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Carroll NM, Eisenstein J, Burnett-Hartman AN, Greenlee RT, Honda SA, Neslund-Dudas CM, Rendle KA, Vachani A, Ritzwoller DP. Uptake of novel systemic therapy: Real world patterns among adults with advanced non-small cell lung cancer. Cancer Treat Res Commun 2023; 36:100730. [PMID: 37352588 PMCID: PMC10528526 DOI: 10.1016/j.ctarc.2023.100730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
INTRODUCTION/BACKGROUND Systemic treatment for advanced non-small cell lung cancer (NSCLC) is shifting from platinum-based chemotherapy to immunotherapy and targeted therapies associated with improved survival in clinical trials. As new therapies are approved for use, examining variations in use for treating patients in community practice can generate additional evidence as to the magnitude of their benefit. PATIENTS AND METHODS We identified 1,442 patients diagnosed with de novo stage IV NSCLC between 3/1/2012 and 12/31/2020. Patient characteristics and treatment patterns are described overall and by type of first- and second-line systemic therapy received. Prevalence ratios estimate the association of patient and tumor characteristics with receipt of first-line therapy. RESULTS Within 180 days of diagnosis, 949 (66%) patients received first-line systemic therapy, increasing from 53% in 2012 to 71% in 2020 (p = 0.0004). The proportion of patients receiving first-line immunotherapy+/-chemotherapy (IMO) increased from 14%-66% (p<0.0001). Overall, 380 (26%) patients received both first- and second-line treatment, varying by year between 16%-36% (p = 0.18). The proportion of patients receiving second-line IMO increased from 13%-37% (p<0.0001). Older age and current smoking status were inversely associated with receipt of first-line therapy. Higher BMI, receipt of radiation, and diagnosis year were positively associated with receipt of first-line therapy. No association was found for race, ethnicity, or socioeconomic status. CONCLUSION The proportion of advanced NSCLC patients receiving first- and second-line treatment increased over time, particularly for IMO treatments. Additional research is needed to better understand the impact of these therapies on patient outcomes, including short-term, long-term, and financial toxicities. MICROABSTRACT Systemic treatment for non-small cell lung cancer (NSCLC) is shifting from platinum-based therapies to immunotherapy and targeted therapies. Using de novo stage IV NSCLC patients identified from 4 healthcare systems, we examine trends in systemic therapy. We saw an increase in the portion of patients receiving any systemic therapy and a sharp increase in the proportion of patients receiving immunotherapy.
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Affiliation(s)
- Nikki M Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA.
| | - Jennifer Eisenstein
- Colorado Permanente Medical Group, Kaiser Permanente Colorado, Denver, CO, USA
| | - Andrea N Burnett-Hartman
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | | | - Stacey A Honda
- Hawaii Permanente Medical Group and Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
| | | | - Katharine A Rendle
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anil Vachani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Debra P Ritzwoller
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
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Osazuwa-Peters OL, Wilson LE, Check DK, Roberts MC, Srinivasan S, Clark AG, Crawford J, Chrischilles E, Carnahan RM, Campbell WS, Cowell LG, Greenlee R, Abbott AM, Mosa ASM, Mandhadi V, Stoddard A, Dinan MA. Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer. Clin Lung Cancer 2023; 24:305-312. [PMID: 37055337 DOI: 10.1016/j.cllc.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/13/2023] [Accepted: 03/10/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into these differences and their effects on treatment is needed to identify opportunities for improvement. PATIENTS AND METHODS We conducted a retrospective cohort study of adult patients diagnosed with mNSCLC between 2011 and 2018 using PCORnet's Rapid Cycle Research Project dataset (n = 3600). Log-binomial, Cox proportional hazards (PH), and time-varying Cox regression models were used to ascertain whether molecular testing was received, and time from diagnosis to molecular testing and/or initial systemic treatment in the context of patient age, sex, race/ethnicity, and multiple comorbidities status. RESULTS The majority of patients in this cohort were ≤ 65 years of age (median [25th, 75th]: 64 [57, 71]), male (54.3%), non-Hispanic white individuals (81.6%), with > 2 comorbidities in addition to mNSCLC (54.1%). About half the cohort received molecular testing (49.9%). Patients who received molecular testing had a 59% higher probability of initial systemic treatment than patients who were yet to receive testing. Multiple comorbidity status was positively associated with receipt of molecular testing (RR, 1.27; 95% CI 1.08, 1.49). CONCLUSION Receipt of molecular testing in academic centers was associated with earlier initiation of systemic treatment. This finding underscores the need to increase molecular testing rates amongst mNSCLC patients during a clinically relevant period. Further studies to validate these findings in community centers are warranted.
