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Characteristics and outcomes of new molecular oncology drug approvals, in combination or monotherapy 获批的分子肿瘤学新药(联合或单一疗法)的特点和疗效
IF 1.3 Q3 Medicine Pub Date : 2023-12-05 DOI: 10.1016/j.jcpo.2023.100462
Sruthi Ranganathan , Alyson Haslam , Jordan Tuia , Vinay Prasad

Importance

Understanding the factors that are associated with new molecular entity (NME) cancer drug approvals as a single agent and in combination, and European Society for Medical Oncology (ESMO) scores, can aid in identifying suitable factors to consider in trial designs for future drugs. In addition, the association between the various outcomes can aid in determining benefit when surrogate outcomes are used in approval consideration.

Objective

This study aims to (1) use the measures used in evaluating clinical trials by ESMO scores to determine the differences in the characteristics of 2013–2022 Food and Drug Administration (FDA) oncology NME drug approvals for those approved for use in combination or as a monotherapy, and (2) analyze the association between survival outcomes and the response rate for monotherapy NME drugs and/or drugs approved in combination.

Design

Cross-sectional analysis.

Setting

US FDA Oncology Drug Approvals (2013–2022)

Participants

US FDA Oncology Drug Approvals (2013–2022)

Exposures

Trial-level characteristics (tumor types, basis of approval, randomized or not, phase) and associations between overall survival (OS), progression-free survival (PFS), or overall response rate (ORR) and whether NME drugs were approved as monotherapy or in combination .

Results

Drugs approved for use as a monotherapy are less likely to be approved using a randomized study (p < 0.001) and more likely to be approved via the accelerated pathway (p = 0.012) and be open-label (p < 0.001). Drugs approved for use as a combination or monotherapy significantly differed on their approval basis (p = 0.002), phase of trial at the time of approval (p = 0.02), and ESMO scores (p = 0.02). There was low correlation between response rate and either PFS or OS metrics. However, nearly all of the drugs with large improvements in OS (> 5months) were drugs with robust ORR.

Conclusions and relevance

Drugs approved as monotherapy with a low response rate are likely to have marginal benefit in OS and PFS.

重要性了解与新分子实体(NME)癌症药物单药和联合批准相关的因素,以及欧洲肿瘤医学学会(ESMO)评分,可以帮助确定未来药物试验设计中考虑的合适因素。此外,当替代结果用于批准考虑时,各种结果之间的关联可以帮助确定获益。本研究旨在(1)利用ESMO评分评估临床试验的方法,确定2013-2022年FDA (Food and Drug Administration, FDA)批准的肿瘤NME药物在联合或单一治疗方面的特点差异;(2)分析单一治疗NME药物和/或联合批准的NME药物的生存结局与缓解率之间的关联。DesignCross-sectional分析。美国FDA肿瘤药物批准(2013-2022):暴露水平的特征(肿瘤类型、批准基础、随机与否、分期)和总生存期(OS)、无进展生存期(PFS)或总缓解率(ORR)之间的关系,以及NME药物是被批准作为单一疗法还是联合疗法。结果批准用作单一疗法的药物在随机研究中被批准的可能性较小(p <0.001),更有可能通过加速途径获得批准(p = 0.012)和开放标签(p <0.001)。被批准作为联合或单一疗法使用的药物在其批准基础(p = 0.002)、批准时的试验阶段(p = 0.02)和ESMO评分(p = 0.02)上存在显著差异。反应率与PFS或OS指标之间的相关性较低。然而,几乎所有对OS有显著改善的药物(>5个月)均为ORR较强的药物。结论和相关性:被批准为单药治疗的低缓解率药物可能在OS和PFS中具有边际效益。
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引用次数: 0
Financial toxicity and its implication on quality of life in patients attending the palliative care department in a regional cancer centre: An observational study 一家地区癌症中心姑息治疗部病人的财务毒性及其对生活质量的影响:一项观察性研究
IF 1.3 Q3 Medicine Pub Date : 2023-12-05 DOI: 10.1016/j.jcpo.2023.100460
Vaishnavi Nikte , Savita Patil , Hemakshi Chaudhari , Chaitanya Patil , Reshma Pawar , Prasad Patil , Harshvardhan More , Ujjwal Katolkar

In India the cancer burden for 2021 was 26.7 million disability-adjusted life years (DALYs), and this is expected to increase to 29.8 million in 2025 (Kulothungan et al., 2022). According to the World Health Organisation (WHO), cancer is a leading cause of death worldwide, accounting for one in six deaths. As per WHO, palliative care is a strategy that assists both adults and children along with their families in dealing with life-threatening illnesses. Currently, only 14% of those in need of pain and palliative (P&P) care receive it globally (WHO, 2020). Financial toxicity (FT) is the term used to describe the negative effects that an excessive financial burden resulting from cancer have on patients, their families, and society (Desai and Gyawali, 2020). Addressing this gap will require significant adjustments to both demand- and supply-side policies to ensure accessible and equitable cancer care in India (Caduff et al., 2019). Measuring FT along with health-related quality of life (HRQoL) represents a clinically relevant and patient-centred approach (de Souza et al., 2017).

Aim and objective

To estimate FT and its association with quality of life (QoL).

Materials and methods

This was an observational descriptive study conducted among cancer patients recommended for P&P care. Scores were estimated from September 2022 to February 2023 using official tools: the Functional Assessment for Chronic illness Treatment Compressive Score for Financial Toxicity (FACIT-COST) and the European Organisation for Research and Treatment of Cancer (EORTC) Quality of life Questionnaires for Cancer (QLQ30).

