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  • 1
    In: Lung Cancer, Elsevier BV, Vol. 92 ( 2016-02), p. 29-34
    Type of Medium: Online Resource
    ISSN: 0169-5002
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2016
    detail.hit.zdb_id: 2025812-4
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  • 2
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Critical Care Medicine Vol. 44, No. 12 ( 2016-12), p. 132-132
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 12 ( 2016-12), p. 132-132
    Type of Medium: Online Resource
    ISSN: 0090-3493
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2034247-0
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  • 3
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e21133-e21133
    Abstract: e21133 Background: Hospitalization is the second largest contributor of cancer care spending, and over 50% of lung cancer patients are admitted to the hospital while receiving treatment. Patients who avoid hospital admission have reduced health care costs with a higher quality of life. This is the first study that characterizes the risk factors and outcomes for avoidable hospital admissions of lung cancer patients. It is the first to examine the extent to which hospitalizations from immunotherapy and targeted therapy could be avoided. Methods: A retrospective chart review of lung cancer patients admitted January 2018 through December 2018 was conducted. Demographics, disease and treatment history, admission characteristics, outcomes, and end-of-life care utilization were recorded. Following a multidisciplinary consensus review, hospitalizations were determined “avoidable” or “unavoidable.” Generalized estimating equation logistic regression models analyzed risks and outcomes associated with avoidable admissions. Kaplan-Meier estimators examined the median overall survival (mOS) between patients with and without avoidable admissions. Results: We evaluated 319 admissions from 188 patients with a median age of 66 and 16%/84% SCLC/NSCLC. Cancer-related symptoms accounted for 66% of hospitalizations; pneumonia and other infections comprised 34%, and 32% were due to cancer-related pain, vomiting, or failure to thrive (FTT). Common causes of unavoidable hospitalizations were unexpected disease progression causing symptoms, COPD exacerbation, and infection. Of the 47 hospitalizations identified as avoidable (15%), the mOS was 1.6 months; the mOS of unavoidable hospitalizations was 9.7 months (HR 2.07; 95% CI 1.34-3.19; p 〈 0.001). Significant reasons for avoidable admissions included cancer-related pain (p = 0.021), hypervolemia (p = 0.033), patient desire to initiate hospice services (p = 0.011), and errors in medication reconciliation or distribution (p 〈 0.001). Errors in medication management caused 26% of the avoidable hospitalizations. Of admissions in patients on immunotherapy (n = 102) or targeted therapy (n = 44), 9% were due to adverse effects of treatment. Patients on immunotherapy and targeted therapy were not more likely to have avoidable hospitalizations compared to patients not on the treatments (p = 0.323 and 0.133, respectively). Patients with avoidable admissions were 3.02 times more likely to enroll in hospice within 30 days of hospitalization compared to unavoidable admissions (95% CI 1.54-5.92; p = 0.001). Conclusions: Patients on immunotherapy or targeted therapy were only rarely admitted due to side effects of treatment. Hospitalizations may be avoided with more aggressive outpatient symptom management, earlier hospice discussion with at-risk patients, and outpatient pharmacist review of medications following hospital discharge.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 4
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. 9077-9077
