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Bizuayehu HM, Belachew SA, Jahan S, Diaz A, Baxi S, Griffiths K, Garvey G. Utilisation of endocrine therapy for cancer in Indigenous peoples: a systematic review and meta-analysis. BMC Cancer 2024; 24:882. [PMID: 39039483 PMCID: PMC11264465 DOI: 10.1186/s12885-024-12627-6] [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: 11/30/2023] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Indigenous peoples worldwide experience inequitable cancer outcomes, and it is unclear if this is underpinned by differences in or inadequate use of endocrine treatment (ET), often used in conjunction with other cancer treatments. Previous studies examining ET use in Indigenous peoples have predominately focused on the sub-national level, often resulting in small sample sizes with limited statistical power. This systematic review aimed to collate the findings ofarticles on ET utilisation for Indigenous cancer patients and describe relevant factors that may influence ET use. METHODS We conducted a systematic review and meta-analysis of studies reporting ET use for cancer among Indigenous populations worldwide. PubMed, Scopus, CINAHL, Web of Science, and Embase were searched for relevant articles. A random-effect meta-analysis was used to pool proportions of ET use. We also performed a subgroup analysis (such as with sample sizes) and a meta-regression to explore the potential sources of heterogeneity. A socio-ecological model was used to present relevant factors that could impact ET use. RESULTS Thirteen articles reported ET utilisation among Indigenous populations, yielding a pooled estimate of 67% (95% CI:54 - 80), which is comparable to that of Indigenous populations 67% (95% CI: 53 - 81). However, among studies with sufficiently sized study sample/cohorts (≥ 500), Indigenous populations had a 14% (62%; 95% CI:43 - 82) lower ET utilisation than non-Indigenous populations (76%; 95% CI: 60 - 92). The ET rate in Indigenous peoples of the USA (e.g., American Indian) and New Zealand (e.g., Māori) was 72% (95% CI:56-88) and 60% (95% CI:49-71), respectively. Compared to non-Indigenous populations, a higher proportion of Indigenous populations were diagnosed with advanced cancer, at younger age, had limited access to health services, lower socio-economic status, and a higher prevalence of comorbidities. CONCLUSIONS Indigenous cancer patients have lower ET utilisation than non-Indigenous cancer patients, despite the higher rate of advanced cancer at diagnosis. While reasons for these disparities are unclear, they are likely reflecting, at least to some degree, inequitable access to cancer treatment services. Strengthening the provision of and access to culturally appropriate cancer care and treatment services may enhance ET utilisation in Indigenous population. This study protocol was registered on Prospero (CRD42023403562).
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Affiliation(s)
- Habtamu Mellie Bizuayehu
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Sewunet Admasu Belachew
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Shafkat Jahan
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Abbey Diaz
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
- Menzies School of Health Research, Darwin, Australia
| | - Siddhartha Baxi
- GenesisCare Australia, Griffith University, Gold Coast, Australia
| | - Kalinda Griffiths
- Poche SA+NT, Flinders University, Darwin, Australia
- Menzies School of Health Research, Darwin, Australia
- Centre for Big Data Research in Health, UNSW, Sydney, Australia
| | - Gail Garvey
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
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Smith S, Drummond K, Dowling A, Bennett I, Campbell D, Freilich R, Phillips C, Ahern E, Reeves S, Campbell R, Collins IM, Johns J, Dumas M, Hong W, Gibbs P, Gately L. Improving Clinical Registry Data Quality via Linkage With Survival Data From State-Based Population Registries. JCO Clin Cancer Inform 2024; 8:e2400025. [PMID: 38924710 DOI: 10.1200/cci.24.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/26/2024] [Accepted: 05/03/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE Real-world data (RWD) collected on patients treated as part of routine clinical care form the basis of cancer clinical registries. Capturing accurate death data can be challenging, with inaccurate survival data potentially compromising the integrity of registry-based research. Here, we explore the utility of data linkage (DL) to state-based registries to enhance the capture of survival outcomes. METHODS We identified consecutive adult patients with brain tumors treated in the state of Victoria from the Brain Tumour Registry Australia: Innovation and Translation (BRAIN) database, who had no recorded date of death and no follow-up within the last 6 months. Full name and date of birth were used to match patients in the BRAIN registry with those in the Victorian Births, Deaths and Marriages (BDM) registry. Overall survival (OS) outcomes were compared pre- and post-DL. RESULTS Of the 7,346 clinical registry patients, 5,462 (74%) had no date of death and no follow-up recorded within the last 6 months. Of the 5,462 patients, 1,588 (29%) were matched with a date of death in BDM. Factors associated with an increased number of matches were poor prognosis tumors, older age, and social disadvantage. OS was significantly overestimated pre-DL compared with post-DL for the entire cohort (pre- v post-DL: hazard ratio, 1.43; P < .001; median, 29.9 months v 16.7 months) and for most individual tumor types. This finding was present independent of the tumor prognosis. CONCLUSION As revealed by linkage with BDM, a high proportion of patients in a brain cancer clinical registry had missing death data, contributed to by informative censoring, inflating OS calculations. DL to pertinent registries on an ongoing basis should be considered to ensure accurate reporting of survival data and interpretation of RWD outcomes.