Results

From 150 patients (70 males and 80 females, mean age 54.96 ± 13.5 years), 92.6% suffered from FT. Eleven patients (7.3%) were under FT grade 0, 41 (27.3%) were FT grade 1, 98 (65.3%) were FT grade 2, and no patients were under FT grade 3. At criterial alpha 0.05 (95%CI), FT and the global score for HRQoL showed an association. Among inpatient department (IPD) expenses, medication bills contributed the greatest expense at 33%, and among outpatient department (OPD) expenses treatment expenses contributed 50% of the total. Breast cancer (30 cases, 20%) and oral cancer (26 cases, 17.3%) were the most frequent cancers.

Conclusion

FT measured using the COST tool showed an association with HRQoL.

Policy summary

This paper refers to the insurance policies available for cancer patients irrespective of P&P care treatment.

在印度,2021年的癌症负担为2670万残疾调整生命年(DALYs),预计到2025年将增加到2980万(Kulothungan等人,2022年)。根据世界卫生组织(WHO)的数据,癌症是全球死亡的主要原因,占死亡人数的六分之一。根据世卫组织的说法,姑息治疗是一项帮助成人和儿童及其家人处理危及生命的疾病的战略。目前,在全球范围内,需要疼痛和姑息治疗的人中只有14%得到了治疗(世卫组织,2020年)。金融毒性(Financial toxicity, FT)是用来描述癌症造成的过度经济负担对患者、家庭和社会产生的负面影响的术语(Desai和Gyawali, 2020)。解决这一差距将需要对需求侧和供给侧政策进行重大调整,以确保印度的癌症护理可及性和公平性(Caduff等人,2019)。测量FT与健康相关生活质量(HRQoL)代表了一种临床相关和以患者为中心的方法(de Souza et al., 2017)。目的与目的评估FT及其与生活质量(QoL)的关系。材料和方法本研究是一项观察性描述性研究,研究对象为推荐进行P&护理的癌症患者。从2022年9月到2023年2月,使用官方工具估计得分:慢性疾病治疗功能评估财务毒性压缩评分(FACIT-COST)和欧洲癌症研究和治疗组织(EORTC)癌症生活质量问卷(QLQ30)。结果150例患者(男70例,女80例,平均年龄54.96±13.5岁)中,FT发生率为92.6%,FT 0级以下11例(7.3%),FT 1级41例(27.3%),FT 2级98例(65.3%),FT 3级无患者。在标准α 0.05 (95%CI)时,FT和HRQoL的总体评分显示出相关性。在住院部(IPD)费用中,医药费占33%,门诊(OPD)费用中,治疗费占50%。乳腺癌(30例,20%)和口腔癌(26例,17.3%)是最常见的癌症。结论使用COST工具测量的ft与HRQoL存在相关性。本论文是针对癌症患者在不考虑p&p护理治疗的情况下可获得的保险政策。
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引用次数: 0
Challenges in building radiotherapy capacity: A longitudinal study evaluating eight years of the Brazilian radiotherapy expansion plan 建立放射治疗能力的挑战:一项评估巴西放射治疗扩展计划8年的纵向研究。
IF 1.3 Q3 Medicine Pub Date : 2023-11-28 DOI: 10.1016/j.jcpo.2023.100459
Andre G. Gouveia , Gustavo A. Viani , Vanessa F. Bratti , Gustavo N. Marta , Samir A. Hanna , Alexandre A. Jacinto , Mauricio S. Silva , Ana C. Hamamura , Arthur A. Rosa , Marcus S. Castilho , Laura Carson , Wilma M. Hopman , Richard Sullivan , Christopher M. Booth , Ajay Aggarwal , Timothy P. Hanna , Fabio Y. Moraes

Background

In 2012, the Brazilian government launched a radiotherapy (RT) expansion plan (PER-SUS) to install 100 linear accelerators. This study assesses the development of this program after eight years.

Methods

Official reports from the Ministry of Health (MoH) were reviewed. RT centres projects status, timeframes, and cost data (all converted to US dollars) were extracted. The time analysis was divided into seven phases, and for cost evaluation, there were five stages. The initial predicted project time (IPPT) and costs (estimated by the MoH) for each phase were compared between the 18 operational RT centres (able to treat patients) and 30 non-operational RT centres using t-tests, ANOVA, and the Mann-Whitney U. A p-value < 0.05 indicates statistical significance.

Results

A significant delay was observed when comparing the IPPT with the overall time to conclude each 48 RT centres project (p < 0.001), with considerable delays in the first five phases (p < 0.001 for all). Moreover, the median time to conclude the first 18 operational RT centres (77.4 months) was shorter compared with the 30 non-operational RT centres (94.0 months), p < 0.001. The total cost of 48 RT services was USD 82,84 millions (mi) with a significant difference in the per project median total cost between 18 operational RT centres, USD1,34 mi and 30 non-operational RT centres USD2,11 mi, p < 0.001. All phases had a higher cost when comparing 30 non-operational RT centres to 18 operational RT centres, p < 0.001. The median total cost for expanding existing RT centres was USD1,30 mi versus USD2,18 mi for new RT services, p < 0.0001.

Conclusion

After eight years, the PER-SUS programs showed a substantial delay in most projects and their phases, with increased costs over time.

Policy summary

Our findings indicate a need to act to increase the success of this plan. This study may provide a benchmark for other developing countries trying to expand RT capacity.

