ESMO Real World Data and Digital Oncology最新文献

英文中文

Trends in smoking and obesity prevalence at breast cancer diagnosis: results from a 35-year real-world observational study 吸烟和肥胖在乳腺癌诊断中的流行趋势：一项35年真实世界观察性研究的结果

ESMO Real World Data and Digital Oncology

Pub Date : 2025-11-17 DOI: 10.1016/j.esmorw.2025.100632

R.D.S. Gbessemehlan , F. Nguyen Van Long , N.K.D. Adenyo , O. Haroun , A. Turgeon , A. Boubaker , C. Laflamme , J. Lemieux , H. Nabi

Background

Breast cancer (BC) is the most commonly diagnosed cancer among women. Understanding long-term trends in modifiable risk factors at the time of diagnosis is essential to inform and evaluate the effectiveness of BC prevention strategies. This study assessed 35-year trends in the prevalence of two modifiable risk factors—obesity and smoking—among BC women.

Methods

We conducted a retrospective cohort study including 14 595 women diagnosed with BC at the Centre des maladies du sein in Quebec City, Canada, between 1987 and 2021. Prevalence ratios (PRs) for obesity and smoking were estimated using multivariable log-binomial regression models adjusted for demographic and clinical characteristics.

Results

Over the 35-year period, obesity prevalence at diagnosis significantly increased [PR 1.19; 95% confidence interval (CI) 1.15-1.24; P < 0.0001], while smoking prevalence declined (PR 0.92; 95% CI 0.89-0.95; P < 0.0001). Stratified analyses showed more pronounced increase in obesity (PR 1.40; 95% CI 1.25-1.57; P < 0.0001) and decline in smoking (PR 0.82; 95% CI 0.78-0.86; P < 0.0001) among premenopausal women, compared with postmenopausal women (obesity: PR 1.16; 95% CI 1.11-1.21; P < 0.0001; smoking: PR 0.97; 95% CI 0.93-1.01; P = 0.1555).

Conclusions

The rising prevalence of obesity among BC patients at diagnosis underscores the need to strengthen public health efforts targeting obesity prevention. While anti-smoking measures appear to have been effective, additional strategies are warranted to address the growing burden of obesity and its potential impact on BC incidence in Canada and elsewhere.

乳腺癌（BC）是女性中最常见的癌症。在诊断时了解可改变的危险因素的长期趋势对于告知和评估BC预防策略的有效性至关重要。本研究评估了不列颠哥伦比亚省妇女中两种可改变的危险因素——肥胖和吸烟——35年来的流行趋势。方法：我们进行了一项回顾性队列研究，包括1987年至2021年间在加拿大魁北克市疾病中心诊断为BC的14595名妇女。使用多变量对数二项回归模型对人口统计学和临床特征进行调整，估计肥胖和吸烟的患病率。结果在35年的时间里，诊断时的肥胖患病率显著增加[PR = 1.19；95%置信区间（CI） 1.15-1.24；P < 0.0001]，而吸烟率下降（PR = 0.92; 95% CI = 0.89-0.95; P < 0.0001）。分层分析显示，与绝经后妇女（肥胖：PR 1.16; 95% CI 1.11-1.21; P < 0.0001；吸烟：PR 0.97; 95% CI 0.93-1.01; P = 0.1555）相比，绝经前妇女的肥胖增加（PR 1.40; 95% CI 1.25-1.57; P < 0.0001）和吸烟减少（PR 0.82; 95% CI 0.78-0.86; P < 0.0001）更为明显。结论：诊断时BC患者肥胖患病率的上升，强调了加强针对肥胖预防的公共卫生努力的必要性。虽然反吸烟措施似乎是有效的，但在加拿大和其他地方，需要采取额外的策略来解决日益增长的肥胖负担及其对BC发病率的潜在影响。

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引用次数: 0

Investigation into the clinical features, treatment patterns, and survival of older men with prostate cancer in Sweden and Belgium 瑞典和比利时老年男性前列腺癌的临床特征、治疗模式和生存率的调查

ESMO Real World Data and Digital Oncology

Pub Date : 2025-11-17 DOI: 10.1016/j.esmorw.2025.100631

G. George , A.-B. Axelson , K. Decaestecker , H. Garmo , N. Lumen , M. Rousseau , P. Stattin , C. Van Praet , W. Everaerts , A. Clinckaert , T.M. de Reijke , M. Van Hemelrijck

Background

A Dutch population-based study showed that older men with intermediate- or high-risk prostate cancer (PCa) were treated with curative intent less often than younger patients. To assess generalisability, we investigated treatment patterns in men with all PCa stages aged <70 years versus ≥70 years in Sweden and Belgium.