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Affiliation(s)
- Samuel Smith
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Kate Drummond
- University of Melbourne, Parkville, VIC, Australia
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Anthony Dowling
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Iwan Bennett
- Department of Neurosurgery, Alfred Health, Prahran, VIC, Australia
| | - David Campbell
- Department of Medical Oncology, Barwon Health, Geelong, VIC, Australia
| | - Ronnie Freilich
- Department of Neurology, Cabrini Hospital, Malvern, VIC, Australia
| | - Claire Phillips
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Elizabeth Ahern
- Department of Medical Oncology, Monash Health, Clayton, VIC, Australia
| | - Simone Reeves
- Department of Radiation Oncology, Ballarat Austin Radiation Oncology Centre, Ballarat, VIC, Australia
| | - Robert Campbell
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - Ian M Collins
- Department of Medical Oncology, South West Oncology, Warnambool, VIC, Australia
| | - Julie Johns
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Megan Dumas
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Wei Hong
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Peter Gibbs
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Lucy Gately
- Systems Biology and Personalised Medicine Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Neurosurgery, Alfred Health, Prahran, VIC, Australia
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3
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Shivshankar S, Sarade M, Bhojane S, Kolekar S, Patil S, Budukh A. Quality assessment of a rural population-based cancer registry (PBCR) at Ratnagiri, Maharashtra, India for the years 2017-18. Ecancermedicalscience 2024; 18:1672. [PMID: 38439807 PMCID: PMC10911674 DOI: 10.3332/ecancer.2024.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Indexed: 03/06/2024] Open
Abstract
Background Cancer registries are valuable resources for cancer control and research. To justify their purpose, their data should be of satisfactory quality by being comparable internationally, complete in their coverage, valid in their values and timely in reporting. This study aimed to assess the quality of the Ratnagiri Population Based Cancer Registry's data for the years 2017-18 across the four dimensions of data quality. Methods Regarding comparability, the registry procedure was reviewed vis-à-vis the rules they follow for cancer registry operation. We have used four methods for validity: re-abstraction and re-coding, diagnostic criteria methods- like the percentage of microscopically verified (MV%) and of death certificate only (DCO%) cases, missing information like proportion of cases of primary site unknown (PSU%) and internal validity. Semi-quantitative methods were employed for assessing completeness. Timeliness for all years of registry functioning was assessed qualitatively. Results The overall accuracy rate of the registry was found to be 91.1% (94.7% for demographic and 88% for tumour details). Mortality to incidence ratios were found to be 0.50 for females and 0.59 for males. MV% was found to be 90.8% for males and 91.5% for females. The average number of sources per case was found to be 1.5. DCO% was found to be 2.7%. PSU% was 7.4%. Conclusion We have positive results regarding the data's validity and comparability, but there is scope for improvement concerning completeness. Continuous training of the registry personnel and monitoring of the registry is recommended.
