ESMO Real World Data and Digital Oncology最新文献

{"title":"Real-world behavioral practices of cancer patients: misconceptions compromising daily life activities","authors":"E. Shachar ,&nbsp;S. Peleg-Hasson ,&nbsp;D. Vorobiof ,&nbsp;N. Moisa ,&nbsp;E. Waller ,&nbsp;T. Safra ,&nbsp;I. Wolf","doi":"10.1016/j.esmorw.2024.100041","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100041","url":null,"abstract":"<div><h3>Background</h3><p>Health-related quality of life is commonly used as an endpoint in clinical trials. While it evaluates the presence of symptoms, it does not measure patients’ ability to maintain normal daily life activities (DLA). We designed a daily life assessment tool, validated among actively treated cancer patients at a single center before the coronavirus 2019 pandemic. We discovered that most patients reported compromised daily activities. In this study we aimed to examine DLA in an international cohort.</p></div><div><h3>Methods</h3><p>A locally validated questionnaire was distributed internationally using the Belong.life digital health platform. We examined real-world patient-reported practices. The survey consisted of demographic, clinical, behavioral parameters and sources guiding and supporting patient practices.</p></div><div><h3>Results</h3><p>The study comprised 1395 patient-reported outcomes. The majority of participants (1005, 73%) reported at least one adopted limitation in daily activities, and 305 (22%) maintained more than half of these constraints. Daily life restrictions included avoiding sun exposure (779, 58%), international travel (417, 33%), indoor public places (431, 33%), hair dyeing (271, 23%), domestic tourism (284, 22%), contact with friends and family (231, 18%), children and grandchildren (202, 16%), public spaces (190, 14.62%), and contact with pets (135, 10%). Multiple sources were implicated by patients guiding their behavior, including healthcare professionals (951, 66%), non-medical authorities [(internet, patient forums, partners, friends, and family (171, 12%)], and both non-medical authorities and the healthcare team (320, 22.19%). There was no association between country of origin (<em>P</em> = 0.12), and education level (<em>P</em> = 0.36) across patients who maintained strict (≥50% of the limitations) and less strict restrictions (&lt;50% of the limitations). A significant association was noted between younger age (<em>P</em> = 0.001), female sex (<em>P</em> = 0.01) and primary cancer site (<em>P</em> &lt; 0.0001), and the adoption of strict restrictions.</p></div><div><h3>Conclusion</h3><p>The majority of patients globally reported compromised daily activities, which are likely attributed to misconceptions about therapy and disease. These findings call for the assessment of an overlooked measure, DLA reflecting real-life quality of life, as an additional endpoint of clinical trials, aiming to achieve the ultimate benefit for our patients, a measure of a full and meaningful life.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000195/pdfft?md5=cd73ed96e136733c4817e31a712ca505&pid=1-s2.0-S2949820124000195-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating GPT-4 as an academic support tool for clinicians: a comparative analysis of case records from the literature","authors":"B.L. Fabre ,&nbsp;M.A.F. Magalhaes Filho ,&nbsp;P.N. Aguiar Jr ,&nbsp;F.M. da Costa ,&nbsp;B. Gutierres ,&nbsp;W.N. William Jr ,&nbsp;A. Del Giglio","doi":"10.1016/j.esmorw.2024.100042","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100042","url":null,"abstract":"<div><h3>Background</h3><p>Artificial intelligence (AI) and natural language processing (NLP) advancements have led to sophisticated tools like GPT-4.0, allowing clinicians to explore its utility as a health care management support tool. Our study aimed to assess the capability of GPT-4 in suggesting definitive diagnoses and appropriate work-ups to minimize unnecessary procedures.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective comparative analysis, extracting clinical data from 10 cases published in the <em>New England Journal of Medicine</em> after 2022 and inputting this data into GPT-4 to generate diagnostic and work-up recommendations. Primary endpoint: the ability to correctly identify the final diagnosis. Secondary endpoints: its ability to list the definitive diagnosis as the first of the five most likely differential diagnoses and determine an adequate work-up.