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Guare EG, Hale CM, Sivik J, Lehman E, Inoue Y, Rakszawski K, Songdej N, Nickolich M, Zheng H, Naik S, Claxton D, Rybka W, Hohl R, Mineishi S, Minagawa K, Paules CI. The addition of doxycycline to fluoroquinolones for bacterial prophylaxis in autologous stem cell transplantation for multiple myeloma. Transpl Infect Dis 2024; 26:e14241. [PMID: 38269469 DOI: 10.1111/tid.14241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Bacterial prophylaxis with a fluoroquinolone (FQ) during autologous stem cell transplant (ASCT) is common, although not standardized among transplant centers. The addition of doxycycline (doxy) to FQ prophylaxis was previously linked to reduced neutropenic fever and bacteremia in multiple myeloma (MM) patients undergoing ASCT although several confounders were present. We compared the incidence of neutropenic fever and bacteremia between MM patients variably receiving prophylaxis with FQ alone and FQ-doxy during ASCT. METHODS Systematic retrospective chart review of MM patients who underwent ASCT between January 2016 and December 2021. The primary objective was to determine the effect of bacterial prophylaxis on neutropenic fever and bacteremia within 30 days of ASCT. Multivariable logistic regression for neutropenic fever and univariate logistic regression for bacteremia accounted for differences in subject characteristics between groups. RESULTS Among 341 subjects, 121 received FQ and 220 received FQ-doxy for prophylaxis. Neutropenic fever developed in 67 (55.4%) and 87 (39.5%) subjects in the FQ and FQ-doxy groups, respectively (p = .005). Bacteremia was infrequent, with 5 (4.1%) and 5 (2.3%) cases developing in the FQ and FQ-doxy groups, respectively (p = .337). Among Gram-negative bacteremia events, 7/7 Escherichia coli strains were FQ-resistant, and 5/7 were ceftriaxone-resistant. CONCLUSION The FQ-doxy prophylaxis group had fewer cases of neutropenic fever than the FQ group, however, there was no significant difference in bacteremia. High rates of antibiotic resistance were observed. An updated randomized controlled trial investigating appropriate prophylaxis for ASCT in the context of current oncology standards and changing antimicrobial resistance rates is warranted.
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Affiliation(s)
- Emma G Guare
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Cory M Hale
- Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jeffrey Sivik
- Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Erik Lehman
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Yoshika Inoue
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Kevin Rakszawski
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Natthapol Songdej
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Myles Nickolich
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Hong Zheng
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Seema Naik
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - David Claxton
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Witold Rybka
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Raymond Hohl
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Shin Mineishi
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Kentaro Minagawa
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Catharine I Paules
- Division of Infectious Diseases, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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King S, Wu EY, Lin C, Labriola M, Nickolich M. Considerations for Designing and Implementing a Multi-institution Undergraduate Medical Education Experience. J Cancer Educ 2023; 38:1636-1640. [PMID: 37225924 PMCID: PMC10208909 DOI: 10.1007/s13187-023-02315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 05/26/2023]
Abstract
Cancer Care Experience (CCE) is a unique elective educational program to further explore the subspecialty of oncology beyond the scope of the traditional undergraduate medical education curriculum. During the COVID-19 pandemic, CCE moved from an in-person to a virtual learning platform. This transition allowed program leaders to offer CCE as a multi-institutional program, with students participating from both Duke University School of Medicine and Penn State College of Medicine. Our study aimed to investigate the effectiveness of virtual learning, student perspectives on multi-institutional collaboration, and the program's impact on the student's understanding of oncology care and clerkship preparedness. Overall, students indicated CCE was an impactful program for them to learn more about oncology and that virtual learning was an effective learning platform. Furthermore, our results suggest students found the multi-institutional aspect valuable and that a multi-institution, hybrid (in-person and virtual) platform was preferred. Our study highlights the success of CCE as a multi-institution program and an effective elective program to expose students to the field of oncology further.