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Affiliation(s)
- Samyukta Shivshankar
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
- Department of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 410210, India
- https://orcid.org/0009-0005-9521-9578
| | - Monika Sarade
- Department of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 410210, India
| | - Sandip Bhojane
- Bhaktashreshth Kamalakarpant Laxman Walawalkar Hospital, Dervan, Ratnagiri 415606, Maharashtra, India
| | - Suvarna Kolekar
- Department of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 410210, India
| | - Suvarna Patil
- Bhaktashreshth Kamalakarpant Laxman Walawalkar Hospital, Dervan, Ratnagiri 415606, Maharashtra, India
| | - Atul Budukh
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
- Department of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 410210, India
- https://orcid.org/0000-0001-6723-802X
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Gard G, Oakley J, Serena K, Gough K, Harold M, Gray K, Anderson H, Byrne J, Cockwill J, Down G, Kiossoglou G, Gibbs P. Co-designing a personalised care plan for patients with rectal cancer: reflections and practical learnings. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:20. [PMID: 38331826 PMCID: PMC10851461 DOI: 10.1186/s40900-024-00553-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Consumer involvement is considered an essential component of contemporary cancer research, with a movement towards participatory methods, to the benefit of consumers and researchers. Overall, in-depth research on participant experiences and perceptions of their co-designer role-and how these may (or may not) change during a co-design project-is limited. The purpose of this paper was to synthesise the reflective accounts of consumers, project staff, and a researcher who partnered on a project to develop a personalised care plan template, with the aim of generating guidance for others looking to partner with consumers in health and medical research. Here, our team of researchers, project staff, and consumers reflect on the experience of working together using Gibbs' Reflective Cycle, which was completed by team members with responses then undergoing inductive data analysis. RESULTS Reflections are categorised under three core themes: (1) setting up the group and building relationships (2) measuring the value of consumer involvement, and (3) potential challenges for consumer involvement. Through reflection on our experiences of co-design, our team developed and identified practical strategies that contributed to the success of our partnership. These include setting expectations as a group; having experienced consumers on the team; having regular, pre-scheduled meetings that run to time; and working to overcome challenges identified by the group such as power imbalances, time commitment, and lack of diversity. CONCLUSION These practical reflections on creating a safe and supportive environment in which genuine consumer involvement can take place could inform other institutions and researchers looking to work meaningfully with consumers in research.
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Affiliation(s)
- Grace Gard
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia.
| | - Jo Oakley
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Kelsey Serena
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Karla Gough
- Victorian Comprehensive Cancer Council Alliance, Melbourne, Australia
| | - Michael Harold
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Katya Gray
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Helen Anderson
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
- Victorian Comprehensive Cancer Council Alliance, Melbourne, Australia
| | - Judi Byrne
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
- Victorian Comprehensive Cancer Council Alliance, Melbourne, Australia
| | - Jo Cockwill
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
- Victorian Comprehensive Cancer Council Alliance, Melbourne, Australia
| | - Graeme Down
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
- Victorian Comprehensive Cancer Council Alliance, Melbourne, Australia
| | - George Kiossoglou
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
- Victorian Comprehensive Cancer Council Alliance, Melbourne, Australia
| | - Peter Gibbs
- Walter and Eliza Hall Institute for Medical Research, WEHI 1 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
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Cho SM, Robba C, Diringer MN, Hanley DF, Hemphill JC, Horn J, Lewis A, Livesay SL, Menon D, Sharshar T, Stevens RD, Torner J, Vespa PM, Ziai WC, Spann M, Helbok R, Suarez JI. Optimal Design of Clinical Trials Involving Persons with Disorders of Consciousness. Neurocrit Care 2024; 40:74-80. [PMID: 37535178 DOI: 10.1007/s12028-023-01813-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Limited data exist regarding the optimal clinical trial design for studies involving persons with disorders of consciousness (DoC), and only a few therapies have been tested in high-quality clinical trials. To address this, the Curing Coma Campaign Clinical Trial Working Group performed a gap analysis on the current state of clinical trials in DoC to identify the optimal clinical design for studies involving persons with DoC. METHODS The Curing Coma Campaign Clinical Trial Working Group was divided into three subgroups to (1) review clinical trials involving persons with DoC, (2) identify unique challenges in the design of clinical trials involving persons with DoC, and (3) recommend optimal clinical trial designs for DoC. RESULTS There were 3055 studies screened, and 66 were included in this review. Several knowledge gaps and unique challenges were identified. There is a lack of high-quality clinical trials, and most data regarding patients with DoC are based on observational studies focusing on patients with traumatic brain injury and cardiac arrest. There is a lack of a structured long-term outcome assessment with significant heterogeneity in the methodology, definitions of outcomes, and conduct of studies, especially for long-term follow-up. Another major barrier to conducting clinical trials is the lack of resources, especially in low-income countries. Based on the available data, we recommend incorporating trial designs that use master protocols, sequential multiple assessment randomized trials, and comparative effectiveness research. Adaptive platform trials using a multiarm, multistage approach offer substantial advantages and should make use of biomarkers to assess treatment responses to increase trial efficiency. Finally, sound infrastructure and international collaboration are essential to facilitate the conduct of trials in patients with DoC. CONCLUSIONS Conduct of trials in patients with DoC should make use of master protocols and adaptive design and establish international registries incorporating standardized assessment tools. This will allow the establishment of evidence-based practice recommendations and decrease variations in care.