</p></div><div><h3>Results</h3><p>The AI could not identify the definitive diagnosis in 2 out of 10 cases (20% inaccuracy). Among the eight cases correctly identified by the AI, five (63%) listed the definitive diagnosis at the top of the differential diagnosis list. In terms of diagnostic tests and exams, the AI suggested unnecessary procedures in two cases, representing 40% of the cases where it failed to correctly identify the final diagnosis. Moreover, the AI could not suggest adequate treatment for seven cases (70%). Among them, the AI suggested inappropriate management for two cases, and the remaining five received incomplete or non-specific advice, such as chemotherapy, without specifying the best regimen.</p></div><div><h3>Conclusions</h3><p>Our study demonstrated GPT-4’s potential as an academic support tool, although it cannot correctly identify the final diagnosis in 20% of the cases and the AI requested unnecessary additional diagnostic tests for 40% of the patients. Future research should focus on evaluating the performance of GPT-4 using a more extensive and diverse sample, incorporating prospective assessments, and investigating its ability to improve diagnostic and therapeutic accuracy.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000201/pdfft?md5=f32f81c8fc771b7987718bc67be461a8&pid=1-s2.0-S2949820124000201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in survival of >3800 patients with metastatic colorectal cancer in Germany: results from a 16-year prospective longitudinal real-world data analysis","authors":"N. Marschner ,&nbsp;T. Seufferlein ,&nbsp;K. Potthoff ,&nbsp;M.-O. Zahn ,&nbsp;J. Uhlig ,&nbsp;S. Dörfel ,&nbsp;A. Karcher ,&nbsp;A. Sauer ,&nbsp;C. Maintz ,&nbsp;S. Fruehauf ,&nbsp;U. Hutzschenreuter ,&nbsp;S. Tech ,&nbsp;M. Grafetstätter ,&nbsp;L. Kruggel ,&nbsp;M. Jänicke","doi":"10.1016/j.esmorw.2024.100040","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100040","url":null,"abstract":"<div><h3>Background</h3><p>Results from recent clinical trials, showing median survival times of &gt;30 months for patients with metastatic colorectal cancer (mCRC), set a new benchmark for first-line treatment. As, however, most patients are treated outside of trials, evidence from population-based studies is warranted to evaluate whether survival times translate to real world.</p></div><div><h3>Patients and methods</h3><p>Data on treatment and outcome of 3816 patients with mCRC, observed between 2006 and 2022, were collected from 166 sites in Germany into the prospective Tumor Registry Colorectal Cancer. Data were analyzed according to start of first-line palliative treatment, divided into three time periods (2006-2010, 2011-2014 and 2015-2018). Overall survival (OS) was estimated using the Kaplan–Meier method.</p></div><div><h3>Results</h3><p>Most patients received doublet chemotherapy (CTx) across all time periods (about 82%). The use of triplet combination CTx increased over time from 0.9% (2006-2010), over 1.3% (2011-2014) to 5.6% (2015-2018). More patients received anti-epidermal growth factor receptor antibodies over time (2006-2010: 6.5%; 2011-2014: 18.7%; 2015-2018: 25.3%). Median OS for patients who started palliative treatment between 2006 and 2010, 2011 and 2014 and 2015 and 2018 was 21.4 months [95% confidence interval (CI) 20.3-23.1 months], 21.9 months (95% CI 20.8-23.4 months) and 22.9 months (95% CI 21.8-24.9 months), respectively.</p></div><div><h3>Conclusion</h3><p>Since the successful introduction of doublet chemotherapy with monoclonal antibodies, median OS of patients with mCRC in clinical practice remained unchanged at about 22 months over a period of 16 years. As such, our data highlight the need for new treatment options to further improve survival of patients with mCRC.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000183/pdfft?md5=994c9a3bf3cc448503ebc671405b55ea&pid=1-s2.0-S2949820124000183-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of machine learning methods for the retrospective detection of ovarian cancer recurrences from chemotherapy data","authors":"A.D. Coles ,&nbsp;C.D. McInerney ,&nbsp;K. Zucker ,&nbsp;S. Cheeseman ,&nbsp;O.A. Johnson ,&nbsp;G. Hall","doi":"10.1016/j.esmorw.2024.100038","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100038","url":null,"abstract":"<div><h3>Background</h3><p>Cancer recurrences are poorly recorded within electronic health records around the world. This hinders research into the efficacy of cancer treatments. Currently, the retrospective identification of recurrence/progression diagnosis dates is achieved by staff who manually review patients’ health records. This is expensive, time-consuming, and inefficient. Machine Learning models may expedite the review of health records and facilitate the assessment of alternative cancer therapies.