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Affiliation(s)
| | - Lauren E Wilson
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Devon K Check
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Megan C Roberts
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC
| | - Swetha Srinivasan
- Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC
| | - Amy G Clark
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Jeffrey Crawford
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | | | - Ryan M Carnahan
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - W Scott Campbell
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Lindsay G Cowell
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Robert Greenlee
- Center for Clinical Epidemiology & Population Health, Marshfield Clinical Research Institute, Marshfield, WI
| | - Andrea M Abbott
- Department of Surgery, Medical University of South Carolina, Clinical Sciences, Charleston, SC
| | - Abu S M Mosa
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, MO
| | - Vasanthi Mandhadi
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, MO
| | - Alexander Stoddard
- Biomedical Informatics, Clinical and Translational Science Institute, Medical College of Wisconsin, Milwaukee, WI
| | - Michaela A Dinan
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT.
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Activities against Lung Cancer of Biosynthesized Silver Nanoparticles: A Review. Biomedicines 2023; 11:biomedicines11020389. [PMID: 36830926 PMCID: PMC9953519 DOI: 10.3390/biomedicines11020389] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/03/2023] Open
Abstract
Nanomedicine is an interdisciplinary field where nanostructured objects are applied to treat or diagnose disease. Nanoparticles (NPs) are a special class of materials at nanometric scale that can be prepared from lipids, polymers, or noble metals through bottom-up approaches. Biological synthesis is a reliable, sustainable, and non-toxic bottom-up method that uses phytochemicals, microorganisms, and enzymes to induce the reduction of metal ions into NPs. Silver (Ag) NPs exhibit potent therapeutic properties that can be exploited to overcome the limitations of current treatment modalities for human health issues such as lung cancer (LC). Here, we review the preparation of AgNPs using biological synthesis and their application against LC using in vitro and in vivo models. An overview of the staging, diagnosis, genetic mutations, and treatment of LC, as well as its main subtypes, is presented. A summary of the reaction mechanisms of AgNPs using microbial cell cultures, plant extracts, phytochemicals, and amino acids is included. The use of capping agents in the biosynthesis of AgNPs with anticancer activity is also detailed. The history and biological activities of metal-based nanostructures synthesized with gold, copper, palladium, and platinum are considered. The possible anticancer mechanisms of AgNPs against LC models are covered. Our perspective about the future of AgNPs in LC treatment and nanomedicine is added.
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Treatment patterns for advanced non-small cell lung cancer in the US: A systematic review of observational studies. Cancer Treat Res Commun 2022; 33:100648. [PMID: 36270164 DOI: 10.1016/j.ctarc.2022.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The advent of immunotherapies (I-O) and targeted therapies has transformed the treatment landscape in advanced non-small cell lung cancer (NSCLC). However, adoption of new treatment guidelines and evolving treatment patterns in clinical practice are largely unknown. The aim of this systematic literature review (SLR) was to capture real-world first-line treatment patterns in advanced (staged IIIB-IV) or recurrent NSCLC patients in the US. METHODS Electronic databases were systematically searched for observational studies published 2012-2020 that reported on adult patients receiving first-line therapy for advanced NSCLC. Included studies were reviewed and treatment patterns were summarized descriptively. RESULTS Eighteen studies were included. Platinum-doublet (PD) chemotherapy and unspecified chemotherapy regimens were the most commonly used first-line treatments (up to 71% and 96%, respectively). Chemotherapy as monotherapy was mainly utilized in patients ≥65 years. While chemotherapy use was continuously high, I-O became the preferred front-line treatment in 2018 (32.9%). I-O monotherapy was more prevalent among patients with PD-L1 ≥50%, compared to patients with lower levels. First-line use of tyrosine kinase inhibitors and bevacizumab-based therapies was common in 2010 (33.4% and 21.7%, respectively), but gradually declined to <1% in 2018. CONCLUSION Consistent with the evolving first-line NSCLC treatment landscape in the US, this SLR captures the increasing use of I-O in recent years. While the brief lag in I-O use from the time of authorization may be attributable to an initial resistance to treatment adoption or publication delays, continued use of chemotherapy regimens may reflect an unmet treatment need, which warrants further research.