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Affiliation(s)
- Sung-Min Cho
- Neuroscience Critical Care Division, Departments of Neurology, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street , Baltimore, MD, 21287, USA
| | - Chiara Robba
- IRCCS for Oncology and Neuroscience and Department of Surgical Science and Integrated Diagnostic, San Martino Policlinico Hospital, University of Genoa, Genoa, Italy
| | - Michael N Diringer
- Departments of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel F Hanley
- Neuroscience Critical Care Division, Departments of Neurology, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street , Baltimore, MD, 21287, USA
| | - J Claude Hemphill
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Ariane Lewis
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, New York University, New York, NY, USA
| | - Sarah L Livesay
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - David Menon
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Tarek Sharshar
- Departments of Neurology and Intensive Care Medicine, Paris-Descartes University, Paris, France
| | - Robert D Stevens
- Neuroscience Critical Care Division, Departments of Neurology, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street , Baltimore, MD, 21287, USA
| | - James Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Paul M Vespa
- Departments of Neurology and Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Wendy C Ziai
- Neuroscience Critical Care Division, Departments of Neurology, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street , Baltimore, MD, 21287, USA
| | - Marcus Spann
- Neuroscience Critical Care Division, Departments of Neurology, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street , Baltimore, MD, 21287, USA
| | - Raimund Helbok
- Departments of Neurology and Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Jose I Suarez
- Neuroscience Critical Care Division, Departments of Neurology, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street , Baltimore, MD, 21287, USA.
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Conduit C, Lewin J, Weickhardt A, Lynam J, Wong S, Grimison P, Sengupta S, Pranavan G, Parnis F, Bastick P, Campbell D, Hansen AR, Leonard M, McJannett M, Stockler MR, Gibbs P, Toner G, Davis ID, Tran B, Kuchel A. Patterns of Relapse in Australian Patients With Clinical Stage 1 Testicular Cancer: Utility of the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations. JCO Oncol Pract 2023; 19:973-980. [PMID: 37327464 DOI: 10.1200/op.23.00191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 06/18/2023] Open
Abstract
PURPOSE International guidelines advocate for active surveillance as the preferred treatment strategy for patients with stage 1 testicular cancer after orchidectomy although a personalized discussion is required. MATERIALS AND METHODS We conducted an analysis of individuals registered in iTestis, Australia's testicular cancer registry, to describe the patterns of relapse and outcomes of patients treated in Australia where the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations are widely adopted. RESULTS A total of 650 individuals diagnosed between 2000 and 2020 were included, 63% (411 of 650) seminoma and 37% (239 of 650) nonseminoma. The median age was 34 years (range 14-74). 26% (106 of 411) with seminoma and 15% (36 of 239) nonseminoma received adjuvant chemotherapy. After a median follow-up of 43 months (range 0-267) postorchidectomy, relapse occurred in 10% (43 of 411) of seminoma and 18% (43 of 239) of nonseminoma. The two-year relapse-free survival was 92% (95% CI, 89 to 95) and 82% (95% CI, 78 to 87) in seminoma and nonseminoma, respectively. All relapses (86 of 86) were detected at a routine surveillance visit; 98% (85 of 86) were asymptomatic and detected solely through imaging (62 of 86, 72%), tumor markers (6 of 86, 7%), or a combination (17 of 86, 20%). The most common relapse site was isolated retroperitoneal lymphadenopathy (53 of 86, 62%). No nonpulmonary visceral metastases occurred. At relapse, 98% (84 of 86) had International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis; 2 of 86 intermediate prognosis (both nonseminoma). No deaths occurred. CONCLUSION In our cohort of stage 1 testicular cancer, where national surveillance recommendations have been widely adopted, recurrences were detected at routine surveillance visits and, almost exclusively, asymptomatic with IGCCCG good-prognosis disease. This provides reassurance that active surveillance is safe.
