Comparative Effectiveness of Palliative Chemotherapy in Metastatic Breast Cancer: A Real-World Evidence Analysis.

Comparative Effectiveness of Palliative Chemotherapy in Metastatic Breast Cancer: A Real-World Evidence Analysis. Oncologist. 2020 Jan 17;: Authors: Feinberg B, Kish J, Dokubo I, Wojtynek J, Gajra A, Lord K Abstract BACKGROUND: In the absence of randomized controlled trials, real-world evidence may aid practitioners in optimizing the selection of therapy for patients with cancer. The study's aim was to determine real-word use, as well as compare effectiveness, of single-agent and combination chemotherapy as palliative treatment for female patients with metastatic breast cancer (mBC). MATERIALS AND METHODS: Using administrative claims data from the Symphony Health's Integrated Oncology Dataverse, female patients with mBC treated with at least one chemotherapy-only treatment (COT) between January 1, 2013, and December 31, 2017 were selected. The frequency of use of single-agent versus combination chemotherapy overall and by line of therapy (LOT) was calculated whereas effectiveness was measured using time to next treatment (TNT). RESULTS: A total of 12,381 patients with mBC were identified, and 3,777 (31%) received at least one line of COT. Of the 5,586 observed LOTs among the 3,777 patients, 66.5% were single-agent and 33.5% combination chemotherapy. Combination chemotherapy was most frequently used in first-line (45%) and least frequently in fifth-line (16%). Across all LOTs, median TNT was significantly longer for single-agent versus combinati...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research

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CONCLUSION: We present a case that underlines the importance of specialized PC assessment not limited to the control of symptoms. The search for the etiopathogenesis of a patient's symptoms and the evaluation of overall clinical conditions may be necessary to plan appropriate diagnostic evaluations, target palliative therapies, and achieve effective symptom control. PMID: 32008478 [PubMed - as supplied by publisher]
Source: Tumori - Category: Cancer & Oncology Tags: Tumori Source Type: research
Conclusion: The evidence obtained from the review suggests that pedometer-based walking programs have a positive impact on cancer-related fatigue and overall quality of life of patients with breast cancer receiving chemotherapy.
Source: Indian Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research
We present the case of a 63-year-old patient that was diagnosed in another Clinic with squamous skin carcinoma, but, after complete resection in our Hospital, it was proven to be breast cancer. At diagnosis, computed tomography (CT) scan showed local disease. Adjuvant treatment, consisting in chemotherapy and radiotherapy, was administered. At the beginning of hormonal therapy, the patient had a new CT scan that showed liver and bone metastases. The patient started palliative hormonal treatment with bisphosphonates. The aim of the study was to highlight both the importance of early diagnosis and treatment and the aggressiv...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
This report reviews the use of hypomethylating agents (HMAs) to treat a 57-year-old woman newly diagnosed with MDS during palliative chemotherapy for metastatic breast cancer. Over a period of 6 years, the patient received several DNA-damaging chemotherapeutics including doxorubicin, cyclophosphamide, and paclitaxel. Repeated thrombocytopenia was the main reason for suspecting secondary hematologic malignancy. She was diagnosed with t-MDS based on bone marrow examination and her treatment history for breast cancer. While azacitidine was originally administered to stabilize MDS, it also stabilized the patient's lung and lym...
Source: Journal of Breast Cancer - Category: Cancer & Oncology Tags: J Breast Cancer Source Type: research
Abstract BACKGROUND: Assessing survival risk is important for discussing treatment options with estrogen receptor-positive (ER+) advanced breast cancer (ABC) patients. However, there are few reports from large-scale databases on the survival risk factors in ER+ ABC. The Safari study (UMIN000015168) was a retrospective, multicenter cohort study involving 1072 Japanese patients receiving fulvestrant 500 mg mostly as a second- or later-line endocrine therapy for ER+ ABC. The follow-up data after the Safari study were examined, focusing on any relationship between clinicopathological factors and overall survival ...
Source: Breast Cancer - Category: Cancer & Oncology Authors: Tags: Breast Cancer Source Type: research
Conclusions: In patients with two cancers, lung cancer is usually the second event, presumably due to comorbidity, survival and our unique population e.g. radical vs adjuvant or palliative intent. The commonest first cancers were breast and prostate. Prostate, bladder and colon cancer developed lung cancer earlier than breast cancer. These data help to inform which cancer types are likely to develop lung cancer and influence tumour surveillance strategies.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Source Type: research
by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Ano...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: cancer opioids pain rosielle The profession Source Type: blogs
Rationale: Ovarian cancer often metastasizes, but it is unusual to transfer to the breast as an isolated mass. In particular, it is rare for patients to have breast metastases after 18 years of diagnosis of ovarian cancer. Therefore, accurate identification of ovarian cancer mammary gland metastasis can contribute to the treatment of the disease. Patient concerns: This case report shows that an 82-year-old woman was diagnosed with breast metastases from ovarian cancer diagnosed 18 years ago. The patient underwent total uterine attachment, omentum, pelvic lymphadenectomy, pelvic floor tumor reduction, and chemotherapy ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract PURPOSE: Addressing unwarranted clinical variation in oncology is a high priority for health systems that aspire to ensure consistent levels of high-quality and cost-effective care. Efforts to improve clinical practice and standardize care have proven challenging. Advocate Physician Partners undertook a patient simulation-based practice measurement and feedback project that was focused on breast and lung cancer to engage oncologists in the care standardization process. METHODS: One hundred three medical oncologists cared for online simulated patients using the Clinical Performance and Value platform,...
Source: JOP - Category: Gastroenterology Authors: Tags: J Oncol Pract Source Type: research
ConclusionDespite the relative lack of evidence in this specific context, our review shows that breast cancer patients naturally value greater benefit and, in scenarios of advanced and metastatic disease, are willing to face risks of some side effects for gains in survival.
Source: The Patient - Patient-Centered Outcomes Research - Category: International Medicine & Public Health Source Type: research
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