</p></div><div><h3>Materials and methods</h3><p>This paper evaluates the use of four machine learning models (random forests, conditional inference trees, decision trees, and logistic regression) in identifying proxy dates of epithelial ovarian cancer recurrence/progression from chemotherapy data, in 531 patients at Leeds Teaching Hospital Trust.</p></div><div><h3>Results</h3><p>The random forest achieved the highest F1 score of 0.941 (95% confidence interval 0.916-0.968) when identifying recurrence events. Both the random forest and decision tree models’ classifications closely conform to chart-reviewed time to next treatment, serving as a surrogate for recurrence-free survival. Additionally, all models reached an F1 score &gt;0.940 when identifying patients whose cancer recurred/progressed.</p></div><div><h3>Conclusions</h3><p>Our models proficiently identify both proxy dates for recurrence/progression diagnoses and patients whose cancer recurred/progressed. Considering the similar performance of the random forest and decision tree, model preference should be determined by the interpretability required to assist chart review and the ease of implementation into existing architecture.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294982012400016X/pdfft?md5=037748083c08b03abbc66eb0cbc15421&pid=1-s2.0-S294982012400016X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in patients with gastrointestinal stromal tumor: data from a real-world cohort compared with a normative population","authors":"D. van de Wal ,&nbsp;D. den Hollander ,&nbsp;I.M.E. Desar ,&nbsp;H. Gelderblom ,&nbsp;A.W. Oosten ,&nbsp;A.K.L. Reyners ,&nbsp;N. Steeghs ,&nbsp;W.T.A. van der Graaf ,&nbsp;O. Husson","doi":"10.1016/j.esmorw.2024.100037","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100037","url":null,"abstract":"<div><h3>Background</h3><p>Treatment and follow-up (FU) care procedures for gastrointestinal stromal tumors (GISTs) impose great challenges on patients and could potentially affect their health-related quality of life (HRQoL). The aims of our study were to (i) assess HRQoL among patients with GIST in different treatment phases and settings and to compare this with the HRQoL of an age- and sex-matched normative population, (ii) determine the occurrence of disease- and treatment-specific symptoms, and (iii) investigate which sociodemographic and clinical characteristics and symptoms were associated with HRQoL.</p></div><div><h3>Methods</h3><p>A total of 328 Dutch patients with GIST (response rate 63%) completed a one-time survey including the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), which was used to assess HRQoL. HRQoL scores are presented as means and standard deviations (mean ± SD), and were compared with those of an age- and sex-matched normative population.</p></div><div><h3>Results</h3><p>The global QoL of patients receiving imatinib in a curative setting (mean ± SD 81.2 ± 12.6) was comparable with the normative population (mean ± SD 77.1 ± 18.2), while patients who had completed their curative treatment [including those discharged from FU (mean ± SD 85.2 ± 14.0) and still in FU (mean ± SD 82.7 ± 15.0)] had a significant better global QoL with comparable functioning scores. Patients on tyrosine kinase inhibitors in a palliative setting scored significantly lower on global QoL (mean ± SD 71.6 ± 19.4) and all functioning scales compared with the normative population. HRQoL was most affected by fatigue, in addition to pain, dyspnea, and financial difficulties, which all occurred more often in patients treated in a palliative setting compared with patients in the curative setting.</p></div><div><h3>Conclusion</h3><p>With these results, medical oncologists can reassure patients with GIST treated in an adjuvant setting that their HRQoL will not be permanently affected by imatinib and provide appropriate support to patients in the palliative setting.