背景:2012年,巴西政府启动了一项放疗(RT)扩展计划(PER-SUS),计划安装100台直线加速器。本研究评估了该项目八年后的发展情况。方法:查阅卫生部官方报告。提取RT中心、项目状态、时间框架和成本数据(全部转换为美元)。时间分析分为7个阶段,成本评估分为5个阶段。每个阶段的初始预测项目时间(IPPT)和成本(由卫生部估计)在18个手术RT中心(能够治疗患者)和30个非手术RT中心之间进行比较,使用t检验,方差分析和Mann-Whitney U. A p值结果:当比较IPPT与完成每48个RT中心项目的总时间时,观察到显着延迟(pConclusion:8年后,PER-SUS项目显示出大多数项目及其阶段的实质性延迟,成本随着时间的推移而增加。政策摘要:我们的研究结果表明,需要采取行动以提高该计划的成功率。这项研究可能为其他发展中国家扩大RT能力提供一个基准。
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引用次数: 0
Cancer care pathways across seven countries in Europe: What are the current obstacles? And how can artificial intelligence help? 欧洲七个国家的癌症治疗途径:目前的障碍是什么?人工智能又能提供什么帮助呢?
IF 1.3 Q3 Medicine Pub Date : 2023-11-25 DOI: 10.1016/j.jcpo.2023.100457
Iman Hesso , Reem Kayyali , Lithin Zacharias , Andreas Charalambous , Maria Lavdaniti , Evangelia Stalika , Tarek Ajami , Wanda Acampa , Jasmina Boban , Shereen Nabhani Gebara

Background

Cancer poses significant challenges for healthcare professionals across the disease pathway including cancer imaging. This study constitutes part of the user requirement definition of INCISIVE EU project. The project has been designed to explore the full potential of artificial intelligence (AI)-based technologies in cancer imaging to streamline diagnosis and management. The study aimed to map cancer care pathways (breast, prostate, colorectal and lung cancers) across INCISIVE partner countries, and identify bottle necks within these pathways.

Methods

Email interviews were conducted with ten oncology specialised healthcare professionals representing INCISIVE partner countries: Greece, Cyprus, Spain, Italy, Finland, the United Kingdom (UK) and Serbia. A purposive sampling strategy was employed for recruitment and data was collected between December 2020 and April 2021. Data was entered into Microsoft Excel spreadsheet to allow content examination and comparative analysis.

Results

The analysed pathways all shared a common characteristic: inequalities in relation to delays in cancer diagnosis and treatment. All the studied countries, except the UK, lacked official national data about diagnostic and therapeutic delays. Furthermore, a considerable variation was noted regarding the availability of imaging and diagnostic services across the seven countries. Several concerns were also noted for inefficiencies/inequalities with regards to national screening for the four investigated cancer types.

Conclusions

Delays in cancer diagnosis and treatment are an ongoing challenge and a source for inequalities. It is important to have systematic reporting of diagnostic and therapeutic delays in all countries to allow the proper estimation of its magnitude and support needed to address it. Our findings also support the orientation of the current policies towards early detection and wide scale adoption and implementation of cancer screening, through research, innovation, and technology. Technologies involving AI can have a great potential to revolutionise cancer care delivery.

Policy summary

This study highlights the widespread delay in cancer diagnosis across Europe and supports the need for, systematic reporting of delays, improved availability of imaging services, and optimised national screening programs. The goal is to enhance cancer care delivery, encourage early detection, and implement research, innovation, and AI-based technologies for improved cancer imaging.