    Abstract: 9077 Background: New tyrosine kinase inhibitors (TKIs) targeting ALK and ROS1 alterations in non-small cell lung cancer (NSCLC) have emerged over the last decade. Given the rarity of these genetic changes in NSCLC, data on long term outcomes with sequential therapies are limited. Methods: We conducted a multicenter retrospective cohort study of patients with metastatic NSCLC and ALK or ROS1 alterations across 12 Academic Thoracic Oncology Medical Investigators Consortium (ATOMIC) sites between 1/29/2007 and 3/31/2021. Data were abstracted from the electronic medical record. Median time to treatment discontinuation (TTD) of 1st TKI, overall survival (OS), and time to brain metastases were estimated using Kaplan-Meier methodology from start date of 1st TKI. Results: 566 patients with ALK (n = 464) or ROS1 (n = 102) were included. The majority (ALK: 426/464, 92%; ROS1: 88/102, 86%) received a TKI at some point during therapy (1 st line TKI n = 262 ALK, 48 ROS1). Crizotinib was the most common 1 st TKI (ALK: 57%; ROS1: 88%). Following crizotinib, alectinib (64%) and lorlatinib (41%) were the most common subsequent TKIs for ALK and ROS1, respectively. Alectinib (38%) and entrectinib (10.2%) were the 2 nd most common initial TKIs used in ALK and ROS1, respectively. Additional treatment patterns presented in table. With a median follow up time of 31.1 (ALK, 95% CI, 27.6-35.0) and 32.6 (ROS1, 95% CI, 25.7-39.6) months, median OS from start of 1 st TKI was 53.3 (ALK, 95% CI, 40.0-68.9) and 42.0 (ROS1, 95% CI, 31.8-NA) months. Out of the 321 patients with brain imaging prior to 1st line therapy, 40% (105/262, ALK) and 39% (23/59, ROS1) had CNS disease. Median time to development of brain metastases from start of 1 st TKI in those without previous CNS disease (ALK: 278; ROS1: 58) was 30.0 (ALK, 95% CI, 25.3-39.1) and 27.0 (ROS1, 95% CI, 18.2-NA) months. Median TTD of 1 st TKI was 11.2 (ALK) and 10.8 (ROS1) months. Conclusions: This is the largest retrospective cohort of NSCLC patients with ALK or ROS1 rearrangements treated in the real world setting. CNS metastases are common and subset analyses by agent and by year of diagnosis will be presented. Median time to CNS metastasis of 〉 2 years supports revision of the NCCN guidelines to include regular surveillance brain MRIs in this population. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e21210-e21210
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e21210-e21210
    Abstract: e21210 Background: The HIC is a blood-based proteomic test that measures immune response in patients with NSCLC. The test stratifies patients into two groups, HIC-H and HIC-C which helps evaluate patient prognosis and response to treatment. While clinical validity of the HIC test has been published, no real-world studies have described healthcare resource utilization (HCRU) amongst patients who have been tested with the HIC. This claims analysis describes HCRU amongst patients with NSCLC tested with the HIC. Methods: MarketScan Commercial and Medicare Supplemental Databases linked to Biodesix data files of HIC test results were retrospectively queried to identify patients who were age 18 and older on index date (date of HIC testing), underwent a HIC proteomic test, were continuously enrolled in the MarketScan database for the 6-months before index (pre-index period) and one month post-index, and had at least one non-diagnostic medical claim of lung cancer during the pre-index period. Data utilized was between January 1, 2016 to June 30, 2021. HCRU was measured per patient per month (PPPM) during the pre-index and post-index period and compared between HIC-H and HIC-C cohorts. Results: Of the 328 included patients, 260 patients were HIC-H and 68 were HIC-C. On index, 178 patients had non-metastatic lung cancer and 150 patients had metastatic lung cancer. When examining HCRU in all patients prior to the HIC test, significantly more HIC-C patients had an outpatient visit with an oncologist (40% vs 27%, P 〈 0.05) or a primary care physician (71% vs 56%, P 〈 0.05). When assessing only patients with metastatic lung cancer prior to index, significantly more HIC-C patients had inpatient admissions (57% vs 37%, P 〈 0.05) and more outpatient visits with a primary care physician (73% vs 50%, P 〈 0.05). When examining HCRU in patients after the HIC test, metastatic patients had significantly more prescriptions (4.6 vs 3.6, P 〈 0.05). Metastatic HIC-H patients also had significantly more visits to the emergency room (64% vs 43%, P 〈 0.05). Conclusions: Patients who are identified as HIC-C tend to have higher HCRU earlier in their lung cancer diagnosis and treatment course (prior to HIC testing). In the post-index period, metastatic HIC-H patients had higher HCRU with respect to prescriptions and emergency visits. Other post-index HCRU metrics such as primary care utilization and inpatient admissions were similar among HIC-C and HIC-H patients. Earlier identification of HIC-C and HIC-H patients may help identify those most likely to benefit from additional health system navigation support.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 6