Patients and methods

Men diagnosed with PCa between 2005 and 2015 were identified from the Prostate Cancer data Base Sweden and from two centres in Ghent and Leuven, Belgium. Multivariable logistic regression, adjusting for PCa stage, prostate-specific antigen, Gleason score, and Charlson comorbidity index, assessed the impact of age (</≥70 years) on curative treatment in intermediate- and high-risk PCa. Ten-year relative survival was calculated for four age groups per country to assess excess mortality versus the general population.

Results

In total, 58 092 men <70 years and 50 886 men ≥70 years were diagnosed in Sweden, Leuven, and Ghent. In both countries, patients aged ≥70 years were less likely to receive curative treatments for intermediate- and high-risk PCa versus those <70 years. In Sweden, 10-year relative survival was roughly 90-95% across all four age groups. In Leuven, survival was 100% for all except those ≥80 years, where it was 90%.

Conclusion

Men aged ≥70 years were treated with curative intent less frequently for intermediate- and high-risk PCa compared with younger men. The differing relative survival rates reflect heterogeneity in PCa stage distribution between countries. Age should be considered when planning curative treatments, but it should not be the sole determinant of therapeutic decisions.

荷兰一项基于人群的研究显示，老年男性中高危前列腺癌（PCa）患者的治疗意图少于年轻患者。为了评估其普遍性，我们调查了瑞典和比利时年龄≥70岁的所有前列腺癌分期男性的治疗模式。2005年至2015年间诊断为前列腺癌的患者和研究人员来自瑞典前列腺癌数据库和比利时根特和鲁汶的两个中心。多变量logistic回归，调整前列腺癌分期、前列腺特异性抗原、Gleason评分和Charlson合病指数，评估年龄（≥70岁）对中高危前列腺癌治愈治疗的影响。计算每个国家四个年龄组的十年相对生存率，以评估与一般人群相比的超额死亡率。结果在瑞典、鲁汶和根特共诊断出58 092名70岁以上男性和50 886名70岁以上男性。在这两个国家，年龄≥70岁的患者与年龄≥70岁的患者相比，接受根治性治疗的可能性更小。在瑞典，所有四个年龄组的10年相对存活率约为90-95%。在鲁汶，除了≥80岁的生存率为90%外，所有患者的生存率均为100%。结论与年轻男性相比，年龄≥70岁的男性中高危前列腺癌的治疗意图较少。不同的相对存活率反映了不同国家前列腺癌分期分布的异质性。在制定治疗方案时应考虑年龄，但不应将年龄作为决定治疗方案的唯一因素。

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引用次数: 0

Real-world effectiveness and safety of avelumab + axitinib combination in first-line treatment of UK patients with advanced renal cell carcinoma 阿维单抗+阿西替尼联合一线治疗英国晚期肾细胞癌患者的实际有效性和安全性

ESMO Real World Data and Digital Oncology

Pub Date : 2025-11-06 DOI: 10.1016/j.esmorw.2025.100630

P. Nathan , N. Charnley , R. Frazer , J. McGrane , I. Muazzam , M. Pillai , S. Rudman , A. Sharma , R. Stevenson , B. Venugopal , J. Hickey , J. Hughes , A.R. Ritchie , Y. Shah

Background

Avelumab + axitinib (A + Ax) combination use in patients with advanced renal cell carcinoma (aRCC) is growing in the United Kingdom, yet real-world evidence of its use remains limited.

Methods

This was a UK-based multicentre, retrospective noninterventional cohort study. Inclusion criteria were diagnosis of aRCC, A + Ax initiation on or after 1 August 2019, and aged ≥18 years at the date of initiation. Primary endpoints were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and best response at 36 months after initiation.

Results

A total of 130 patients were included. Median age was 67.1 years; 74% (n = 96) were male. OS and PFS rates [95% confidence interval (95% CI)] at 36 months were 53% (45.2% to 62.9%) and 27% (20.3% to 36.0%), respectively. Median OS was not reached; median PFS was 13.5 months (95% CI 10.2-17.7 months). ORR (n = 127) at 36 months was 62% (95% CI 53.8% to 70.6%), including best response of complete response in 5% (n = 6) and partial response in 57% (n = 73).

Conclusions

In this UK-based real-world study of first-line A + Ax treatment in patients with aRCC, OS, PFS, ORR, and best response observed at 36 months were in line with findings from JAVELIN Renal 101 (NCT02684006) and other observational studies, with no newly emerging adverse events.

