Science and Health Policy最新文献

{"title":"Abstract 3337: A racially/ethnically diverse 3D PDX model of prostate cancer","authors":"Lindsey K. Sablatura, K. Bircsak, Peter D A Shepherd, R. Kittles, P. Constantinou, Anthony D. Saleh, N. Navone, D. Harrington","doi":"10.1158/1538-7445.AM2019-3337","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-3337","url":null,"abstract":"Prostate cancer (PCa) incidence and mortality rates in African American men are double that of any other race/ethnicity in the United States. Thorough understanding of the biological factors that contribute to this long-standing cancer health disparity (CHD) is required to improve the major public health concern and close this gap. However, few models exist that can compare racially-diverse specimens directly and provide a platform for dissecting the impact of ancestry-dependent factors on disease pathway selection and drug susceptibility. Both the conventional 2D culture of clonal human cell lines and the purely rodent-based in vivo models fail to reflect the heterogeneity of human tumors, often leading to inaccurate prediction of in vivo tumor response in patients, and confounding researchers’ ability to detect potentially subtle biological factors that may contribute to prostate CHD. PCa patient-derived xenografts (PDXs) offer substantially greater fidelity to original patient tumors but are non-adherent and ultimately non-viable in extended in vitro 2D culture. Therefore, a population-based PCa platform which accurately mimics the three-dimensional (3D) tumor microenvironment (TME) is urgently needed. We have employed MIMETAS’ OrganoPlate®, a high throughput microfluidic culture platform containing 40-96 individual tissue chips, for ex vivo 3D culture of multiple racially/ethnically diverse PCa PDXs (African American, Caucasian, Hispanic) developed at MD Anderson Cancer Center (the MDA PCa PDXs series). MDA PCa PDX tumors were reconstituted from single-cell digestates into multicellular clusters, suspended within HyStem® hyaluronic acid hydrogel precursor solutions, and loaded into the OrganoPlate®. PDXs were maintained in 3D either as monocultures, as cocultures with bone marrow-derived stromal fibroblasts, or as tricultures with endothelial cell blood vessel mimics under continuous perfusion. High-content fluorescence imaging identified retention of stable, viable cultures for at least 7 days. Positive immunofluorescent staining for human nuclear antigen (HNA) confirmed that nearly 100% of encapsulated PCa cells were of human origin. For each PCa model developed, appropriate expression of phenotypic prostate-specific antigen (PSA) and androgen receptor (AR) was maintained over the life of the culture. PCa cultures were treated with various chemotherapeutic drugs and viability was monitored to generate dose response curves for comparison to clinical data. This engineered “tumor-on-a-chip” will better predict patient responses and, by incorporating PCa cells from patients with diverse ancestries, support CHD research. Citation Format: Lindsey K. Sablatura, Kristin M. Bircsak, Peter Shepherd, Rick Kittles, Pamela E. Constantinou, Anthony D. Saleh, Nora M. Navone, Daniel A. Harrington. A racially/ethnically diverse 3D PDX model of prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 20","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"6 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90361362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3350:Not letting the cancer take any more than it had from me: Latina mothers surviving cancer in the Paso del Norte border region","authors":"Clara Reyes, R. Palacios, Karoline Sondgeroth, F. Lewis","doi":"10.1158/1538-7445.SABCS18-3350","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3350","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73308503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract SY11-02: Antigen-independent de novo prediction of cancer-associated immune repertoire","authors":"Bo Li","doi":"10.1158/1538-7445.SABCS18-SY11-02","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-SY11-02","url":null,"abstract":"Cancer-associated T cells play a critical role in mediating immune responses in the anti-tumor immunity. However, due to the complex nature of cancer antigens, and the limited experimental approaches for collecting antigen-specific T cells, it remains a difficult task in cancer immunology to detect cancer-associated T cells. In the past we developed TRUST for de novo assembly of TCR hypervariable CDR3 regions from the tumor RNA-seq data. Application of TRUST to the TCGA samples resulted in calling over 1.5 million cancer-related TCRs. From this dataset, we trained a classifier to distinguish cancer vs non-cancer CDR3s, independent of cancer antigens, and developed a method, TCRboost, for the prediction of cancer-associated TCR repertoire. TCRboost assigns a 9cancer score9 to a given immune repertoire, as an estimation of its probability of being derived from a cancer patient. We applied TCRboost to study over 1,100 TCR repertoire sequencing samples from 15 study cohorts covering healthy donors, viral infections, autoimmune disorders and 10 types of malignancies of both early and late stages. Surprisingly, we observed consistently and significantly higher cancer scores using the cancer patients’ immune repertoire data, while none of the non-cancer repertoire was significant compared to healthy donors. We therefore used repertoire cancer score as a single predictor for