-0.146) but decreasing over time (HR 1.351-2.310). The predicted survivor curves revealed best survival under ICI-TT treatment and worst survival under TT treatment alone. (5) Conclusions: We found real-world evidence for survival benefits of patients with metastatic melanoma who received sequential ICI and TT treatment. It is conceivable that the observed high survival differences were overestimated due to bias, such as confounding by indication.

scholarly journals FOLLOW-UP OF PATIENTS AND PROGNOSTIC IMPACT OF TUMOUR MARKER CA 15-3 ON PATIENTS OF BREAST CANCER: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 8 (11) ◽  
pp. 656-660
Author(s):  
Anjali Vinocha ◽  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Cancer Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Relative Survival ◽  
Rank Test ◽  
Prognostic Impact ◽  
Breast Cancer Patients

Introduction:Breast cancer is the most common cancer in women, with 5- and 10-year relative survival rates are 91% and 84%, respectively for women with invasive breast cancer. This study aimed to detect the role of serum breast cancer marker CA 15-3 for early detection of metastasis, relapse or recurrence for management of breast cancer patients. Methods: It was a retrospective cohort study with a total of 132 breast cancer patients from the year 2010 to march 2020 were taken and followed up. For these patients demographic, biochemical parameters, radiological and clico-pathological data were collected and analysed. Result: The mean age at the time of presentation and mean duration of follow-up was 47 years and 31 months respectively. There was elevation in the serum level of CA 15-3 at the time of diagnosis of metastasis, recurrence or residual disease in 41 patients. This shows that sensitivity of elevated CA 15-3 (> 30 IU/ml) level in Ca Breast patients was 84%, 75 % and 75 % with respect to metastasis, recurrence and relapse. Log Rank test Chi- square value was 7.39 which was statistically significant (p=0.007). Cox proportional hazard model was created for effect of age at presentation, CA 15-3 at the time of diagnosis and MRM on distant metastasis and was statistically significant (p=0.037). Conclusion: We recommend that for the management of breast cancer patients, Cancer antigen (CA 15-3) levels can be used as prognostic marker for early diagnosis of metastasis, recurrence or relapse.

scholarly journals Increase in Distant Stage Breast Cancer Incidence Rates in US Women Aged 25–49 Years, 2000–2011: The Stage Migration Hypothesis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Anthony P. Polednak
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Incidence ◽  
Relative Survival ◽  
Distant Metastases ◽  
Incidence Rates ◽  
Stage Migration ◽  
Relative Survival Rate ◽  
Regional Stage ◽  
Er Positive ◽  
Using Data

Background.Unexplained increases have been reported in incidence rates for breast cancer diagnosed at distant stage in younger U.S. women, using data from the Surveillance, Epidemiology and End Results (SEER) Program.Methods.This report focused on recent SEER trends (2000–2011) in age-standardized incidence rates of invasive breast cancer at ages 25–39 and 40–49 years and the hypothesis that stage migration may have resulted from advances in detecting distant metastases at diagnosis.Results.Increases in the rates for distant stage were roughly equal to decreases in the rates for the most advanced stage subgroups within regional stage; this was evident for estrogen receptor (ER) negative cancers, associated with poorer prognosis, but not for ER positive cancers. The 3-year relative survival rate increased over time for distant stage (especially in the ER positive subgroup) and regional stage but not for localized stage; these trends do not contradict the stage-migration hypothesis.Conclusions.Findings provide some support for stage migration as one explanation for the recent increase in incidence of distant stage breast cancer, but additional studies are needed using other databases.

Cancer risk from nitrosamine-contaminated valsartan

2021 ◽  
pp. dtb-2021-000041
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Cancer Risk ◽  
Longitudinal Cohort Study ◽  
Health Insurance Data ◽  
Longitudinal Cohort ◽  
German Health ◽  
Insurance Data

AbstractOverview of: Gomm W, Röthlein C, Bowl K, et al. Valsartan contaminated with N-nitrosodimethylamine and cancer risk: a longitudinal cohort study with German health insurance data. Dtsch Arztebl Int 2021; 118:357–62. doi: 10.3238/arztebl.m2021.0129.

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