背景:癌症对包括癌症成像在内的整个疾病途径的医疗保健专业人员提出了重大挑战。本研究构成了INCISIVE EU项目用户需求定义的一部分。该项目旨在探索基于人工智能(AI)的癌症成像技术的全部潜力,以简化诊断和管理。该研究旨在绘制INCISIVE合作伙伴国家的癌症治疗途径(乳腺癌、前列腺癌、结直肠癌和肺癌),并确定这些途径中的瓶颈。方法:通过电子邮件采访了10位来自INCISIVE合作伙伴国家的肿瘤学专业医疗保健专业人员:希腊、塞浦路斯、西班牙、意大利、芬兰、英国和塞尔维亚。采用有目的的抽样策略进行招募,并在2020年12月至2021年4月期间收集数据。将数据输入到Microsoft Excel电子表格中进行内容检查和比较分析。结果:分析的途径都有一个共同的特点:在癌症诊断和治疗延迟的不平等。除英国外,所有被研究的国家都缺乏关于诊断和治疗延误的官方国家数据。此外,在成像和诊断服务的可得性方面,7个国家差别很大。委员会还注意到在对四种被调查的癌症类型进行全国筛查方面的效率低下/不平等现象。结论:癌症诊断和治疗的延迟是一个持续的挑战,也是不平等的来源。重要的是对所有国家的诊断和治疗延误进行系统报告,以便适当估计其严重程度和解决延误所需的支持。我们的研究结果还支持当前政策的方向,即通过研究、创新和技术,早期发现和大规模采用和实施癌症筛查。涉及人工智能的技术有可能彻底改变癌症治疗的方式。政策总结:这项研究强调了整个欧洲癌症诊断的普遍延迟,并支持系统报告延迟,改善成像服务的可用性和优化国家筛查计划的必要性。目标是加强癌症护理服务,鼓励早期发现,并实施研究、创新和基于人工智能的技术,以改善癌症成像。
{"title":"Cancer care pathways across seven countries in Europe: What are the current obstacles? And how can artificial intelligence help?","authors":"Iman Hesso ,&nbsp;Reem Kayyali ,&nbsp;Lithin Zacharias ,&nbsp;Andreas Charalambous ,&nbsp;Maria Lavdaniti ,&nbsp;Evangelia Stalika ,&nbsp;Tarek Ajami ,&nbsp;Wanda Acampa ,&nbsp;Jasmina Boban ,&nbsp;Shereen Nabhani Gebara","doi":"10.1016/j.jcpo.2023.100457","DOIUrl":"10.1016/j.jcpo.2023.100457","url":null,"abstract":"<div><h3>Background</h3><p>Cancer poses significant challenges for healthcare professionals across the disease pathway including cancer imaging. This study constitutes part of the user requirement definition of INCISIVE EU project. The project has been designed to explore the full potential of artificial intelligence (AI)-based technologies in cancer imaging to streamline diagnosis and management. The study aimed to map cancer care pathways (breast, prostate, colorectal and lung cancers) across INCISIVE partner countries, and identify bottle necks within these pathways.</p></div><div><h3>Methods</h3><p>Email interviews were conducted with ten oncology specialised healthcare professionals representing INCISIVE partner countries: Greece, Cyprus, Spain, Italy, Finland, the United Kingdom (UK) and Serbia. A purposive sampling strategy was employed for recruitment and data was collected between December 2020 and April 2021. Data was entered into Microsoft Excel spreadsheet to allow content examination and comparative analysis.</p></div><div><h3>Results</h3><p>The analysed pathways all shared a common characteristic: inequalities in relation to delays in cancer diagnosis and treatment. All the studied countries, except the UK, lacked official national data about diagnostic and therapeutic delays. Furthermore, a considerable variation was noted regarding the availability of imaging and diagnostic services across the seven countries. Several concerns were also noted for inefficiencies/inequalities with regards to national screening for the four investigated cancer types.</p></div><div><h3>Conclusions</h3><p>Delays in cancer diagnosis and treatment are an ongoing challenge and a source for inequalities. It is important to have systematic reporting of diagnostic and therapeutic delays in all countries to allow the proper estimation of its magnitude and support needed to address it. Our findings also support the orientation of the current policies towards early detection and wide scale adoption and implementation of cancer screening, through research, innovation, and technology. Technologies involving AI can have a great potential to revolutionise cancer care delivery.</p></div><div><h3>Policy summary</h3><p>This study highlights the widespread delay in cancer diagnosis across Europe and supports the need for, systematic reporting of delays, improved availability of imaging services, and optimised national screening programs. The goal is to enhance cancer care delivery, encourage early detection, and implement research, innovation, and AI-based technologies for improved cancer imaging.</p></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213538323000747/pdfft?md5=afd536d2a53d02f52f743a571937652a&pid=1-s2.0-S2213538323000747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441348","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}
引用次数: 0
Where are the inequalities in ovarian cancer care in a country with universal healthcare? A systematic review and narrative synthesis 在一个拥有全民医疗保健的国家,卵巢癌治疗的不平等在哪里?一个系统的回顾和叙述综合。
IF 1.3 Q3 Medicine Pub Date : 2023-11-25 DOI: 10.1016/j.jcpo.2023.100458
Benjamin Pickwell-Smith , Sarah Greenley , Michael Lind , Una Macleod

Introduction

Patients diagnosed with ovarian cancer from more deprived areas may face barriers to accessing timely, quality healthcare. We evaluated the literature for any association between socioeconomic group, treatments received and hospital delay among patients diagnosed with ovarian cancer in the United Kingdom, a country with universal healthcare.

Methods

We searched MEDLINE, EMBASE, CINAHL, CENTRAL, SCIE, AMED, PsycINFO and HMIC from inception to January 2023. Forward and backward citation searches were conducted. Two reviewers independently reviewed titles, abstracts, and full-text articles. UK-based studies were included if they reported socioeconomic measures and an association with either treatments received or hospital delay. The inclusion of studies from one country ensured greater comparability. Risk of bias was assessed using the QUIPS tool, and a narrative synthesis was conducted. The review is reported to PRISMA 2020 and registered with PROSPERO [CRD42022332071].

Results

Out of 2876 references screened, ten were included. Eight studies evaluated treatments received, and two evaluated hospital delays. We consistently observed socioeconomic inequalities in the likelihood of surgery (range of odds ratios 0.24–0.99) and chemotherapy (range of odds ratios 0.70–0.99) among patients from the most, compared with the least, deprived areas. There were no associations between socioeconomic groups and hospital delay.

Policy summary

Ovarian cancer treatments differed between socioeconomic groups despite the availability of universal healthcare. Further research is needed to understand why, though suggested reasons include patient choice, health literacy, and financial and employment factors. Qualitative research would provide a rich understanding of the complex factors that drive these inequalities.

来自较贫困地区的卵巢癌患者在获得及时、高质量的医疗保健方面可能面临障碍。我们评估了文献中社会经济群体、接受的治疗和在英国诊断为卵巢癌的患者住院延误之间的任何关联,英国是一个全民医疗保健的国家。方法:检索MEDLINE, EMBASE, CINAHL, CENTRAL, SCIE, AMED, PsycINFO和HMIC自成立至2023年1月。进行了前向和后向引文检索。两位审稿人独立审查标题、摘要和全文文章。如果英国的研究报告了社会经济指标以及与接受治疗或住院延误的关系,则将其纳入研究。纳入来自一个国家的研究确保了更大的可比性。使用QUIPS工具评估偏倚风险,并进行叙事综合。该审查报告给PRISMA 2020,并在PROSPERO注册[CRD42022332071]。结果:筛选2876篇文献,纳入10篇。8项研究评估了接受的治疗,2项研究评估了医院延误。我们一直观察到,在最贫困地区和最贫困地区的患者中,手术(比值比范围为0.24-0.99)和化疗(比值比范围为0.70-0.99)的可能性存在社会经济不平等。社会经济群体和住院延误之间没有关联。政策摘要:尽管有全民医疗保健,但不同社会经济群体之间的卵巢癌治疗存在差异。需要进一步的研究来理解原因,尽管提出的原因包括患者选择、健康素养、经济和就业因素。定性研究将提供对导致这些不平等的复杂因素的丰富理解。
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引用次数: 0
A tailored approach to horizon scanning for cancer medicines 为癌症药物量身定制的水平扫描方法
IF 1.3 Q3 Medicine Pub Date : 2023-11-20 DOI: 10.1016/j.jcpo.2023.100441
Jennifer A. Soon , Yat Hang To , Marliese Alexander , Karen Trapani , Paolo A. Ascierto , Sophy Athan , Michael P. Brown , Matthew Burge , Andrew Haydon , Brett Hughes , Malinda Itchins , Thomas John , Steven Kao , Miriam Koopman , Bob T. Li , Georgina V. Long , Jonathan M. Loree , Ben Markman , Tarek M. Meniawy , Alexander M. Menzies , Maarten IJzerman