cancer status to distinguish cancer patients from healthy donors, and observed high prediction power measured by area under the ROC (AUROC) curves. The AUROC reached 0.90 for early breast cancer patients, which is better than a number of current early prediction methods based on cancer biomarkers, such as PSA, CA-125, CEA, etc. Additional analysis of TCRboost on a longitudinal cohort of healthy individuals suggested that the cancer scores are robust against random fluctuations in the immune repertoire. Therefore, it is unlikely to predict a healthy donor to be a cancer patient due to random sampling, and vice versa. Furthermore, we investigated two cohorts of late-stage cancer patients treated with anti-CTLA4 mAb (melanoma and prostate), where TCRboost predicted cancer scores are predictive of the patient outcome. These results indicate that it is potentially feasible to use biomarkers derived blood repertoire to track clinical responses to checkpoint blockade therapies. Finally, since cancer score is a quantity derived from the immune repertoire, it is an independent criterion to the existing methods based on cancer-related materials, such as ctDNA, CTC, cfDNA, cancer antigens, or imaging-based approaches detecting lesions of tumor. This quality makes it legitimate to be combined with any existing approach to increase the detection power and accuracy. We anticipate cancer score to serve as a potential powerful tool to facilitate cancer diagnosis and immunotherapy prognosis. Citation Format: Bo Li. Antigen-independent de novo prediction of cancer-associated immune repertoire [abstrac","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91167765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3349: Collected experiences of young-onset colorectal cancer caregivers","authors":"K. L. Newcomer, R. Yarden, Never Too Young Advisory","doi":"10.1158/1538-7445.SABCS18-3349","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3349","url":null,"abstract":"","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90833189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract SY29-01: The Cancer Tsunami: What is it and what does it mean for survivors, clinicians, and researchers","authors":"D. Mayer, C. Alfano, Frank Panedo","doi":"10.1158/1538-7445.AM2019-SY29-01","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-SY29-01","url":null,"abstract":"We are facing a tsunami of cancer survivors; the majority of whom will be older and longer-term survivors most of whom will also have comorbid illnesses. Care of survivors include surveillance for recurrences and new cancers, management of the sequelae of treatment, and health promotion all requiring care coordination. This session will describe the changes in the number and type of survivors, discuss late and long-term effects of cancer and its treatment on this growing population and focus on the impact in vulnerable populations. Needed research and interventions to address the issues survivors face will be examined. Practice, research and policy issues to address survivors care will be discussed. A Research Roadmap for Equitably Improving Outcomes for Cancer Survivors Cancer care delivery is being shaped by growing numbers of cancer survivors coupled with provider shortages, rising costs of primary treatment and follow-up care, significant survivorship health disparities, increased reliance on informal caregivers, and the transition to value-based care. These factors create a compelling need to provide coordinated, comprehensive, personalized care for cancer survivors in ways that meet survivors’ and caregivers’ unique needs while minimizing the impact of provider shortages and controlling costs for healthcare systems, survivors, and families. These changes involve reforming care delivery, education, and policy to equitably improve survivor outcomes and support caregivers. In Dr. Alfano’s talk, she will focus on three critical research priorities to accelerate these changes including: (1) implementing routine assessment of survivors’ needs and functioning and caregivers’ needs; (2) facilitating personalized, tailored, information and referrals from diagnosis onward for both survivors and caregivers, shifting services from point-of-care to point-of-need wherever possible; and (3) disseminating and supporting the implementation of new care methods and interventions. Opportunities and challenges to address these priorities will be discussed. Survivorship Interventions in Vulnerable Populations: Improving Patient Reported Outcomes Via Technology Based Delivery and Addressing the Sociocultural Context Over the past several decades, advances in early detection and treatment efficacy in oncology patients has led to a growing and unprecedented number of cancer survivors. The cancer survivorship experience can be highly variable based on multiple factors including pre-morbid psychosocial functioning, disease severity, financial and social resources, and treatment-related impairment. Benefits of survivorship can be offset by chronic and debilitating treatment-related side effects, ongoing disease monitoring, financial burden and interpersonal disruption. These challenges are often exacerbated in vulnerable populations (e.g., racial/ethnic minorities, rural communities) due to social and contextual barriers, limited access to care, culturally-driven illn","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74771070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract LB-163: Comparing clinical value