在英国，davelumab + axitinib （A + Ax）联合应用于晚期肾细胞癌（aRCC）患者的数量正在增长，但实际使用的证据仍然有限。方法：这是一项基于英国的多中心、回顾性非干预性队列研究。纳入标准为诊断为aRCC，在2019年8月1日或之后开始A + Ax，并且在开始时年龄≥18岁。主要终点是总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和开始治疗后36个月的最佳缓解。结果共纳入130例患者。中位年龄为67.1岁；男性占74% （n = 96）。36个月的OS和PFS率[95%置信区间（95% CI）]分别为53%（45.2%至62.9%）和27%（20.3%至36.0%）。中位OS未达到；中位PFS为13.5个月（95% CI 10.2-17.7个月）。36个月时的ORR （n = 127）为62% (95% CI 53.8%至70.6%)，其中完全缓解的最佳应答率为5% (n = 6)，部分缓解的最佳应答率为57% （n = 73）。结论：在这项基于英国的现实世界研究中，一线A + Ax治疗在aRCC、OS、PFS、ORR患者中，36个月时观察到的最佳反应与JAVELIN Renal 101 （NCT02684006）和其他观察性研究的结果一致，没有新出现的不良事件。

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引用次数: 0

Cost-effectiveness of first-line osimertinib informed by electronic medical records via text-mining: a real-world Italian case study of EGFR-mutated advanced NSCLC patients 通过文本挖掘的电子医疗记录告知一线奥西替尼的成本效益：一个真实的意大利egfr突变晚期NSCLC患者的案例研究

ESMO Real World Data and Digital Oncology

Pub Date : 2025-11-03 DOI: 10.1016/j.esmorw.2025.100198

F. Corso , P. Baili , F. Scotti , L. Mazzeo , V. Torri , G. Lo Russo , C. Proto , C. Giani , M. Ganzinelli , R.M. di Mauro , A. Cappozzo , A.M. Paganoni , A. Prelaj , F. Ieva

Background

Tyrosine kinase inhibitors (TKIs) have significantly changed the therapeutic landscape of non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) gene mutation. The primary objective is to assess the use of real-world data (RWD) extracted from electronic health records (EHRs) via a text-mining technique. Then, RWD are used to inform a cost-effectiveness model of first-line TKI third-generation osimertinib compared with standard EGFR inhibitors.

Materials and methods

A cohort of 190 NSCLC EGFR-mutated patients has been enrolled from an Italian cancer institute. A rule-based named-entity recognition algorithm is carried out to extract RWD from medical records stored in the data warehouse. A Bayesian cost-effectiveness analysis is developed from the Italian health care system perspective. Survival curves are extrapolated over an observed follow-up horizon of a real-world population to estimate the time to treatment discontinuation (TTD) and overall survival (OS) distributions.

Results

An incremental cost-effectiveness ratio (ICER) of 48 398€/quality-adjusted life year (QALY) is found for the base-case scenario, while 51 779€/QALY is found for a second scenario. While higher total annual costs are observed, effectiveness analysis confirms greater QALYs associated with osimertinib versus non-osimertinib. This result is also supported by significantly longer TTD (median 15 months) and OS (median 27 months) for osimertinib. Sensitivity and scenario analyses are used to validate the results.

Conclusions

This study represents a pilot assessment for encouraging the adoption of text-mining approaches for RWD generation and informing health economic evaluations in oncology. RWD analysis confirms that osimertinib is cost-effective as a first-line treatment compared with previous generations of TKIs for advanced EGFR-mutated NSCLC patients.

背景酪氨酸激酶抑制剂（TKIs）显著改变了表皮生长因子受体（EGFR）基因突变的非小细胞肺癌（NSCLC）的治疗前景。主要目标是评估通过文本挖掘技术从电子健康记录（EHRs）中提取的真实世界数据（RWD）的使用情况。然后，RWD用于第一线TKI第三代奥西替尼与标准EGFR抑制剂的成本-效果模型。材料和方法来自意大利癌症研究所的190例非小细胞肺癌egfr突变患者入组。提出了一种基于规则的命名实体识别算法，从存储在数据仓库中的病历中提取RWD。贝叶斯成本效益分析是从意大利医疗保健系统的角度发展起来的。生存曲线是根据观察到的现实世界人群的随访水平推断出来的，以估计治疗停止时间（TTD）和总生存期（OS）分布。结果基本情景的增量成本效益比（ICER）为48 398欧元/质量调整生命年（QALY），而第二情景的增量成本效益比为51 779欧元/质量调整生命年。虽然观察到较高的年度总成本，但有效性分析证实，与非奥希替尼相比，奥希替尼的QALYs更高。这一结果也得到了奥希替尼显着延长的TTD（中位15个月）和OS（中位27个月）的支持。灵敏度分析和情景分析用于验证结果。本研究代表了一项试点评估，旨在鼓励采用文本挖掘方法生成RWD，并为肿瘤学中的健康经济评估提供信息。RWD分析证实，与前几代TKIs相比，奥西替尼作为一线治疗晚期egfr突变的NSCLC患者具有成本效益。

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引用次数: 0

9P Benchmarking instance segmentation architectures for whole-cell segmentation in IHC-stained images: A multi-cancer study ihc染色图像全细胞分割的基准实例分割架构：一项多癌研究

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ESMO Real World Data and Digital Oncology

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ESMO Real World Data and Digital Oncology

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ESMO Real World Data and Digital Oncology

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