Background

Horizon scanning (HS) is the systematic identification of emerging therapies to inform policy and decision-makers. We developed an agile and tailored HS methodology that combined multi-criteria decision analysis weighting and Delphi rounds. As secondary objectives, we aimed to identify new medicines in melanoma, non-small cell lung cancer and colorectal cancer most likely to impact the Australian government’s pharmaceutical budget by 2025 and to compare clinician and consumer priorities in cancer medicine reimbursement.

Method

Three cancer-specific clinician panels (total n = 27) and a consumer panel (n = 7) were formed. Six prioritisation criteria were developed with consumer input. Criteria weightings were elicited using the Analytic Hierarchy Process (AHP). Candidate medicines were identified and filtered from a primary database and validated against secondary and tertiary sources. Clinician panels participated in a three-round Delphi survey to identify and score the top five medicines in each cancer type.

Results

The AHP and Delphi process was completed in eight weeks. Prioritisation criteria focused on toxicity, quality of life (QoL), cost savings, strength of evidence, survival, and unmet need. In both curative and non-curative settings, consumers prioritised toxicity and QoL over survival gains, whereas clinicians prioritised survival. HS results project the ongoing prevalence of high-cost medicines. Since completion in October 2021, the HS has identified 70 % of relevant medicines submitted for Pharmaceutical Benefit Advisory Committee assessment and 60% of the medicines that received a positive recommendation.

Conclusion

Tested in the Australian context, our method appears to be an efficient and flexible approach to HS that can be tailored to address specific disease types by using elicited weights to prioritise according to incremental value from both a consumer and clinical perspective.

Policy summary

Since HS is of global interest, our example provides a reproducible blueprint for adaptation to other healthcare settings that integrates consumer input and priorities.

背景水平扫描(HS)是对新兴疗法的系统识别,为政策和决策者提供信息。我们开发了一种灵活的、量身定制的HS方法,该方法结合了多标准决策分析权重和德尔菲回合。作为次要目标,我们旨在确定到2025年最有可能影响澳大利亚政府制药预算的黑色素瘤、非小细胞肺癌和结直肠癌的新药,并比较临床医生和消费者在癌症药物报销方面的优先级。方法组成3个肿瘤特异性临床专家小组(共27人)和1个消费者小组(共7人)。根据消费者的意见,制定了六个优先级标准。使用层次分析法(AHP)得出标准权重。候选药物从一级数据库中确定和筛选,并对照二级和三级来源进行验证。临床医生小组参与了一项三轮德尔菲调查,以确定和评分每种癌症类型的前五种药物。结果8周内完成AHP法和德尔菲法。优先标准侧重于毒性、生活质量(QoL)、成本节约、证据强度、生存和未满足的需求。在治疗和非治疗情况下,消费者优先考虑毒性和生活质量,而不是生存收益,而临床医生优先考虑生存。卫生调查结果预测了高成本药物的持续流行。自2021年10月完成以来,HS已经确定了70%提交给药品效益咨询委员会评估的相关药物和60%获得积极建议的药物。结论:在澳大利亚进行的测试表明,我们的方法似乎是一种有效而灵活的HS方法,可以根据消费者和临床角度的增量价值使用引出的权重来确定优先级,从而针对特定疾病类型进行定制。由于卫生保健具有全球利益,我们的示例提供了一个可复制的蓝图,用于将消费者输入和优先事项集成到其他医疗保健环境中。
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引用次数: 0
The promise of POSIT: Real-world application of the Paediatric Oncology System Integration Tool POSIT的前景:儿科肿瘤系统集成工具的实际应用。
IF 1.3 Q3 Medicine Pub Date : 2023-11-19 DOI: 10.1016/j.jcpo.2023.100454
Laura Carson , Kadia Petricca , Avram Denburg

Childhood cancer presents significant acute and long-term challenges for patients,families, communities, and health systems. Although meaningful strides have been made in research and treatment, severe outcome disparities prevail between low- and middle-income countries (LMICs) and high-income countries (HICs), with childhood cancer survival rates lower than 20% in LMICs, as compared with over 80% across many HICs. In recent years, greater emphasis has been placed on health system strengthening as a means to develop domestic policy and capacity for sustainable improvements in childhood cancer outcomes in LMICs. In pursuit of a systems approach to childhood cancer in LMICs, our research team developed the Paediatric Oncology System Integration Tool (POSIT)—the first comprehensive framework for the design and evaluation of childhood cancer systems. Since its development, POSIT has been applied in an exploration of key determinants of access to essential childhood cancer medicines across two separate multi-site studies. In this commentary, we explore the value of the POSIT framework and toolkit as a constructive systems-level guide for examining interactions between childhood cancer-specific programs and encompassing health system. socio-political, and economic contexts.