scores (NCCN, ASCO and ESMO) for TTFields treatment in glioblastoma","authors":"J. Kelly, C. Proescholdt, N. Blondin","doi":"10.1158/1538-7445.AM2019-LB-163","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-LB-163","url":null,"abstract":"Objective: To compare the tools of the National Comprehensive Cancer Network (NCCN), American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) for the assessment of the clinical value for Tumor treating fields (TTFields) in newly diagnosed Glioblastoma (GBM). Background: The effectiveness and safety of TTFields in newly diagnosed GBM was demonstrated by the final analysis of the randomized controlled EF-14 Trial (n=695). NCCN, ASCO and ESMO have developed tools to help inform physicians and policymakers about the clinical value of new cancer treatments in a standardized way. We report on the results of the tools for scoring the EF-14 trial data and comparatively discuss the results. Materials/Methods: The EF-14 Trial proved the effect of adding TTFields to maintenance temozolomide (TMZ) for newly diagnosed glioblastoma patients. The ESMO Magnitude of Clinical Benefit Scale (MCBS) and the ASCO Net Health Benefit (NHB) frameworks calculate a score for the clinical value of a cancer treatment. We applied both classifications to the EF-14 trial data. Quality of life data from the EF-14 Trial was also published and is included in the scoring. NCCN self reports “evidence blocks” which are assessed by clinician panels and were recently published for the first line treatment of newly diagnosed GBM. Results: Applying the ASCO framework to the EF-14 data resulted in a NHB score of 56. This scores is among the highest identified in the literature search. Applying the ESMO framework resulted in MCBS scores of A/5, these being the highest achievable scores for this framework. The ESMO framework valued the Health Related Quality of Life (HRQoL) gain during deterioration-free survival time with TTFields. The NCCN CNS panel designated TTFields as a category 1 recommendation in newly diagnosed GBM; the related NCCN evidence blocks support this recommendation. Conclusions: While the frameworks used by ASCO and ESMO focus on different aspects and definition of clinical value both suggest that adding TTFields to maintenance TMZ for newly diagnosed glioblastoma patients provides patients with significant clinical benefits. The high ESMO and ASCO scores are reflecting the fact, that treatment with TTFields extended progression free and overall survival without additional systemic toxicities. The NCCN evidence blocks together with the NCCN category 1 recommendation strongly support the use of Optune in newly diagnosed GBM Citation Format: Justin Kelly, Christina Proescholdt, Nicholas A. Blondin. Comparing clinical value scores (NCCN, ASCO and ESMO) for TTFields treatment in glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-163.","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"33 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86500139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3359: Multiple objective analysis of first line medicine with non-small cell lung cancer","authors":"Yueh-Fu Fang, Min-Chia Lee","doi":"10.1158/1538-7445.SABCS18-3359","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-3359","url":null,"abstract":"Background The standard first line treatments of lung cancer are chemotherapy and targeted therapy. Taiwan launch National Health Insurance since 1995 and Taiwanese can receive medical treatment in a low price. However, National Health Insurance facing bankruptcy so it is important to find which treatment provide good medical effect and low medical cost. We will use analytic hierarchy process (AHP) to combine medical effect and medical cost. Patients and Methods We had analyzed the Database of Lung Cancer from Taiwan National Health Insurance Database (NHIRD). The database included the coding of diagnoses, examinations and treatments from 1996 to 2013 in the patients who were diagnosed with lung cancer in 1996 to 2013. The Analytic Hierarchy Process (AHP) is a theory of measurement through pairwise comparisons. It relies on the judgements of experts to get the weight of the pairwise comparison. And it uses the pairwise comparison to derive priority scales. It scales that measure intangibles in relative terms. The methods of survival analysis are Kaplan-Meier method and Life table method. Results The aim of the questionnaire for AHP is to get the weights between each criteria or subcriteria. The weight of medical effect is about 71%, and the weight of medical cost is approximately 29%. According to the result of questionnaire, medical effect is much more important than medical cost. There are four part of medical cost. The weight is about 23% in average medical cost in first line. The weight is about 22% in average medical cost related to lung cancer in first line. The weight is approximately 26% in average medical cost per day after receiving first treatment. The weight is about 29% in average medical cost related to lung cancer per day after receiving first treatment. The average progression survival day is 106.86 days. The overall survival day is 262.68 days. The average time of the emergency is 2.15. The average medical cost in first line is 4655.38 new Taiwan dollars per day. The average medical cost related to lung cancer in first line is 4545.92 new Taiwan dollar per day. The average cost after receiving the first treatment is 3369.75 new Taiwan dollar per day. The