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Affiliation(s)
- Steven King
- Penn State College of Medicine, Hershey, USA.
| | - Emma Y Wu
- Penn State College of Medicine, Hershey, USA
| | | | - Matthew Labriola
- Division of Medical Oncology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Myles Nickolich
- Penn State College of Medicine, Hershey, USA
- Penn State Cancer Institute, Hershey, USA
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Potiaumpai M, Schmitz KH, Mineishi S, Naik S, Wirk B, Rakszawski K, Ehmann WC, Claxton D, Nickolich M, Zemel BS, Zheng H. IMPROVE-BMT: a protocol for a pilot randomised controlled trial of prehabilitation exercise for adult haematopoietic stem cell transplant recipients. BMJ Open 2023; 13:e066841. [PMID: 36657760 PMCID: PMC9853231 DOI: 10.1136/bmjopen-2022-066841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Haematopoietic stem cell transplant (HSCT) in adults is an intensive medical procedure for a variety of haematological malignancies. Although there is a large body of evidence demonstrating the negative effects of HSCT on physical function and psychosocial parameters, there is limited evidence on the impact of HSCT on body composition and bone health. Further, aerobic and resistance-training exercise interventions aimed at improving physical function and patient-reported outcomes largely take place during the peritransplant and post-transplant period. Prehabilitative exercise, or exercise prior to medical treatment, has been successfully deployed in presurgical candidates and other tumour sites, yet there is a paucity of evidence on the effect of prehabilitation in HSCT patients. The aim of this study is to investigate the feasibility, acceptability and safety of a resistance training exercise programme in patients with haematological malignancies prior to HSCT. METHODS AND ANALYSIS IMpact of PRehabilitation in Oncology Via Exercise-Bone Marrow Transplant is a single-site, pilot randomised controlled trial of an exercise intervention compared with usual care. The primary aim is to assess the feasibility, acceptability and safety of the resistance-training exercise intervention prior to HSCT. Secondary aims include evaluating the differences in physical function, body composition, bone mineral density and patient-reported outcomes between the exercise group and usual care control group. Outcome measurements will be assessed: prior to HSCT, on/around day of HSCT admission, +30 days post-HSCT and +100 days post-HSCT. The exercise intervention is a home-based resistance training exercise programme that incorporates resistance band and body weight exercises. The primary outcomes will be reported as percentages and/or mean values. The secondary outcomes will be analysed using appropriate statistical methods to portray within-group and between-group differences. ETHICS AND DISSEMINATION The study has Penn State College of Medicine approval. Results will be disseminated through scientific publication and presentation at exercise-related and oncology-related scientific meetings. TRIAL REGISTRATION NUMBER NCT03886909.
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Affiliation(s)
- Melanie Potiaumpai
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kathryn H Schmitz
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shin Mineishi
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Seema Naik
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Baldeep Wirk
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Kevin Rakszawski
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - W Christopher Ehmann
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - David Claxton
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Myles Nickolich
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Babette S Zemel
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hong Zheng
- Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania, USA
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Shah N, Cioccio J, Rakszawski K, Zheng H, Nickolich M, Naik S, Wirk B, Rybka W, Ehmann C, Silar B, Vajdic C, Mierski J, Zhou S, Shike H, Greiner R, Brown V, Hohl R, Claxton D, Mineishi S, Minagawa K, Tuanquin L. Low-dose total body irradiation promotes T-cells donor chimerism in reduced-intensity/non-myeloablative allogeneic stem cell transplant with post-transplant cyclophosphamide. Leuk Res 2022; 123:106969. [DOI: 10.1016/j.leukres.2022.106969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/20/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022]
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Pizzola CJ, Cioccio J, Rakszawski KL, Nickolich M, Ehmann WC, Rybka WB, Wirk B, Naik S, Zheng H, Silar B, Shike H, Zhou S, Mineishi S, Minagawa K, Claxton DF. Non-myeloablative allogeneic stem cell transplant with fludarabine and reduced dose cyclophosphamide in acute myeloid leukemia for older adults with comorbidities. Bone Marrow Transplant 2022; 57:1743-1745. [PMID: 36097041 DOI: 10.1038/s41409-022-01821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | - Joseph Cioccio
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | | | - Myles Nickolich
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | | | - Witold B Rybka
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Baldeep Wirk
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Seema Naik
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Hong Zheng
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Brooke Silar
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Hiroko Shike
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Shouhao Zhou
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA.,Division of Biostatistics and Bioinformatics, Penn State College of Medicine, 700 HMC Crescent Road, Hershey, PA, 17033, USA
| | - Shin Mineishi
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Kentaro Minagawa
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA.