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 3002-3002
    Abstract: 3002 Background: Small cell lung cancer (SCLC) has a dismal prognosis and new therapies are urgently needed. SEZ6 is a transmembrane protein expressed in SCLC tumors that may be used as a therapeutic target. ABBV-011 is an antibody-drug conjugate (ADC) targeting SEZ6 with a calicheamicin payload, which has shown antitumor activity in preclinical models of SCLC. Preliminary results from the monotherapy dose-escalation and -expansion cohorts of the first-in-human ABBV-011 study are presented. Methods: Phase 1, open-label, multicenter study (NCT03639194) of ABBV-011 alone or in combination with budigalimab, a programmed cell death 1 inhibitor. Primary objectives were to assess the safety and tolerability and to determine the maximum tolerated dose (MTD) and/or recommended phase 2 dose of ABBV-011. Adults (≥18 years) with relapsed/refractory SCLC (1–3 lines of prior therapy) were enrolled. Dose escalation was guided by Bayesian continual reassessment method. ABBV-011 was administered intravenously at doses from 0.3 to 2.0 mg/kg once every 3 weeks. Dose expansion was conducted in SEZ6-selected patients. Results: At data cutoff on August 22, 2022, 99 patients were treated with ABBV-011 monotherapy. Median age was 63 years (range, 41–79), 50% of patients were male, and 68% had received ≥2 prior therapies. ABBV-011 ADC pharmacokinetics were approximately dose-proportional with an elimination half-life of 4.6 days across the dose range of 0.3–2.0 mg/kg. In dose escalation (n=26), 1 patient had a dose-limiting toxicity of grade (G) 3 fatigue at 2.0 mg/kg. We report safety and efficacy results for 40 patients in the dose-expansion 1.0-mg/kg ABBV-011 cohort. Median duration of treatment was 12 weeks (range, 1.9–63.3). Treatment-emergent adverse events (TEAEs) occurred in 39 (98%) patients, the most frequent being fatigue (48%), nausea (45%), anorexia (38%), thrombocytopenia (38%), and vomiting (35%). G3 TEAEs occurred in 18 (45%) patients, the most frequent being fatigue, thrombocytopenia, and neutropenia (10% each); 1 G4 TEAE of dyspnea was reported. Seven patients died due to malignant neoplasm/disease progression (n=6) or respiratory distress (n=1); none were related to ABBV-011. Hepatotoxicity was observed, including G≥2 TEAEs of hyperbilirubinemia (18%), increased gamma-glutamyltransferase (8%), ascites (5%), veno-occlusive liver disease (3%), and portal hypertension (3%). Confirmed objective response rate was 25% (10 partial responses [PR] ), with median duration of response of 4.2 months (95% CI: 2.6, 6.7). Clinical benefit rate (CBR) was 65% (10 PR and 16 stable disease) and CBR lasting 〉 12 weeks was 43%. The median progression-free survival was 3.5 months. Conclusions: The MTD was not reached and ABBV-011 was well tolerated at 1.0 mg/kg with promising antitumor activity observed. Further evaluation of ABBV-011 is ongoing. Clinical trial information: NCT03639194 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 15_suppl ( 2018-05-20), p. e20563-e20563
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 15_suppl ( 2018-05-20), p. e20563-e20563
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 8
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 27_suppl ( 2019-09-20), p. 272-272
    Abstract: 272 Background: Expert knowledge is often shared among academic oncologists at tumor boards (TBs) at National Cancer Institute Designated Cancer Centers (NCI-CCs), but not documented or made accessible to community oncologists. Using an oncologist-only question and answer (Q & A) website, we sought to disseminate expert insights from TBs at NCI-CCs to provide educational benefit to the oncology community. Methods: A process was designed with faculty at 11 NCI-CCs to document and share discussions from TBs focused on areas of clinical complexity and practice variation on theMednet.org, an interactive Q & A website of over 8,700 US oncologists. One faculty member from each TB was selected as a site leader. She or he distilled discussions about patient management from the TB into a question that addressed the clinical situation being