儿童癌症给患者、家庭、社区和卫生系统带来了重大的急性和长期挑战。尽管在研究和治疗方面取得了重大进展,但低收入和中等收入国家与高收入国家之间存在严重的结果差异,低收入和中等收入国家的儿童癌症存活率低于20%,而许多高收入国家的儿童癌症存活率超过80%。近年来,更加重视加强卫生系统,以此作为制定国内政策和能力的手段,以可持续地改善中低收入国家的儿童癌症结局。为了寻求一种针对中低收入国家儿童癌症的系统方法,我们的研究团队开发了儿科肿瘤系统集成工具(POSIT),这是设计和评估儿童癌症系统的第一个综合框架。自开发以来,POSIT已在两项独立的多地点研究中应用于探索获得基本儿童癌症药物的关键决定因素。在这篇评论中,我们探讨了POSIT框架和工具包作为一种建设性的系统级指南的价值,用于检查儿童癌症特定项目与整体卫生系统之间的相互作用。社会政治和经济背景。
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引用次数: 0
The views of cancer patients of Turkish, Moroccan, Surinamese, and Dutch-Caribbean descent on diagnosis, treatment and prognosis: A systematic literature review 土耳其裔、摩洛哥裔、苏里南裔和荷兰-加勒比裔癌症患者的诊断、治疗和预后:系统的文献回顾。
IF 1.3 Q3 Medicine Pub Date : 2023-11-19 DOI: 10.1016/j.jcpo.2023.100455
Asiye Gedik , Esther van Meerten , Milou J.P. Reuvers , Olga Husson , Winette T.A. van der Graaf

Background

The number of international migrants is increasing worldwide. The four major non-western ethnic groups in the Netherlands are Turkish, Moroccan, Surinamese, and Dutch-Caribbean. This review examined the scientific literature on the views of cancer patients from these four ethnic groups on cancer diagnosis, treatment, and prognosis.

Methods

A systematic literature review was conducted using the databases EMBASE, Medline Web of Science, and Cochrane Central Register. Studies with patients who were of Turkish, Moroccan, Surinamese, and Dutch-Caribbean descent were included. Both qualitative and quantitative studies were included, and thematic analysis was performed. The methodological quality was assessed using the Mixed Methods Appraisal Tool.

Results

Thirteen studies were conducted in Turkey on Turkish cancer patients, while three were conducted in the Netherlands on Turkish and Moroccan cancer patients. Four themes emerged from the included studies: disclosure of diagnosis, communication, information provision, and decision-making. The majority of cancer patients in Turkey wanted information regarding their diagnosis and treatment. However, disclosure of a cancer diagnosis was rarely discussed with cancer patients in Turkey, whereas in the Netherlands it was provided directly. Family members in both the host and native countries had a strong influence on communication and decision-making. No literature on this topic for Surinamese or Dutch-Caribbean cancer patients was found.

Conclusion

Although major ethnic groups live in host countries, there is a lack of knowledge on optimal communication and information disclosure on cancer to patients and their families.

Policy summary

Further research into the views of ethnic groups on how to communicate about cancer is essential to ensuring that every patient receives optimal care and treatment.

背景:世界范围内的国际移民人数正在增加。荷兰的四个主要非西方民族是土耳其人、摩洛哥人、苏里南人和荷属加勒比人。本文回顾了有关这四个民族的癌症患者对癌症诊断、治疗和预后的看法的科学文献。方法:采用EMBASE、Medline Web of Science和Cochrane Central Register数据库进行系统文献综述。研究纳入了土耳其、摩洛哥、苏里南和荷兰-加勒比血统的患者。包括定性和定量研究,并进行专题分析。使用混合方法评估工具评估方法学质量。结果:在土耳其对土耳其癌症患者进行了13项研究,而在荷兰对土耳其和摩洛哥癌症患者进行了3项研究。从纳入的研究中出现了四个主题:诊断披露、沟通、信息提供和决策。土耳其的大多数癌症患者希望获得有关其诊断和治疗的信息。然而,在土耳其,很少与癌症患者讨论癌症诊断的披露,而在荷兰,这是直接提供的。东道国和原籍国的家庭成员对沟通和决策都有很大的影响。没有关于苏里南或荷兰-加勒比癌症患者这一主题的文献。结论:虽然主要的少数民族生活在东道国,但缺乏对患者及其家属的最佳沟通和癌症信息披露的知识。政策总结:进一步研究不同种族对如何沟通癌症的看法,对于确保每位患者获得最佳护理和治疗至关重要。
{"title":"The views of cancer patients of Turkish, Moroccan, Surinamese, and Dutch-Caribbean descent on diagnosis, treatment and prognosis: A systematic literature review","authors":"Asiye Gedik ,&nbsp;Esther van Meerten ,&nbsp;Milou J.P. Reuvers ,&nbsp;Olga Husson ,&nbsp;Winette T.A. van der Graaf","doi":"10.1016/j.jcpo.2023.100455","DOIUrl":"10.1016/j.jcpo.2023.100455","url":null,"abstract":"<div><h3>Background</h3><p>The number of international migrants is increasing worldwide. The four major non-western ethnic groups in the Netherlands are Turkish, Moroccan, Surinamese, and Dutch-Caribbean. This review examined the scientific literature on the views of cancer patients from these four ethnic groups on cancer diagnosis, treatment, and prognosis.</p></div><div><h3>Methods</h3><p>A systematic literature review was conducted using the databases EMBASE, Medline Web of Science, and Cochrane Central Register. Studies with patients who were of Turkish, Moroccan, Surinamese, and Dutch-Caribbean descent were included. Both qualitative and quantitative studies were included, and thematic analysis was performed. The methodological quality was assessed using the Mixed Methods Appraisal Tool.</p></div><div><h3>Results</h3><p>Thirteen studies were conducted in Turkey on Turkish cancer patients, while three were conducted in the Netherlands on Turkish and Moroccan cancer patients. Four themes emerged from the included studies: disclosure of diagnosis, communication, information provision, and decision-making. The majority of cancer patients in Turkey wanted information regarding their diagnosis and treatment. However, disclosure of a cancer diagnosis was rarely discussed with cancer patients in Turkey, whereas in the Netherlands it was provided directly. Family members in both the host and native countries had a strong influence on communication and decision-making. No literature on this topic for Surinamese or Dutch-Caribbean cancer patients was found.</p></div><div><h3>Conclusion</h3><p>Although major ethnic groups live in host countries, there is a lack of knowledge on optimal communication and information disclosure on cancer to patients and their families.</p></div><div><h3>Policy summary</h3><p>Further research into the views of ethnic groups on how to communicate about cancer is essential to ensuring that every patient receives optimal care and treatment.</p></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213538323000723/pdfft?md5=d2ff0e2a2951c79faf00859a59d827eb&pid=1-s2.0-S2213538323000723-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177519","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}
引用次数: 0
HIV knowledge and information access among women cancer survivors in Nigeria 尼日利亚妇女癌症幸存者的艾滋病毒知识和信息获取。
IF 1.3 Q3 Medicine Pub Date : 2023-11-19 DOI: 10.1016/j.jcpo.2023.100456
Candidus Nwakasi , Darlingtina Esiaka , Theresa Staab , Aaron Akpu Philip , Chizobam Nweke

