Tilley Jenkins Vogel1, Christie Jeon2, Beth Karlan3, Christine Walsh4. 1. Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 West Tower, Los Angeles, CA 90048, USA. Electronic address: tilley.jenkinsvogel@cshs.org. 2. Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard 1S33, Los Angeles, CA 90048, USA. Electronic address: christie.jeon@cshs.org. 3. Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 West Tower, Los Angeles, CA 90048, USA. Electronic address: beth.karlan@cshs.org. 4. Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 West Tower, Los Angeles, CA 90048, USA. Electronic address: christine.walsh@cshs.org.
Abstract
OBJECTIVES: Both in vitro and clinical trial data suggest that cardiac glycosides demonstrate a synergistic anti-tumor effect when administered with platinum chemotherapy. Epidemiologic studies have also demonstrated improved cancer survival in colorectal, breast, head and neck and hepatocellular carcinoma patients on digoxin therapy at the time of cancer treatment. We sought to determine whether digoxin improves survival in epithelial ovarian cancer patients treated with platinum. METHODS: Surveillance, Epidemiology and End-Results (SEER) tumor registries program data on ovarian cancer patients diagnosed in 2007-2009 were linked to Medicare claims data to capture platinum administration, digoxin use and cardiac comorbidities. We analyzed 762 patients who underwent cancer-directed surgery and received platinum chemotherapy. Patients were considered digoxin users during platinum administration if a prescription was filled within 6months of cancer diagnosis. Cox proportional hazards regression models were used to determine the impact of digoxin use on overall survival (OS). RESULTS: Among 762 epithelial ovarian cancer patients treated with surgery and platinum chemotherapy, 53 (7%) used digoxin ever and 38 (5%) used digoxin specifically during platinum administration. Adjusting for age, heart disease and Charlson comorbidity score, digoxin use was not associated with OS (HR=1.29, 95% CI 0.81, 2.06). CONCLUSIONS: In this SEER-Medicare database analysis, digoxin use during chemotherapy was not associated with improved OS outcomes in patients with epithelial ovarian cancer treated with surgery and platinum chemotherapy. These conclusions are limited, however, by a small sample size and bias intrinsic to claims-based data and should be further evaluated in a larger cohort.
OBJECTIVES: Both in vitro and clinical trial data suggest that cardiac glycosides demonstrate a synergistic anti-tumor effect when administered with platinum chemotherapy. Epidemiologic studies have also demonstrated improved cancer survival in colorectal, breast, head and neck and hepatocellular carcinomapatients on digoxin therapy at the time of cancer treatment. We sought to determine whether digoxin improves survival in epithelial ovarian cancerpatients treated with platinum. METHODS: Surveillance, Epidemiology and End-Results (SEER) tumor registries program data on ovarian cancerpatients diagnosed in 2007-2009 were linked to Medicare claims data to capture platinum administration, digoxin use and cardiac comorbidities. We analyzed 762 patients who underwent cancer-directed surgery and received platinum chemotherapy. Patients were considered digoxin users during platinum administration if a prescription was filled within 6months of cancer diagnosis. Cox proportional hazards regression models were used to determine the impact of digoxin use on overall survival (OS). RESULTS: Among 762 epithelial ovarian cancerpatients treated with surgery and platinum chemotherapy, 53 (7%) used digoxin ever and 38 (5%) used digoxin specifically during platinum administration. Adjusting for age, heart disease and Charlson comorbidity score, digoxin use was not associated with OS (HR=1.29, 95% CI 0.81, 2.06). CONCLUSIONS: In this SEER-Medicare database analysis, digoxin use during chemotherapy was not associated with improved OS outcomes in patients with epithelial ovarian cancer treated with surgery and platinum chemotherapy. These conclusions are limited, however, by a small sample size and bias intrinsic to claims-based data and should be further evaluated in a larger cohort.
Authors: Wei-Lun Chen; Yulin Ren; Jinhong Ren; Christian Erxleben; Michael E Johnson; Saverio Gentile; A Douglas Kinghorn; Steven M Swanson; Joanna E Burdette Journal: J Nat Prod Date: 2017-02-24 Impact factor: 4.050
Authors: Thomas Crezee; Marika H Tesselaar; James Nagarajah; Willem E Corver; Johannes Morreau; Catrin Pritchard; Shioko Kimura; Josephina G Kuiper; Ilse van Engen-van Grunsven; Jan W A Smit; Romana T Netea-Maier; Theo S Plantinga Journal: Cell Oncol (Dordr) Date: 2021-02-03 Impact factor: 6.730