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Sariahmed K, Kurian J, Singh AK, Leyton C, Minuti A, Jerschow E, Arora S, Jariwala SP. Social, political, and economic determinants of access to biologics: A scoping review of structural determinants in the clinical disparities literature. Res Social Adm Pharm 2022; 18:4038-4047. [DOI: 10.1016/j.sapharm.2022.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/05/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
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Marrett E, Kwong WJ, Chow LQ. Factors associated with time to EGFR TKI treatment in patients with non-squamous metastatic non-small-cell lung cancer. Future Oncol 2022; 18:1535-1544. [PMID: 35147043 DOI: 10.2217/fon-2021-1452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Assess factors associated with EGFR TKI initiation among patients with metastatic non-small-cell lung cancer (mNSCLC). Patients & methods: Medicare Part D patients diagnosed with non-squamous mNSCLC and starting an EGFR TKI within 1 year of diagnosis were selected from the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Associations between patient characteristics and time from diagnosis to treatment initiation (time to treatment [TTT]) were analyzed. Results: Among the sample (n = 890), the patients who were younger, Black or from rural communities had significantly longer TTT. Patients who did not receive surgery, who were Asian and those with brain metastases had significantly shorter TTT. Conclusion: Patient demographics and clinical characteristics may affect timeliness of EGFR TKI treatment for mNSCLC. Future research should examine potential barriers to treatment.
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Affiliation(s)
- Elizabeth Marrett
- Health Economics & Outcomes Research, Daiichi Sankyo, Inc., Basking Ridge, NJ 07920, USA
| | | | - Laura Qm Chow
- University of Texas at Austin, Dell Medical School, Austin, TX 78712, USA
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Patterns of Care in Maintenance Therapy in US Patients Undergoing Definitive Chemoradiation for Stage 3 Non-Small Cell Lung Cancer (NSCLC). Am J Clin Oncol 2022; 45:49-54. [PMID: 34991107 DOI: 10.1097/coc.0000000000000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The recommended treatment for patients with unresectable stage 3 non-small cell lung cancer (NSCLC) is definitive chemoradiation followed by 1 year of maintenance durvalumab. Our objective was to assess the rate of maintenance durvalumab use after chemoradiation. METHODS Analyses were conducted in both open claims (IQVIA pharmacy and medical claims data) and adjudicated closed claims (IQVIA PharMetrics Plus Health Plan Claims Database). Patients with a lung cancer diagnosis between November 2017 and November 2020 who received definitive chemoradiation were included. RESULTS Of the 5802 NSCLC patients included in the open claims source, 1794 (31%) received durvalumab, 1403 (24%) received maintenance chemotherapy, and 2605 (45%) did not receive any maintenance therapy. Of the 239 NSCLC patients included in the closed claims source, 127 (53%) received durvalumab, 40 (17%) received maintenance chemotherapy, and 72 (30%) did not receive any maintenance therapy. The most common maintenance chemotherapy agents patients received were carboplatin, pemetrexed, and paclitaxel. CONCLUSIONS The rate of durvalumab utilization was overall low in both the open and closed claims data sources (31% and 53%, respectively). It remains unknown what percent of eligible patients end up receiving durvalumab, as our analysis was unable to filter out patients who were unfit for durvalumab or if they had progression after chemoradiation. Future efforts are needed to increase maintenance durvalumab utilization and to determine how best to manage patients who are unfit for durvalumab.