Women in Nigeria have a high burden of diseases, such as cancer and HIV. Nigerian women also have inadequate access to health information, especially for disease prevention and health promotion. Researchers have indicated that living with HIV can be particularly harmful to the health and survival of cancer survivors. However, there is a dearth of research on Nigerian women cancer survivors’ knowledge of cancer and HIV linkage and their access to HIV health information. This knowledge gap may have negative health consequences. Therefore, there is a need to ensure HIV prevention among Nigerian women cancer survivors by improving access to health information. This study used a qualitative descriptive method to examine HIV knowledge and access to health information among women cancer survivors in Nigeria. Semi-structured interviews were conducted with a purposive sample of 30 women cancer survivors from Abuja, Nigeria. We identified three themes from the data, illuminating women’s knowledge of the connection between HIV and cancer. The themes include: (a) perception of HIV versus cancer which described views of HIV and cancer as distinct health conditions, (b) perceived effect of HIV on cancer given that HIV can worsen cancer outcomes, and (c) sourcing for HIV health information which highlighted issues of inadequate or inaccessible HIV-cancer information. Our findings showed that targeted health education interventions are required to address the lack of HIV information among cancer survivors.

尼日利亚妇女患癌症和艾滋病毒等疾病的负担很高。尼日利亚妇女获得保健信息的机会也不足,特别是在预防疾病和促进健康方面。研究人员指出,感染艾滋病毒对癌症幸存者的健康和生存尤其有害。然而,缺乏关于尼日利亚妇女癌症幸存者对癌症和艾滋病毒联系的了解以及她们获得艾滋病毒健康信息的研究。这种知识差距可能对健康产生负面影响。因此,有必要通过改善获得保健信息的机会,确保尼日利亚妇女癌症幸存者中预防艾滋病毒。本研究采用定性描述方法,调查尼日利亚妇女癌症幸存者的艾滋病毒知识和获得健康信息的情况。对来自尼日利亚阿布贾的30名女性癌症幸存者进行了半结构化访谈。我们从数据中确定了三个主题,阐明了妇女对艾滋病毒和癌症之间联系的认识。主题包括:(a)对艾滋病毒与癌症的看法,其中描述了将艾滋病毒和癌症视为不同的健康状况的看法;(b)认为艾滋病毒对癌症的影响,因为艾滋病毒可能使癌症结果恶化;(c)艾滋病毒健康信息的来源,其中突出了艾滋病毒-癌症信息不足或难以获得的问题。我们的研究结果表明,需要有针对性的健康教育干预措施来解决癌症幸存者中缺乏艾滋病毒信息的问题。
{"title":"HIV knowledge and information access among women cancer survivors in Nigeria","authors":"Candidus Nwakasi ,&nbsp;Darlingtina Esiaka ,&nbsp;Theresa Staab ,&nbsp;Aaron Akpu Philip ,&nbsp;Chizobam Nweke","doi":"10.1016/j.jcpo.2023.100456","DOIUrl":"10.1016/j.jcpo.2023.100456","url":null,"abstract":"<div><p><span>Women in Nigeria have a high burden of diseases, such as cancer and HIV. Nigerian women also have inadequate access to health information, especially for disease prevention and health promotion. Researchers have indicated that living with HIV can be particularly harmful to the health and survival of cancer survivors. However, there is a dearth of research on Nigerian women cancer survivors’ knowledge of cancer and HIV linkage and their access to HIV health information. This knowledge gap may have negative health consequences. Therefore, there is a need to ensure </span>HIV prevention among Nigerian women cancer survivors by improving access to health information. This study used a qualitative descriptive method to examine HIV knowledge and access to health information among women cancer survivors in Nigeria. Semi-structured interviews were conducted with a purposive sample of 30 women cancer survivors from Abuja, Nigeria. We identified three themes from the data, illuminating women’s knowledge of the connection between HIV and cancer. The themes include: (a) perception of HIV versus cancer which described views of HIV and cancer as distinct health conditions, (b) perceived effect of HIV on cancer given that HIV can worsen cancer outcomes, and (c) sourcing for HIV health information which highlighted issues of inadequate or inaccessible HIV-cancer information. Our findings showed that targeted health education interventions are required to address the lack of HIV information among cancer survivors.</p></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291889","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}
引用次数: 0
Social vulnerability and lung malignancy mortality 社会脆弱性与肺恶性肿瘤死亡率
IF 1.3 Q3 Medicine Pub Date : 2023-11-17 DOI: 10.1016/j.jcpo.2023.100453
Ramzi Ibrahim , Lewjain Sakr , Jennifer A. Lewis , Roger Y. Kim , Bryan S. Benn , See-Wei Low