average cost related to lung cancer after receiving first treatment is 3262.38 new Taiwan dollar. KPI of chemotherapy with Cisplatin or Carboplatin is higher than thatn of chemotherapy without Cisplatin or Carboplatin. For those who only use chemotherapy medicine, the highest KPI is not fixed on a certain medicine. In addition, Alimta is the most expensive one so that the lowest KPI is usually on Alimta. Conclusion This is the first time not only using the survival analysis but also using a new method to evaluate the efficiency of a treatment or drug. The future work is to develop a new method based on this analytic model. Citation Format: Yueh-Fu Fang, Min-Chia Lee. Multiple objective analysis of first line medicine with non-small cell lung cancer [abstract]. In: Proceedings of ","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"229 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77559155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract LB-160: Glioblastoma and mesothelioma: Do estimates of health state utilities compare in rare cancers treatable with tumor treating fields","authors":"C. Proescholdt, J. Kelly","doi":"10.1158/1538-7445.SABCS18-LB-160","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-LB-160","url":null,"abstract":"Objective: To compare the estimated health state utilities of glioblastoma (GBM) and malignant pleural mesothelioma (MPM) given that they are both rare cancers treatable with tumor treating fields (TTFields) Background: Glioblastoma (GBM) is the most aggressive form of primary brain cancer in adults. MPMis an invasive and generally fatal malignancy of the lung mainly caused by exposure to asbestos fibers. To understand the comparative economic value of new treatments, the quality-adjusted life year (QALY) has been developed and is widely used in health economic literature. Given that GBM and MPM are both rare and aggressive cancers, both potentially treatable with TTFields, we aimed to understand whether the estimated health state utilities for each disease state were comparable. Clinical results show a comparable effect on median overall survival (OS). The EF-14 Trial showed that the addition of TTFields treatment increases median OS by 4.9 months in GBM, while the EF-23 showed that TTFields adds a median OS of 6.1 months compared to historical control in MPM. Differing health state utilities by disease, in this case a central nervous system tumor versus a pleural tumor, could influence the adoption of a new treatment regardless of whether the efficacy and safety of that new treatment is comparable for both disease states. Methods: We reviewed the structure and results of the EF-14 and STELLAR trials. We determined the appropriate health states for evaluation in both diseases as stable disease, progressed disease, and death. We then performed a comprehensive review of the published literature regarding health utility values in GBM and MPM patients using a boolean search in the Medline database. The estimated health state utilities were then compared by disease. Results: All publications that reference health utilities for GBM are derived from the same source. Estimates of utility were obtained from the NHS Value of Health Panel (VoHP) and based on the standard gamble method for preference elicitation, rating a total of nine descriptive health state scenarios. Utilities for stable disease in glioblastoma were 0.85 and 0.73 for progressed disease as a base case respectively. The estimates for MPM utilities were obtained using varying methods not correlated to stable or progressive disease. One method elicited utilities describing 243 distinct states from the EQ-5 questionnaire data collected during the trial at an indiviual patient level. Conclusions: Health utility estimates published so far for GBM are not comparable to the helth utilities published and used for MPM. While the utilities in GBM are scarce, but allow for use in a three health state disease model, utilities for MPM are more diverse and do at the moment not support a health state model. MPM utilities elicited from the EQ-5 however describe more adequately the individual utilities and their change during the course of the disease. The lack of such detailed utilities e.g. in GBM could","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72777620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract LB-162: Treating elderly glioblastoma patients > 65 years with TTFields - a cost-effectiveness perspective","authors":"G. Guzauskas, E. Pollom, V. Stieber","doi":"10.1158/1538-7445.AM2019-LB-162","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-LB-162","url":null,"abstract":"Objective: To compare the incremental cost effectiveness results of treating elderly Glioblastoma (GBM) patients age 65 years or older with tumor treating fields (TTFields) and maintenance Temozolomide (TMZ) versus maintenance TMZ alone with reported willingness to pay thresholds for cancer patients. Background: Glioblastoma is the most aggressive form of primary brain cancer in adults. Around half of the patients in the real-world setting are diagnosed at the age of 65 and older. The EF-14 trial demonstrated significantly increased five-year overall survival results for all patients in the TTFields plus TMZ group, with the subgroup of patients age 65 and older showing the greatest survival benefit from TTFields plus TMZ treatment. We report on the cost-effectiveness of adding TTFields from a U.S. health system perspective and recent literature on