| | - David F Claxton
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
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Zulch E, Cioccio J, Rakszawski K, Nickolich M, Ehmann WC, Wirk B, Naik S, Rybka W, Zheng H, Shike H, Sivik J, Mierski J, Silar B, Greiner R, Brown V, Tuanquin L, Claxton DF, Mineishi S, Minagawa K. Splenomegaly Predisposes Graft Failure in Ptcy Transplant. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00339-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shah N, Rakszawski K, Zheng H, Nickolich M, Naik S, Wirk B, Rybka W, Ehmann WC, Silar B, Vajdic C, Mackey G, Zhou S, Cioccio J, Bartock M, Shike H, Greiner RJ, Brown V, Hohl R, Claxton DF, Mineishi S, Minagawa K, Tuanquin L. Low Dose Total Body Irradiation (TBI) Plus Post-Transplant Cyclophosphamide As Graft-Versus-Host Disease (GVHD) Prophylaxis Facilitates Early Chimerism Achievement and a Tendency Towards Improved Disease-Free Survival in Alternative Donor Allogeneic Stem Cell Transplant. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bartock M, Zhao C, Claxton DF, Wirk B, Rakszawski K, Nickolich M, Naik S, Rybka W, Ehmann WC, Hohl R, Valentin J, Bernas-Peterson M, Gerber E, Zimmerman M, Mierski J, Mineishi S, Zheng H. Post-Transplant Cyclophosphamide Leads to Upregulation of T Cell Inhibitory Molecules and Decreased T Cell Function Post Allogeneic Hematopoietic Stem Cell Transplant. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00424-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cioccio J, Rakszawski K, Zheng H, Nickolich M, Naik S, Wirk B, Rybka W, Ehmann WC, Silar B, Vajdic C, Mackey G, Shah N, Bartock M, Shike H, Tuanquin L, Greiner RJ, Brown V, Hohl R, Claxton DF, Mineishi S, Minagawa K. Post-Transplant Cyclophosphamide As GVHD Prophylaxis Eliminates GVHD Mortality and Improves Overall Survival in Alternative Donor Allogeneic Stem Cell Transplant. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00301-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Twomey K, Nickolich M. THOSE OPACITIES AREN'T INFECTION OR EDEMA, IT'S LEUKEMIA. Chest 2020. [DOI: 10.1016/j.chest.2020.08.1720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Shah N, Rakszawski K, Nickolich M, Ehmann WC, Wirk B, Naik S, Rybka W, Zheng H, Mierski J, Silar B, Mackey G, Greiner RJ, Brown V, Claxton DF, Mineishi S, Minagawa K. Improved Outcome for AML Relapse after Allogeneic Transplant with High Intensity Chemotherapy Followed By 2nd Allogeneic Stem Cell Transplant or Donor Lymphocyte Infusion; A Retrospective Analysis. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
A growing literature demonstrates that MDS is associated with significant impairments in overall quality of life. Given the poor prognosis for many patients with MDS, and the considerable morbidities associated with this disease, there is a critical need to address palliative and end-of-life care needs in this population. However, palliative and end-of-life care issues are under-represented in the MDS literature. In this article, we highlight a growing body of literature that demonstrates unmet palliative and end-of-life care needs in hematologic malignancies, including MDS, and highlight opportunities for further research and quality improvement initiatives to address unmet needs in MDS care.
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Affiliation(s)
- Myles Nickolich
- Divisions of Hematology, Medical Oncology, and Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Thomas W LeBlanc
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA. .,DUMC, Box 2715, Durham, NC, 27710, USA.