Introduction

Lung cancer is a major cause of death in the United States. Social determinants of health (SDOH) are important factors that impact the treatment and prognosis of lung cancer. The social vulnerability index (SVI) is a validated measure of SDOH. This cross-sectional study aimed to investigate the impact of the SVI on lung cancer mortality using descriptive epidemiology.

Methods

Mortality data for lung malignancies from 2014 to 2018 was obtained from the CDC database and was age-adjusted and standardized to the population in the year 2000. The SVI for the same years was obtained from the CDC Agency for Toxic Substances and Disease Registry database. Age-adjusted mortality rates (AAMR) were estimated for each SVI quartile (SVI-Q) and demographic subgroup.

Results

We found that counties in SVI-Q4 (most vulnerable) had a higher cumulative AAMR compared to counties in SVI-Q1 (least vulnerable), accounting for a 4.48 excess death rate per 100,000 person-years. AAMR among males in SVI-Q4 was higher compared to SVI-Q1, accounting for a 9.96 excess death rate per 100,000 person-years, whereas no mortality differences were observed for female populations between SVI-Q4 and SVI-Q1. AAMR in SVI-Q4 was higher for both Hispanic and non-Hispanic populations, except for American Indian/Alaska Native populations. Similar trends were observed in both metropolitan and non-metropolitan counties.

Conclusion

Our study suggests that the SVI may play a significant role in lung cancer mortality and highlights the need for interventions targeting vulnerable populations to improve outcomes.

在美国,肺癌是导致死亡的主要原因。健康的社会决定因素(SDOH)是影响肺癌治疗和预后的重要因素。社会脆弱性指数(SVI)是衡量SDOH的有效指标。本横断面研究旨在利用描述流行病学研究SVI对肺癌死亡率的影响。方法从CDC数据库中获取2014 - 2018年肺部恶性肿瘤死亡率数据,并根据2000年的人群进行年龄调整和标准化。同年的SVI数据来自疾病预防控制中心有毒物质和疾病登记处数据库。估计每个SVI四分位数(SVI- q)和人口统计学亚组的年龄调整死亡率(AAMR)。结果我们发现,与SVI-Q1(最不脆弱)的县相比,SVI-Q4(最脆弱)的县具有更高的累积AAMR,占每10万人年4.48的额外死亡率。SVI-Q4中男性的AAMR高于SVI-Q1,占每10万人年9.96的额外死亡率,而SVI-Q4和SVI-Q1中女性人群的死亡率没有差异。SVI-Q4的AAMR在西班牙裔和非西班牙裔人群中都较高,除了美洲印第安人/阿拉斯加土著人群。在大都市县和非大都市县都观察到类似的趋势。结论我们的研究表明SVI可能在肺癌死亡率中起重要作用,并强调需要针对弱势群体进行干预以改善预后。
{"title":"Social vulnerability and lung malignancy mortality","authors":"Ramzi Ibrahim ,&nbsp;Lewjain Sakr ,&nbsp;Jennifer A. Lewis ,&nbsp;Roger Y. Kim ,&nbsp;Bryan S. Benn ,&nbsp;See-Wei Low","doi":"10.1016/j.jcpo.2023.100453","DOIUrl":"10.1016/j.jcpo.2023.100453","url":null,"abstract":"<div><h3>Introduction</h3><p>Lung cancer is a major cause of death in the United States. Social determinants of health<span><span> (SDOH) are important factors that impact the treatment and prognosis of lung cancer. The social vulnerability index (SVI) is a validated measure of SDOH. This cross-sectional study aimed to investigate the impact of the SVI on lung cancer mortality using </span>descriptive epidemiology.</span></p></div><div><h3>Methods</h3><p>Mortality data for lung malignancies from 2014 to 2018 was obtained from the CDC database and was age-adjusted and standardized to the population in the year 2000. The SVI for the same years was obtained from the CDC Agency for Toxic Substances and Disease Registry database. Age-adjusted mortality rates (AAMR) were estimated for each SVI quartile (SVI-Q) and demographic subgroup.</p></div><div><h3>Results</h3><p>We found that counties in SVI-Q4 (most vulnerable) had a higher cumulative AAMR compared to counties in SVI-Q1 (least vulnerable), accounting for a 4.48 excess death rate per 100,000 person-years. AAMR among males in SVI-Q4 was higher compared to SVI-Q1, accounting for a 9.96 excess death rate per 100,000 person-years, whereas no mortality differences were observed for female populations between SVI-Q4 and SVI-Q1. AAMR in SVI-Q4 was higher for both Hispanic and non-Hispanic populations, except for American Indian/Alaska Native populations. Similar trends were observed in both metropolitan and non-metropolitan counties.</p></div><div><h3>Conclusion</h3><p>Our study suggests that the SVI may play a significant role in lung cancer mortality and highlights the need for interventions targeting vulnerable populations to improve outcomes.</p></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399673","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}
引用次数: 0
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Journal of Cancer Policy
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