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Affiliation(s)
- Ciara Conduit
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Jeremy Lewin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Melbourne, VIC, Australia
| | - Andrew Weickhardt
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
- La Trobe University, Melbourne, VIC, Australia
- Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia
| | - James Lynam
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia
- University of Newcastle, Callaghan, NSW, Australia
| | - Shirley Wong
- Department of Medical Oncology, Western Health, Footscray, VIC, Australia
| | - Peter Grimison
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Shomik Sengupta
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Urology, Eastern Health, Box Hill, VIC, Australia
| | - Ganes Pranavan
- Department of Medical Oncology, The Canberra Hospital, Garran, ACT, Australia
| | - Francis Parnis
- Department of Medical Oncology, Icon Cancer Centre, Adelaide, SA, Australia
| | - Patricia Bastick
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Southside Cancer Care Centre, Kogarah, NSW, Australia
- Department of Medical Oncology, St George/Sutherland Hospital, Caringbah, NSW, Australia
| | - David Campbell
- Department of Medical Oncology, Barwon Health, Geelong, VIC, Australia
| | - Aaron R Hansen
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Matt Leonard
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Margaret McJannett
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Martin R Stockler
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Peter Gibbs
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Oncology, Western Health, Footscray, VIC, Australia
| | - Guy Toner
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Ian D Davis
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Monash University Eastern Health Clinical School, Box Hill, VIC, Australia
- Department of Medical Oncology, Eastern Health, Box Hill, VIC, Australia
| | - Ben Tran
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Anna Kuchel
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- University of Queensland, Brisbane, QLD, Australia
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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Fernando M, Anton A, Weickhardt A, Azad AA, Uccellini A, Brown S, Wong S, Parente P, Shapiro J, Liow E, Torres J, Goh J, Parnis F, Steer C, Warren M, Gibbs P, Tran B. Treatment patterns and outcomes in older adults with castration-resistant prostate cancer: Analysis of an Australian real-world cohort. J Geriatr Oncol 2023; 14:101621. [PMID: 37683368 DOI: 10.1016/j.jgo.2023.101621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/18/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Prostate cancer (PC) is the second commonest malignancy and fifth leading cause of cancer death in men worldwide. Older men are more likely to develop PC but are underrepresented in pivotal clinical trials, leading to challenges in treatment selection in the real-world setting. We aimed to examine treatment patterns and outcomes in older Australians with metastatic castration-resistant prostate cancer (mCRPC). MATERIALS AND METHODS We identified 753 men with mCRPC within the electronic CRPC Australian Database (ePAD). Clinical data were analysed retrospectively to assess outcomes including time to treatment failure (TTF), overall survival (OS), PSA doubling time (PSADT), PSA50 response rate, and pre-defined adverse events of special interest (AESIs). Descriptive statistics were used to report baseline characteristics, stratified by age groups (<75y, 75-85y and >85y). Groups were compared using Kruskal-Wallis and Chi-square analyses. Time-to-event analyses were performed using Kaplan-Meier methods and compared through log-rank tests. Cox proportional hazards univariate and multivariate analyses were performed to evaluate the influence of variables on OS. RESULTS Fifty-seven percent of men were aged <75y, 31% 75-85y, and 12% >85y. Patients ≥75y more frequently received only one line of systemic therapy (40% of <75y vs 66% 75-85y vs 68% >85y; P < 0.01). With increasing age, patients were more likely to receive androgen receptor signalling inhibitors (ARSIs) as initial therapy (42% of <75y vs 70% of 75-85y vs 84% of >85y; p < 0.01). PSA50 response rates or TTF did not significantly differ between age groups for chemotherapy or ARSIs. Patients >85y receiving enzalutamide had poorer OS but this was not an independent prognostic variable on multivariate analysis (hazard ratio [HR] 0.93(0.09-9.35); p = 0.95). PSADT >3 months was an independent positive prognostic factor for patients receiving any systemic therapy. Older patients who received docetaxel were more likely to experience AESIs (18% in <75y vs 37% 75-85y vs 33% >85y, p = 0.038) and to stop treatment as a result (21% in <75y vs 39% in 75-85y; p = 0.011). DISCUSSION In our mCRPC cohort, older men received fewer lines of systemic therapy and were more likely to cease docetaxel due to adverse events. However, treatment outcomes were similar in most subgroups, highlighting the importance of individualised assessment regardless of age.