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Nickolich M, Babakoohi S, Fu P, Dowlati A. Clinical Trial Design in Small Cell Lung Cancer: Surrogate End Points and Statistical Evolution. Clin Lung Cancer 2014; 15:207-12. [DOI: 10.1016/j.cllc.2013.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/17/2013] [Accepted: 12/23/2013] [Indexed: 10/25/2022]
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Sharma N, Pennell N, Nickolich M, Halmos B, Ma P, Mekhail T, Fu P, Dowlati A. Phase II trial of sorafenib in conjunction with chemotherapy and as maintenance therapy in extensive-stage small cell lung cancer. Invest New Drugs 2014; 32:362-8. [PMID: 24420556 DOI: 10.1007/s10637-013-0061-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/26/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Sorafenib is a multi-tyrosine kinase inhibitor of Raf kinase, VEGFR, and PDGFR. Angiogenesis is important for growth and progression of SCLC. This trial was conducted to evaluate whether the combination of cisplatin and etoposide plus concurrent and sequential sorafenib could prolong survival in patients with previously untreated SCLC. METHODS Previously untreated patients with extensive stage SCLC were treated with cisplatin and etoposide days 1, 2, 3 for four cycles, concurrent with sorafenib 200 mg orally bid starting day 1 cycle 1. Patients with no disease progression after four cycles continued sorafenib 400 mg orally bid as maintenance for maximum of 12 months. The primary endpoint was 1 year survival with response rate and safety as secondary endpoints. RESULTS A total of 18 patients were enrolled with 17 evaluable patients. One patient had a complete response, seven patients had a partial response (overall response rate of 47 %) and one patient had stable disease. Overall median survival was 7.4 months and 1 year survival was 25 %. The most common treatment-related adverse events included fatigue, anorexia, rash, diarrhea, neutropenia and weight loss. Grade 5 GI bleeding, pulmonary hemorrhage and neutropenia occurred in one pt (6 %) each. Accrual was halted on the basis of safety profile as well as preliminary efficacy data. CONCLUSIONS The combination of platinum based chemotherapy and sorafenib has significant toxicity at current dose levels and is associated with disappointing efficacy data.
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Affiliation(s)
- Neelesh Sharma
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA,
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Nickolich M, Fu P, Babakoohi S, Dowlati A. Clinical trial design in small cell lung cancer: Surrogate endpoints and statistical evolution. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.7087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7087 Background: Small cell lung cancer (SCLC) is a devastating disease for which little recent therapeutic advance has been achieved. SCLC trial design and reporting may have an impact on the interpretation of studies conducted. Furthermore the use of surrogate endpoints in SCLC has not been explored. Methods: Through examining all phase II and III SCLC trials published in the Journal of Clinical Oncology (8,471 patients from 66 trials between 1983-2010), we examined how SCLC trial reporting and design has evolved, determining if the type I error, power, and sample size calculations were provided. We assessed primary endpoints for all trials and sought to discover if response rate (RR) or progression-free survival (PFS) correlated with overall survival (OS). We analyzed response and survival outcomes for associations using Pearson correlation coefficient and differences between data groups by ANOVA followed by Tukey’s multiple comparison procedure. Results: There were increased reporting trends of statistical design in power (16.7% in 1986-1996 to 77.8% of trials in 2006-2010 [p=0.001]) and type I error (22.2% in 1986-1996 to 72.2% in 2006-2010 [p=0.005]). 72.2% of trials published in 1986-1996 failed to report a primary endpoint whereas only 5.56% of trials in 2006-2010 failed to do so (p=0.004). Of phase II trials, primary endpoint was identified as RR in 65%, OS in 25%, and PFS in 10% (p<0.0001). There is a strong correlation between RR and both PFS (p=0.013) and OS (p=0.012) in extensive-stage disease (ED) but not limited-stage disease (LD) (p=0.978 for PFS, p=0.193 for OS). This correlation is for partial response rate (pRR) but not complete response rate. RR (p=0.029) exhibits a negative trend over time with a dramatic and significant decrease in RR across all studies starting in 2005. A strong positive correlation exists between PFS and OS for LD (p=0.036) and ED (p=0.058). We found no change in median overall survival (p=0.383). Conclusions: Over time there has been improvement in reporting the essential statistical data for proper interpretation of SCLC trials. No change in survival was seen over the past 28 years. RR should be evaluated as a surrogate endpoint for OS in ED but not LD. pRR correlates with OS and PFS in both LD and ED.
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Affiliation(s)
| | - Pingfu Fu
- Case Comprehensive Cancer Center, University Hospital of Cleveland Medical Center, Cleveland, OH
| | | | - Afshin Dowlati
- Case Comprehensive Cancer Center, University Hospitals of Cleveland Medical Center, Cleveland, OH
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