Marjolaine Gauthier-Loiselle

Real-world Characteristics and Outcomes of Patients With Metastatic Castration-resistant Prostate Cancer Receiving Chemotherapy Versus Androgen Receptor-targeted Therapy After Failure of First-line Androgen Receptor-targeted Therapy in the Community Setting

Background In metastatic castration‐resistant prostate cancer (mCRPC), optimal treatment sequences are unknown. We assessed second‐line taxane (TT) versus androgen receptor‐targeted therapy (ART), after initial ART failure, in United States oncology community practices. Patients and Methods Using electronic medical records, patients with mCRPC receiving first‐line ART and second‐line therapy (TT, ART) were identified. Response and overall survival (OS) were evaluated from second‐line therapy initiation. Multivariate analyses were adjusted for year, age, metastases, opioid use, prostate‐specific antigen (PSA), hemoglobin, alkaline phosphatase, and albumin levels. Results Of 546 patients receiving first‐line ART, 206 and 340 received second‐line TT and ART. Compared with patients receiving second‐line ART, patients receiving TT were younger (median, 74 vs. 79 years), more had intermediate‐high Halabi risk scores (59% vs. 35%), had higher opioid use (42% vs. 22%), median PSA (116 vs. 48 ng/mL), alkaline phosphatase (112 vs. 87 U/L), and lactate dehydrogenase (254 vs. 201 U/L), and had lower hemoglobin (11.2 vs. 12.3 g/dL) and albumin levels (3.8 vs. 4.0 g/dL); all P < .001. Response rates were higher with second‐line TT versus ART (clinical response, 44.2% vs. 24.7%; P = .006; PSA response, 44.5% vs. 28.7%; P = .004). OS did not differ between cohorts (hazard ratio [HR], 0.90; P = .511). Among patients with a poor prognosis (hemoglobin < 11 g/d; albumin < lower limit of normal), those receiving second‐line TT versus ART showed improved OS (HR, 0.52; P = .004 and HR, 0.36; P = .003, respectively). Conclusions Despite more severe disease profiles, patients with mCRPC receiving second‐line TT versus ART achieved higher response rates after initial ART. Poor prognosis patients had improved OS with second‐line TT versus ART. Microabstract Optimal treatment sequences for metastatic castration‐resistant prostate cancer are unknown. This retrospective study assessed outcomes in patients with metastatic castration‐resistant prostate cancer receiving second‐line taxane chemotherapy versus second‐line androgen receptor‐targeted therapy (ART), after failure of first‐line ART, in a real‐world setting. In patients who have previously recieved ART, second‐line taxane chemotherapy, versus alternative ART, may be associated with improved outcomes, particularly among patients with a worse disease prognosis.

The risk of cardiovascular events in psoriasis patients treated with tumor necrosis factor–α inhibitors versus phototherapy: An observational cohort study

Background: Psoriasis is a risk factor for cardiovascular events. Objective: To assess the risk of major cardiovascular events and the effect of cumulative treatment exposure on cardiovascular event risk in patients with psoriasis treated with tumor necrosis factor–&agr; inhibitors (TNFis) versus phototherapy. Methods: Adult patients with psoriasis were selected from a large US administrative claims database (from the first quarter of 2000 through the third quarter of 2014) and classified in 2 mutually exclusive cohorts based on whether they were treated with TNFis or phototherapy. Cardiovascular event risk was compared between cohorts using multivariate Cox proportional hazards models. Cumulative exposure was defined based on treatment persistence. Results: A total of 11,410 TNFi and 12,433 phototherapy patients (psoralen plus ultraviolet A light phototherapy, n = 1117; ultraviolet B light phototherapy, n = 11,316) were included in this study. TNFi patients had a lower risk of cardiovascular events compared to phototherapy patients (adjusted hazard ratio 0.77, P < .05). The risk reduction associated with 6 months of cumulative exposure was 11.2% larger for patients treated with TNFis compared to phototherapy (P < .05). Limitations: Information on psoriasis severity and mortality was limited/not available. Conclusions: Patients with psoriasis who were treated with TNFis exhibited a lower cardiovascular event risk than patients treated with phototherapy. Cumulative exposure to TNFis was associated with an incremental cardiovascular risk reduction compared to phototherapy.

Patient and Caregiver Burden Associated With Fragile X Syndrome in the United States

This study evaluated the incremental healthcare costs associated with Fragile X syndrome (FXS) for patients and their caregivers. Using administrative healthcare claims data (1999-2012), subjects with ≥ 1 FXS diagnosis (ICD-9-CM: 759.83) were matched 1:5 with non-FXS controls using high-dimensional propensity scores. Costs and resource utilization were examined. Among employees, payment for disability leave and absenteeism were also examined. We identified 590 FXS and 2,950 non-FXS individuals along with 647 and 2,611 caregivers, respectively. FXS patients and their caregivers experienced higher all-cause direct costs compared to control cohorts (total[SD]:

Economic burden following allogeneic hematopoietic stem cell transplant in patients with diffuse large B-cell lymphoma

14,677[46,752] vs.

Validation of a New Risk Measure for Chronic Obstructive Pulmonary Disease Exacerbation Using Health Insurance Claims Data.

6,103[26,081];

Assessment of costs associated with adverse events in patients with cancer

5,259[19,360] vs.

Real-world outcomes in patients with metastatic castration-resistant prostate cancer receiving second-line chemotherapy versus an alternative androgen receptor-targeted agent (ARTA) following early progression on a first-line ARTA in a US community oncology setting

2,120[6,425], respectively, p < 0.05). Employed FXS patients and caregivers had higher indirect costs compared to their controls (total[SD]:

Abstract P5-21-03: Delay in trastuzumab initiation leads to decreased overall survival in patients with HER2+ early stage breast cancer

4,477[5,161] vs.

Survival in patients with non-metastatic breast cancer treated with adjuvant trastuzumab in clinical practice

1,751[2,556];

Delay in initiation of adjuvant trastuzumab therapy leads to decreased overall survival and relapse-free survival in patients with HER2-positive non-metastatic breast cancer.

2,641[4,238] vs.