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000158/pdfft?md5=9b727b1bb57d82eff8476753d6b9791d&pid=1-s2.0-S2949820124000158-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward optimizing patient selection for EGFR antibody therapies in metastatic colorectal cancer: outcomes and resistance features in real-world data","authors":"M.J. Emmett ,&nbsp;J.C.F. Quintanilha ,&nbsp;R.P. Graf ,&nbsp;G. Li ,&nbsp;H. Tukachinsky ,&nbsp;A.B. Schrock ,&nbsp;S. Morley ,&nbsp;V.A. Fisher ,&nbsp;G.R. Oxnard ,&nbsp;C.H. Lieu ,&nbsp;P.A. Myer ,&nbsp;S.J. Klempner","doi":"10.1016/j.esmorw.2024.100036","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100036","url":null,"abstract":"<div><h3>Background</h3><p>Patients with metastatic colorectal cancer (mCRC) with <em>RAS</em><em>-</em> or <em>BRAF</em>-mutant tumors do not benefit from epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) therapy. Among patients with <em>RAS/BRAF</em> wild-type (WT) tumors, a substantial portion still do not benefit from EGFR mAb treatment. Using real-world clinicogenomic data, we investigated the impact of primary and acquired genomic resistance alterations upon treatment outcomes and determined the prevalence of alterations before and after EGFR mAb treatment.</p></div><div><h3>Materials and methods</h3><p>This study utilized a de-identified mCRC clinicogenomic database from ∼280 US cancer clinics between March 2014 and April 2023. We examined real-world progression-free survival (rwPFS) and overall survival (rwOS) between patients with and those without pre-specified genomic alterations (PSGAs) by Cox models and an adjusted risk score. Genomic alterations were also compared between samples collected before and after EGFR mAb therapy.</p></div><div><h3>Results</h3><p>Nearly, one-third of microsatellite stable (MSS) <em>RAS/BRAF</em> WT tumors harbor intrinsic resistance alterations before treatment. MSS mCRC patients with WT <em>RAS/BRAF</em> tumors having resistance alterations within the PSGA set [non-canonical RAS/RAF/MAPK and PI3K/PTEN/AKT pathway components; ERBB2 alterations; alternative receptor tyrosine kinases (RTKs) including <em>FGFR1</em>, <em>FGFR2</em>, <em>EGFR</em>, <em>MET</em>, <em>RET</em>, <em>PDGFRA</em>, <em>and NRTK1</em> fusion] demonstrated decreased rwPFS and/or rwOS on first-line EGFR mAb treatment. The prevalence of RAS/RAF/MAPK and RTK alterations was higher in samples collected after EGFR mAb therapy. The risk of acquiring an RTK resistance alteration increased with the total duration of EGFR mAb treatment.</p></div><div><h3>Conclusions</h3><p>Detection of genomic resistance alterations in MSS <em>RAS/BRAF</em> WT patients confers less favorable EGFR mAb treatment outcomes. The duration of EGFR mAb treatment increased the risk of emergence of an acquired resistance alteration.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000146/pdfft?md5=0dfbceb2f2a77c9b421cd2bce220ba31&pid=1-s2.0-S2949820124000146-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary to Corti et al.: Exploring the utility and limitations of ChatGPT in scientific literature searches","authors":"K.S. Olsen ,&nbsp;M. Lukic","doi":"10.1016/j.esmorw.2024.100028","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100028","url":null,"abstract":"","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"3 ","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000067/pdfft?md5=d11f4ab2023c5b86bf72c87642c01916&pid=1-s2.0-S2949820124000067-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140030111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of artificial intelligence in transforming the doctor–cancer patient relationship","authors":"P.-E. Heudel ,&nbsp;H. Crochet ,&nbsp;J.-Y. Blay","doi":"10.1016/j.esmorw.2024.100026","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100026","url":null,"abstract":"<div><h3>Background</h3><p>The integration of Artificial Intelligence (AI) in oncology is a developing field, impacting the doctor-patient relationship and the efficacy of cancer care. While AI’s role in improving clinical efficiency and personalized care through the analysis of vast medical datasets is acknowledged, its full scope and impact are not yet completely understood.</p></div><div><h3>Materials and methods</h3><p>This article synthesizes empirical studies and expert opinions to offer a comprehensive understanding of AI’s current role in oncology. The methodology focuses on exploring the balance between technological advancements and the essential elements of patient-centered care.