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Affiliation(s)
- Michael Fernando
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | - Angelyn Anton
- Eastern Health, Melbourne, Australia; Monash University, Melbourne, Australia; Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.
| | - Andrew Weickhardt
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | - Arun A Azad
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Anthony Uccellini
- Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia
| | | | | | - Phillip Parente
- Eastern Health, Melbourne, Australia; Monash University, Melbourne, Australia
| | | | - Elizabeth Liow
- Monash Health, Melbourne, Australia; Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | | | - Jeffrey Goh
- Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Francis Parnis
- Adelaide Cancer Centre, Adelaide, Australia; University of Adelaide, Adelaide, Australia
| | - Christopher Steer
- Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, Australia; University of NSW, Rural Clinical Campus, Albury, Australia
| | | | - Peter Gibbs
- Western Health, Melbourne, Australia; Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Ben Tran
- Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia
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8
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Miller MC, Bayakly R, Schreurs BG, Flicker KJ, Adams SA, Ingram LA, Hardin JW, Lohman M, Ford ME, McCollum Q, McCrary-Quarles A, Ariyo O, Levkoff SE, Friedman DB. Highlighting the value of Alzheimer's disease-focused registries: lessons learned from cancer surveillance. FRONTIERS IN AGING 2023; 4:1179275. [PMID: 37214775 PMCID: PMC10196140 DOI: 10.3389/fragi.2023.1179275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/26/2023] [Indexed: 05/24/2023]
Abstract
Like cancer, Alzheimer's disease and related dementias (ADRD) comprise a global health burden that can benefit tremendously from the power of disease registry data. With an aging population, the incidence, treatment, and mortality from ADRD is increasing and changing rapidly. In the same way that current cancer registries work toward prevention and control, so do ADRD registries. ADRD registries maintain a comprehensive and accurate registry of ADRD within their state, provide disease prevalence estimates to enable better planning for social and medical services, identify differences in disease prevalence among demographic groups, help those who care for individuals with ADRD, and foster research into risk factors for ADRD. ADRD registries offer a unique opportunity to conduct high-impact, scientifically rigorous research efficiently. As research on and development of ADRD treatments continue to be a priority, such registries can be powerful tools for conducting observational studies of the disease. This perspectives piece examines how established cancer registries can inform ADRD registries' impact on public health surveillance, research, and intervention, and inform and engage policymakers.
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Affiliation(s)
- Margaret C. Miller
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Office of the Study of Aging, University of South Carolina, Columbia, SC, United States
| | - Rana Bayakly
- Georgia Department of Public Health, Atlanta, GA, United States
| | - Bernard G. Schreurs
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Kimberly J. Flicker
- Office of the Study of Aging, University of South Carolina, Columbia, SC, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Swann Arp Adams
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Lucy A. Ingram
- Office of the Study of Aging, University of South Carolina, Columbia, SC, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Matthew Lohman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Office of the Study of Aging, University of South Carolina, Columbia, SC, United States
| | - Marvella E. Ford
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
- Hollings Cancer Center, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Quentin McCollum
- College of Social Work, University of South Carolina, Columbia, SC, United States
| | - Audrey McCrary-Quarles
- Department of Health Sciences, South Carolina State University, Orangeburg, SC, United States
| | - Oluwole Ariyo
- Department of Biology, Allen University, Columbia, SC, United States
| | - Sue E. Levkoff
- College of Social Work, University of South Carolina, Columbia, SC, United States
| | - Daniela B. Friedman
- Office of the Study of Aging, University of South Carolina, Columbia, SC, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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