willingness to pay for cancer patients. Methods: We calculated the Incremental cost effectiveness ratio for patients above 65 years using TTFields as part of their first line treatment. Patient outcomes were simulated using a 3-state area under the curve model including alive with stable disease, progressed disease, and death. Survival was modeled over a lifetime horizon by integrating the 5-year survival results for elderly patients reported in the EF-14 trial with long-term GBM epidemiology data and U.S. background mortality rates. Data on patient utilities used to calculate quality-adjusted life years (QALYs) were based on a previous analysis of GBM-specific health-state preferences. Frequency of adverse events associated with TTFields and TMZ were derived from the EF-14 trial for the patients over 65 years. Costs for adverse events and supportive care cost estimates were used according to published literature. Future survival benefits and costs were discounted to present value at a rate of 3%. One-way and probabilistic sensitivity analyses were performed to assess result uncertainty due to parameter variability. A literature research with specific focus on willingness to pay threshold for elderly patients was conducted and the results of the ICER for using TTFields are discussed and compared to the literature. Results: Willingness to pay thresholds is rarely reported separately for older patients. The recent literature reports a large scale of willingness to pay thresholds for cancer patient in general. For patients treated with TTFields and maintenance TMZ the resulting ICER was $109,500 per life year gained (LYG) and $142,400 per QALY gained. The probability of TTFields being cost-effective was 85% at a willingness-to-pay threshold of $200,000 per QALY. Conclusions: TTFields therapy, evaluated at its full list price, demonstrated a high probability of cost-effectiveness at willingness-to-pay thresholds reported in economic literature for the United States. Treating newly diagnosed GBM patients over 65 years of age with TTFields and TMZ has the potential to increase mean lifetime survival and quali","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89868642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract 3348: Top 10 living with and beyond cancer research priorities","authors":"Feng Li, A. Morgan, A. McCullagh, Anne Johnson, C. Giles, D. Greenfield, Graeme Crawford, J. Gath, J. Lyons, J. Andreyev, Jonathan Tobutt, Julia Tugwell, K. Robb, L. Cove-Smith, Lindsey Bennister, N. Doyle, Nicolas Lee, Rebecca Nash, R. Simcock, R. Stephens, S. Best, S. Moug, Kristina Staley, S. Regan, Patricia Ellis, Stuart Griffiths, I. Lewis","doi":"10.1158/1538-7445.AM2019-3348","DOIUrl":"https://doi.org/10.1158/1538-7445.AM2019-3348","url":null,"abstract":"More and more people are living with the consequences of cancer and its treatment (living with and beyond cancer), yet the level of relevant research is low compared to other types of cancer research in the UK. NCRI aims to increase the level of research in this area and to ultimately improve the lives of those affected by cancer. Undefined research priorities in this broad area has been a barrier to research. The 2015 NHS Independent Cancer Taskforce report also recommends defining research priorities and to enable this research to happen. To address this barrier the NCRI has undertaken a James Lind Alliance Priority Setting Partnership (PSP) to identify priorities that matter most to people affected by cancer and the health and social care professionals.A PSP consists of patients and carers, health and social care professionals. PSPs have several stages and begin with a UK-wide survey to gather questions about uncertainties in living with and beyond cancer. Once the results were analysed, an interim exercise takes place to further prioritise the uncertainties. The last stage is a final workshop where partners debate and finally arrive at a top 10 list of shared uncertainties.The living with and beyond cancer PSP received 3500 questions submitted by people affected by cancer and healthcare professionals. Through a 18-month established rigorous process, the questions are prioritised down to the Top 10 living with and beyond cancer priorities for research in June 2018. This is the first time that clear research priorities have been identified in this area. They are the most impactful research questions that will help improve the lives of people affected by cancer. The Top 10 uncertainties will be publicised widely to ensure that researchers and those who fund research really understand what matters to people affected by cancer. The top uncertainties will be promoted to many research organizations and relevant funders in the UK. We anticipate they will directly influence future research. Citation Format: Feng Li, Adrienne Morgan, Angela McCullagh, Anne Johnson, Ceinwen Giles, Diana Greenfield, Graeme Crawford, Jacqui Gath, Jane Lyons, Jervoise Andreyev, Jonathan Tobutt, Julia Tugwell, Karen Robb, Laura Cove-Smith, Lindsey Bennister, Natalie Doyle, Nicolas Lee, Rebecca Nash, Richard Simcock, Richard Stephens, Sabine Best, Susan Moug, Kristina Staley, Sandra Regan, Patricia Ellis, Stuart Griffiths, Ian Lewis. Top 10 living with and beyond cancer research priorities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3348.","PeriodicalId":21579,"journal":{"name":"Science and Health Policy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84937754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}