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Lung Cancer Stigma Then and Now: Continued Challenges Amid a Landscape of Progress. J Thorac Oncol 2021; 16:17-20. [PMID: 33384057 DOI: 10.1016/j.jtho.2020.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/25/2022]
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Brat K, Bratova M, Skrickova J, Barinova M, Hurdalkova K, Pesek M, Havel L, Koubkova L, Hrnciarik M, Krejci J, Fischer O, Zemanova M, Coupkova H, Svaton M. Real-life effectiveness of first-line anticancer treatments in stage IIIB/IV NSCLC patients: Data from the Czech TULUNG Registry. Thorac Cancer 2020; 11:3346-3356. [PMID: 33016001 PMCID: PMC7606010 DOI: 10.1111/1759-7714.13679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Data regarding real-life effectiveness of any treatment may improve clinical decision-making. The aim of this study was to evaluate real-life effectiveness of tyrosin-kinase inhibitors, bevacizumab and pemetrexed as first-line treatments in patients with advanced/metastatic non-small cell lung cancer (NSCLC). METHODS We analyzed data of 2157 patients of the Czech TULUNG Registry of patients with advanced/metastatic NSCLC who received modern-era treatments between 2011 and 2018. Patients treated with gefitinib, erlotinib, afatinib, bevacizumab (+ maintenance), pemetrexed (+ maintenance) as first-line therapy were included in the study. A systematic literature search separately identified clinical trials suitable for calculation of comparator pooled OS and PFS for each regimen. For each subgroup, basic characteristics and survival data (Kaplan-Meier estimates) are shown. We propose the "index of real-life effectiveness" (IRE), a ratio of real-life OS/PFS and comparator pooled OS/PFS. Univariate and multivariate logistic regression identified factors were associated with longer OS (ie, IRE>1.1). RESULTS Survival analysis showed median OS of 23 months for erlotinib, 29.3 months for afatinib, 19.6 months for gefitinib, 12.2 months for pemetrexed, 17.5 months for pemetrexed maintenance, 15.8 months for bevacizumab and 15.8 months for bevacizumab maintenance. Calculated IREs for OS for the regimens were: erlotinib 1.013, afatinib 1.184, gefitinib 0.736, pemetrexed 1.188, pemetrexed maintenance 1.294, bevacizumab 1.178, and bevacizumab maintenance 1.189. Multivariate regression analysis showed that these factors were associated with longer OS: lower PS for afatinib; lower PS, absence of adverse events and female sex for bevacizumab; and lower PS and female sex for pemetrexed. CONCLUSIONS This study clearly demonstrated that real-life effectiveness of certain treatment regimens may strongly differ in various populations/health care systems, and comparison between TULUNG data and pooled survival data from trials showed higher real-life effectiveness for most of the studied first-line regimens. Lower ECOG PS, younger age, female sex and adverse events were associated with longer survival in most regimens. KEY POINTS SIGNIFICANT FINDINGS OF THE STUDY: Comparison between TULUNG data and pooled survival data from trials showed higher real-life effectiveness for most of the studied first-line regimens; for most regimens, lower ECOG PS, younger age, female sex and adverse events were associated with longer survival. WHAT THIS STUDY ADDS Real-life effectiveness of certain treatment regimens may strongly differ in various populations/health care systems.
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Affiliation(s)
- Kristian Brat
- Department of Respiratory DiseasesUniversity Hospital BrnoBrnoCzech Republic
- Faculty of MedicineMasaryk UniversityBrnoCzech Republic
| | - Monika Bratova
- Department of Respiratory DiseasesUniversity Hospital BrnoBrnoCzech Republic
- Faculty of MedicineMasaryk UniversityBrnoCzech Republic
| | - Jana Skrickova
- Department of Respiratory DiseasesUniversity Hospital BrnoBrnoCzech Republic
- Faculty of MedicineMasaryk UniversityBrnoCzech Republic
| | - Magda Barinova
- Institute of Biostatistics and Analyses, Ltd.BrnoCzech Republic
| | | | - Milos Pesek
- Department of PneumologyUniversity Hospital PilsenPilsenCzech Republic
- Faculty of MedicineCharles University in PraguePilsenCzech Republic
| | - Libor Havel
- Department of Respiratory MedicineThomayer HospitalPragueCzech Republic
| | - Leona Koubkova
- Department of PneumologyUniversity Hospital MotolPragueCzech Republic
- 2nd Faculty of MedicineCharles UniversityPragueCzech Republic
| | - Michal Hrnciarik
- Department of PneumologyUniversity Hospital Hradec KraloveHradec KraloveCzech Republic
- Faculty of MedicineCharles University in PragueHradec KraloveCzech Republic
