scholarly journals Impact of the First Wave of the COVID-19 Pandemic on the Lyon University Hospital Cancer Institute (IC-HCL)

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 29
Author(s):  
Anne-Sophie Belmont ◽  
Christophe Sajous ◽  
Amandine Bruyas ◽  
Sara Calattini ◽  
Stéphanie Cartalat ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Stage Iv ◽  
University Hospital ◽  
Clinical Activity ◽  
Solid Cancer ◽  
Protective Measures ◽  
Team Meetings ◽  
Treatment Regimens ◽  
Patient Enrolment ◽  
Multidisciplinary Team Meetings

This article presents the protective measures put in place at the “Institut de Cancérologie des Hospices de Lyon” (IC-HCL) during the first wave of the COVID-19 pandemic in France (spring 2020) and how they impacted IC-HCL clinical activity. Spring 2020 activities were compared to winter 2019–2020. Results showed a decrease of activity of 9% for treatment dispensations, 17% for multidisciplinary team meetings, 20% for head and neck and thoracic surgeries, and 58% for new patient enrolment in clinical trials. Characteristics of patients treated for solid cancer and hospitalized for COVID-19 during spring 2020 were collected in a retrospective study. Mortality was attributed to COVID-19 for half of the cases, 82% being patients above 70 and 73% being stage IV. This is in concordance with current findings concluding that the risk of developing severe or critical symptoms of COVID-19 is correlated with factors co-occurring in cancer patients and not to the cancer condition per se. While a number of routines and treatment regimens were changed, there was no major decline in numbers of treatments conducted at the IC-HCL during the first wave of the COVID-19 pandemic that hit France between March and May 2020, except for clinical trials and some surgery activities.

Feasibility and clinical impact of next-generation sequencing (NGS) in patients with stage IV or recurrent malignancies.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14697-e14697
Author(s):  
Fahrettin Covut ◽  
Tariq Zuheir Kewan ◽  
Bicky Thapa ◽  
Abdo S. Haddad ◽  
Timothy Peter Spiro ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Systemic Therapy ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Cleveland Clinic ◽  
Stage Iv ◽  
Solid Cancer ◽  
Recurrent Cancer ◽  
Cox Regression Analysis ◽  
Best Response

e14697 Background: Feasibility and outcomes of routine NGS in patients with stage IV or recurrent malignancies remain debatable. Methods: We reviewed patients who underwent Foundation One NGS between 9/2012 and 10/2018 after diagnosis of stage IV or recurrent solid cancer at Cleveland Clinic. Overall survival (OS) was estimated by the Kaplan-Meier method. Logistic and Cox regression analysis were performed to identify predictors of receiving targeted gene therapy (TGT) and OS, respectively. Results: We identified 1699 patients, 825 (49%) were female, 1634 (96%) had stage IV and 65 (4%) had recurrent cancer. At diagnosis of stage IV/recurrent cancer, median age was 61 (range: 18 – 94) and ECOG performance score was 0, 1, and ≥ 2 for 578 (34%), 859 (51%), and 258 (15%) patients, respectively. Most common primary cancers were lung (20%), colorectal (17%), urothelial/prostate (12%), and breast (10%). NGS revealed median of 4 mutated genes (range: 0 – 34), ≥ 1 FDA approved TGT was available in 505 (30%) and 1114 (66%) patients for the same and different primary cancer, respectively. Overall, 219 (13%) patients received 247 lines of TGT for median of 3 months (range: 0.1 – 62) based on NGS results. TGT use was via clinical trials for 49 (22%) and off-label for 83 (38%) patients. Best response was complete/partial response for 63 (29%) and stable disease for 40 (18%) patients. Commonly targeted genes were EGFR (12%), ERBB2/3 (11%), BRAF (10%), BRCA1/2 (8%), and PIK3CA (7%). Median follow-up after diagnosis of stage IV/recurrent cancer was 19 months. Two-year OS for TGT and no TGT cohorts were 70% (95% CI: 64 – 77) and 55% (95% CI: 53 – 58), respectively (p < 0.0001). On multivariable analysis, ECOG ( < 2vs ≥2), systemic therapy between diagnosis of stage IV/recurrent cancer and NGS (≥2 vs < 2 lines), and each 1 increase in number of mutated genes were predictors of receiving TGT (p < 0.05 for all). On multivariable analysis, age (≤65 vs > 65), ECOG ( < 2vs ≥2), stage (recurrent vs IV), and systemic therapy before NGS (≥2 vs < 2 lines) predicted longer OS (p < 0.01 for all). Conclusions: In this large cohort, NGS provided further therapeutic options including clinical trials for approximately 1 out of 10 patients with stage IV or recurrent cancer.

scholarly journals Impact of the COVID-19 pandemic urology trainees in the West of Scotland

2021 ◽  
pp. 205141582098767
Author(s):  
Ashley Carrera ◽  
Je Song Shin ◽  
Holly Bekarma
Keyword(s):  
Multidisciplinary Team ◽  
Online Teaching ◽  
The West ◽  
Level Of Evidence ◽  
Team Meetings ◽  
Educational Benefit ◽  
Teaching Modules ◽  
The Impact ◽  
Training Opportunities ◽  
Multidisciplinary Team Meetings