discussed. After the question was posted, faculty at the participating NCI-CCs were asked to answer the question on theMednet. Answers were peer reviewed, indexed, stored and disseminated via email newsletters to registered oncologists. Community engagement was measured by Q & A page views, upvotes of Q & A, and poll participation. Results: A total of 15 Breast, Thoracic, and Gastrointestinal programs from 11 NCI-CCs participated. Between 12/2016 and 5/2019, faculty highlighted 146 questions from their TBs. Q & A were viewed 43,291 times by 3,585 oncologists including 2,264 community oncologists. One hundred and eighty-four answers are posted by 56 academic physicians and peer reviewed by 76 academic physicians. One hundred and eighty-five publications were cited. Community oncologists upvoted Q & A 808 times and voted in 45 polls related to the questions 1,667 times. Viewership of NCI-CC Q & A increased by 419% over time. Q & A were repeatedly searched and viewed, with 90% of all TB Q & A viewed every month. Conclusions: Via the online Q & A theMednet platform, NCI-CC providers effectively made expert knowledge easily accessible to community oncologists across the US. Timely access to evidence based recommendations from expert faculty can inform future practice choices in the community. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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  • 9
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. e14044-e14044
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. e14044-e14044
    Abstract: e14044 Background: CTCs not only constitute a cellular component of liquid biopsy for dynamic, longitudinal information of malignancies, but also pose a continuous threat to seed new metastasis. Detection of these cells can help identify patients with residual disease and poor prognosis. However, it is unknown if heterogeneous CTCs can be profiled to monitor cancer stemness and immunotherapy response for patients. Limited clinical data exist for monitoring CTCs for markers of cancer stem cells, such as CD44 or CD166, and immunotherapy therapeutic targets including PD-L1. We hypothesized that dynamic monitoring of CTC positivity for these markers would correlate with responses to immune checkpoint inhibitor treatment for patients with NSCLC. Methods: As part of a prospective analysis of peripheral blood cells, 30 patients with NSCLC undergoing immunotherapy (pembrolizumab or atezolizumab) or combination therapy with chemotherapy had blood samples collected at 3-4 week intervals for up to 24 weeks. Peripheral blood mononuclear cells were isolated and analyzed for CD45, to identify non-leukocyte putative CTCs, CD166 and CD44, to identify cancer stem cell markers among potential CTCs, and PD-L1. Patients were evaluated for response based on RECIST criteria. Statistical analysis was performed using one-way ANOVA on samples from each time point. Results: A decrease in PD-L1+ CD45- cells (CTCs) at the second interval was most strongly associated with initial response. In contrast, increasing number of PD-L1+ CD45- cells were found among patients with progressive disease as compared to those with stable disease or a partial response (p = 0.01). (1) CD45- cells, (2) CD44+; CD45- cells and (3) CD166+; CD45- cells demonstrated no significant association with clinical outcomes. Baseline PD-L1 level on CTCs did not correlate with the PD-L1 level on tissue. Conclusions: We report the feasibility and potential clinical significance of monitoring surface markers on CTCs in the blood before and after initiation of immunotherapy. Our findings that PD-L1+ CTCs increased among non-responders to immunotherapy warrant further validation. Testing is ongoing to evaluate how these changes predict long-term outcome to treatment for patients.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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  • 10
    Online Resource
    Online Resource
    Informa UK Limited ; 2015
    In:  Leukemia & Lymphoma Vol. 56, No. 3 ( 2015-03-04), p. 797-800
    In: Leukemia & Lymphoma, Informa UK Limited, Vol. 56, No. 3 ( 2015-03-04), p. 797-800
    Type of Medium: Online Resource
    ISSN: 1042-8194 , 1029-2403
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2015
    detail.hit.zdb_id: 2030637-4
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