| | - Jana Krejci
- Department of Pneumology and Thoracic SurgeryBulovka HospitalPragueCzech Republic
| | - Ondrej Fischer
- Department of Respiratory MedicineUniversity Hospital OlomoucOlomoucCzech Republic
- Faculty of MedicinePalacky UniversityOlomoucCzech Republic
| | - Milada Zemanova
- Department of OncologyGeneral Teaching HospitalPragueCzech Republic
- 1st Faculty of MedicineCharles UniversityPragueCzech Republic
| | - Helena Coupkova
- Clinic of Comprehensive Cancer CareMasaryk Memorial Cancer InstituteBrnoCzech Republic
| | - Martin Svaton
- Department of PneumologyUniversity Hospital PilsenPilsenCzech Republic
- Faculty of MedicineCharles University in PraguePilsenCzech Republic
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Norris RP, Dew R, Sharp L, Greystoke A, Rice S, Johnell K, Todd A. Are there socio-economic inequalities in utilization of predictive biomarker tests and biological and precision therapies for cancer? A systematic review and meta-analysis. BMC Med 2020; 18:282. [PMID: 33092592 PMCID: PMC7583194 DOI: 10.1186/s12916-020-01753-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/19/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Novel biological and precision therapies and their associated predictive biomarker tests offer opportunities for increased tumor response, reduced adverse effects, and improved survival. This systematic review determined if there are socio-economic inequalities in utilization of predictive biomarker tests and/or biological and precision cancer therapies. METHODS MEDLINE, Embase, Scopus, CINAHL, Web of Science, PubMed, and PsycINFO were searched for peer-reviewed studies, published in English between January 1998 and December 2019. Observational studies reporting utilization data for predictive biomarker tests and/or cancer biological and precision therapies by a measure of socio-economic status (SES) were eligible. Data was extracted from eligible studies. A modified ISPOR checklist for retrospective database studies was used to assess study quality. Meta-analyses were undertaken using a random-effects model, with sub-group analyses by cancer site and drug class. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed for each study. Pooled utilization ORs for low versus high socio-economic groups were calculated for test and therapy receipt. RESULTS Among 10,722 citations screened, 62 papers (58 studies; 8 test utilization studies, 37 therapy utilization studies, 3 studies on testing and therapy, 10 studies without denominator populations or which only reported mean socio-economic status) met the inclusion criteria. Studies reported on 7 cancers, 5 predictive biomarkers tests, and 11 biological and precision therapies. Thirty-eight studies (including 1,036,125 patients) were eligible for inclusion in meta-analyses. Low socio-economic status was associated with modestly lower predictive biomarker test utilization (OR 0.86, 95% CI 0.71-1.05; 10 studies) and significantly lower biological and precision therapy utilization (OR 0.83, 95% CI 0.75-0.91; 30 studies). Associations with therapy utilization were stronger in lung cancer (OR 0.71, 95% CI 0.51-1.00; 6 studies), than breast cancer (OR 0.93, 95% CI 0.78-1.10; 8 studies). The mean study quality score was 6.9/10. CONCLUSIONS These novel results indicate that there are socio-economic inequalities in predictive biomarker tests and biological and precision therapy utilization. This requires further investigation to prevent differences in outcomes due to inequalities in treatment with biological and precision therapies.
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Affiliation(s)
- Ruth P. Norris
- School of Pharmacy, Newcastle University, King George VI Building, King’s Road, Newcastle-upon-Tyne, NE1 7RU UK
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle-upon-Tyne, UK
| | - Rosie Dew
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle-upon-Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle-upon-Tyne, UK
| | | | - Stephen Rice
- Health Economics Group and Evidence Synthesis Team, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Adam Todd
- School of Pharmacy, Newcastle University, King George VI Building, King’s Road, Newcastle-upon-Tyne, NE1 7RU UK
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle-upon-Tyne, UK
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Thistlethwaite PA. The sparkle of creativity. J Thorac Cardiovasc Surg 2020; 160:740-752. [PMID: 32800264 DOI: 10.1016/j.jtcvs.2020.03.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/03/2020] [Accepted: 03/14/2020] [Indexed: 01/27/2023]
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