Hospitals worldwide have taken unprecedented steps to cope with the coronavirus disease 2019 (COVID-19) pandemic. Changes to services created challenges for delivering training in urology. Statutory education bodies implemented processes addressing trainee progression, but the extent of training disruption has not been quantified. To establish the impact on urology trainees in the West of Scotland, online questionnaires were sent to trainees and educational supervisors. Twenty-five trainees working at six hospitals across four health boards responded. Elective operating was significantly reduced, with 64% of trainees having no weekly sessions. Before the pandemic, the majority of trainees (92%) had one or two clinic sessions or more per week, but with new measures, 76% of trainees did not attend clinics. Trainee attendance at multidisciplinary team meetings halved during the pandemic. Sixteen per cent ( n=4) of trainees were redeployed, with 50% ( n=2) reporting no educational benefit. Commonly used alternative educational resources included webinars (52%) and online teaching modules (28%). Thirty-two per cent ( n=8) of trainees had examinations postponed. COVID-19 has impacted urology training in the West of Scotland, with a significant reduction in training opportunities across elective theatre, clinic exposure and education. However, trainees will be more adaptable, learn to work remotely, have opportunities to develop leadership and may help redesign services for the future of urology. Level of evidence: Not applicable.

scholarly journals Readiness to Participate in Psychiatric Research

2003 ◽  
Vol 48 (7) ◽  
pp. 480-484 ◽  
Author(s):  
Daniele Zullino ◽  
Philippe Conus ◽  
François Borgeat ◽  
Charles Bonsack
Keyword(s):  
Clinical Trials ◽  
Financial Incentive ◽  
University Hospital ◽  
Psychiatric Research ◽  
Willingness To Participate ◽  
Research Projects ◽  
Hospital Physician ◽  
Recruitment Process ◽  
Consent Rate ◽  
Retention Strategies

Background: The feasibility of clinical trials depends, among other factors, on the number of eligible patients, the recruitment process, and the readiness of patients to participate in research. Seeking patients' views about their experience in research projects may allow investigators to develop more effective recruitment and retention strategies. Methods: A total of 100 patients consecutively admitted to a psychiatric university hospital were interviewed with respect to their willingness to participate in a study. For a different study scenario, patients were asked whether they would be ready to participate if such a study were organized in the service and to indicate their reasons for refusing or for participating. Results: The general readiness to participate in a study ranged between 70% and 96%. The prospect of remuneration did not notably augment the potential consent rate. The most common and spontaneous motivation for agreeing to take part in a study was to help science progress and to allow future patients to benefit from improved diagnosis and treatment (87%). The presence or lack of a financial incentive was rarely chosen as an argument to agree (23%) or to refuse (7%) to participate. Patients relied mainly on their treating physicians when contemplating possible participation in a study (family physician [65%] and hospital physician [54%]). Conclusions: Clinicians and, in particular, treating doctors can play an important role in facilitating the recruitment process.

PP45 Developing Recommendations to Improve the Effectiveness of Multidisciplinary Team Meetings for Patients with Chronic Diseases

2013 ◽  
Vol 67 (Suppl 1) ◽  
pp. A66.2-A67
Author(s):  
C Nic a’ Bháird ◽  
I Wallace ◽  
P Xanthopoulou ◽  
J Barber ◽  
A Clarke ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Multidisciplinary Team ◽  
Team Meetings ◽  
Multidisciplinary Team Meetings

Therapeutic innovation and sustainability in immune-mediated pathologies

2021 ◽  
Author(s):  
Miguel Ángel Calleja Hernández
Keyword(s):  
Patient Adherence ◽  
Serum Levels ◽  
Pharmacy Service ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Clinical Activity ◽  
Pharmacy Services ◽  
Biological Drugs ◽  
Obstructive Pulmonary Disease ◽  
Immune Mediated

For a few years now, we have been experiencing a disruptive therapeutic innovation in immune-mediated pathologies with the incorporation of biological and targeted therapies that have significantly improved efficacy, safety and convenience for patients. The objective of the Pharmacy Services is to achieve the best health results with the rational use of the drug, that is, it is effective, safe and efficient. Pharmacy Services behave as a strategic element in hospitals and have four main axes: technology, logistics, scientific advice and direct clinical activity. In clinical activity, from the Pharmacy Services we promote greater patient adherence to their treatments, information about them to patients, review of drug interactions and effective monitoring to achieve the best health results. We use the CMO model (Capacity / Motivation / Opportunity), and we have implemented telepharmacy programs to facilitate collaborative dispensing with the community pharmacy. Thus, we gain comfort for patients and improvement of the comprehensive approach to patient needs. The levels of adherence are lower in chronic diseases as time passes from the start of treatment and with the disease controlled; pathologies such as chronic obstructive pulmonary disease, diabetes, or depression have mean adherence values of less than 50%. In the case of immune-mediated diseases the values are 70-90%, but we still need to improve them to achieve maximum effectiveness. From the Pharmacy Service we promote the maximum individualization of therapy, and we believe that no two patients are the same, not even the same patient is the same after the diagnosis and when he has been treatment for several years. For this reason, we have incorporated the determination of levels of biological drugs in the blood to be able to adjust the dosage to the individual needs of the patient. This allows us to optimize the dose when the pathology is controlled, maintaining the target serum levels, or to intensify the dose when control of the disease is not achieved, due to low levels of the drug or high levels of the antibodies that the patient may have generated. Currently, in the Pharmacy Service of University Hospital Virgen Macarena we monitor the levels of Infliximab, Adalimumab, Vedolizumab and Ustekinumab, with optimal results for the patients. It is vital to implement these strategies in a multidisciplinary way with the services involved, in this case mainly Digestive, Rheumatology and Dermatology. We have a pharmacist who is an expert in these pathologies who streamlines and catalyzes all activities in this area.

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