</p></div><div><h3>Results</h3><p>The paper hypothesizes that AI can enhance the quality of cancer care, but notes challenges such as potential depersonalization, data privacy issues, and ethical dilemmas. It also highlights AI’s potential in facilitating Shared Decision-Making, empowering patients and assisting oncologists in making more informed decisions. However, the risk of AI-driven paternalism and the need for balancing AI recommendations with patient autonomy are discussed.</p></div><div><h3>Conclusions</h3><p>AI holds significant potential to transform cancer care. The paper concludes that for AI to be beneficial, its integration should be collaborative and patient-centered, ensuring that technological advancements support and enhance the quality of the doctor-patient relationship, rather than undermining it. The article emphasizes the importance of transparent communication, patient education about AI, and the need for oncologists to effectively understand and convey AI-generated data.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"3 ","pages":"Article 100026"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000043/pdfft?md5=1d72afab5acab3adfb261564dca341e6&pid=1-s2.0-S2949820124000043-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140030971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editoiral Board","authors":"","doi":"10.1016/S2949-8201(24)00010-9","DOIUrl":"https://doi.org/10.1016/S2949-8201(24)00010-9","url":null,"abstract":"","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"3 ","pages":"Article 100032"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000109/pdfft?md5=0ac82353a456608b7fa8335b730246e6&pid=1-s2.0-S2949820124000109-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140145387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world patterns of treatment and response in metastatic renal cell carcinoma: a multicentre UK-wide review with UK Renal Oncology Collaborative (UK ROC)","authors":"R. Frazer ,&nbsp;J.M. McGrane ,&nbsp;A. Challapalli ,&nbsp;G. Ratnayake ,&nbsp;J. Malik ,&nbsp;C. Forde ,&nbsp;S. Alam ,&nbsp;E. Jones ,&nbsp;A. Shaheen ,&nbsp;A. Ferrara ,&nbsp;S. Gupta ,&nbsp;S.Y. Moorcraft ,&nbsp;N. Moon ,&nbsp;D. Parslow ,&nbsp;Y. Wang ,&nbsp;S. Walters ,&nbsp;J. Liu ,&nbsp;T. Geldart ,&nbsp;C. Dyke ,&nbsp;A. Reni ,&nbsp;A. Bahl","doi":"10.1016/j.esmorw.2024.100027","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100027","url":null,"abstract":"<div><h3>Background</h3><p>The introductions of immunotherapy and first-line combinations have led to major changes in systemic anti-cancer treatment (SACT) options and outcomes in metastatic renal cell carcinoma (mRCC).</p></div><div><h3>Objectives</h3><p>To evaluate current real-world UK practice in the immunotherapy era looking at survival outcomes by International Metastatic RCC Database Consortium (IMDC) risk stratification and prescribing patterns/drop-off rates of SACT in mRCC.</p></div><div><h3>Materials and methods</h3><p>This is a retrospective multi-institutional cohort of SACT patients for mRCC at 17 centres across the UK from 1 January 2018 and 30 June 2021. Patient characteristics, IMDC risk group and lines of therapy were recorded. Overall survival (OS) and progression-free survival (PFS) for IMDC groups were analysed.</p></div><div><h3>Results</h3><p>Of the 1319 patients, 22.3%, 52.7% and 24.3% were IMDC group favourable, intermediate and poor, respectively. Across all risk groups and censoring for patients who have not progressed on their current therapy line, 59.2%, 23.5% and 6.3 % of first-line patients with SACT received second-, third- and fourth-line treatments; 40.1%, 33.2% and 44.2%, respectively, did not receive immunotherapy at any stage in their treatment. Median PFS was statistically different by IMDC risk group: 14.0, 8.2 and 4.8 months in the favourable, intermediate and poor groups (<em>P</em> &lt; 0.0001). Median OS was statistically different by risk group and were 40.9, 24.1 and 10.2 months for favourable, intermediate and poor risk groups, respectively.</p></div><div><h3>Conclusions</h3><p>The majority of patients receive only one or two treatment lines in mRCC. The IMDC prognostic risk groups remain valid in the immunotherapy era. A significant group of patients in this cohort did not receive immunotherapy at any stage.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"3 ","pages":"Article 100027"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000055/pdfft?md5=f3ff5db600ecfed00ab55b13ddd76aa1&pid=1-s2.0-S2949820124000055-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}