H J M Smit1, J Aerts2, M van den Heuvel3, T J N Hiltermann4, I Bahce5, E F Smit6, A-M C Dingemans7, L E Hendriks7, J A Stigt8, F M N H Schramel9, H van Tinteren6, H J M Groen10. 1. Department of Pulmonary Diseases, Rijnstate Hospital, Arnhem, the Netherlands. 2. Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, the Netherlands. 3. Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, the Netherlands. 4. Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands. 5. Department of Pulmonary Diseases, Amsterdam University Medical Center, Amsterdam, the Netherlands. 6. Department of Thoracic Oncology, Antoni Van Leeuwenhoek Hospital, Amsterdam, the Netherlands. 7. Department of Pulmonary Diseases, University Medical Center Maastricht, Maastricht, the Netherlands. 8. Department of Pulmonary Diseases, Isala Hospital, Zwolle, the Netherlands. 9. Department of Pulmonary Diseases, St. Antonius Hospital, Nieuwegein, the Netherlands. 10. Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands. Electronic address: h.j.m.groen@umcg.nl.
Abstract
OBJECTIVE: Phase III studies of checkpoint inhibitors changed the therapeutic landscape for lung cancer. In 2015 the Dutch Society of Chest Physicians (NVALT) introduced a national immunotherapy registry for patients with lung cancer; quality standards for hospitals were implemented. At population level we studied clinical benefit in daily practice and in patients who are underrepresented in phase III trials. MATERIALS AND METHODS: From the initial introduction of checkpoint inhibitors in the Netherlands patients were centrally registered. Educational programs and quality control were provided under supervision of NVALT. The largest immunotherapy providing hospitals were compared to hospitals who provided less checkpoint inhibitors as marker of experience. Patients characteristics, treatment and side effects, response rate and survival were studied. RESULTS: A total of 2676 patients were registered, 2302 with follow up data were evaluated. Between October 2015 and December 2017 a gradual increase from 12 to 30 qualified hospitals showed no major toxicity differences. Toxicity led to a hospital admission rate of 9.1 with an average duration of 10.4 days. Overall tumor response was 21.8 % and median overall survival 12.6 months. Overall survival was not significantly different for patients aged ≥ 75 years, those having brain metastases or selected auto-immune diseases before start checkpoint inhibitors compared to younger patients or those without, respectively. Survival outcomes were worse in patients with PS 2+, non-smokers, and patients who received any palliative radiotherapy (HR 2.1, 95 % CI 1.7-2.7; 1.3, 95 % CI 1.0-1.6 and 1.2, 95 % CI 1.1-1.4, respectively). CONCLUSIONS: Changes in the therapeutic landscape did not lead to major differences in quality of care between hospitals. Elderly patients, those with brain metastases or selected auto-immune disease underrepresented in clinical trials did not do worse on checkpoint inhibitors, except for those with PS 2 + .
OBJECTIVE: Phase III studies of checkpoint inhibitors changed the therapeutic landscape for lung cancer. In 2015 the Dutch Society of Chest Physicians (NVALT) introduced a national immunotherapy registry for patients with lung cancer; quality standards for hospitals were implemented. At population level we studied clinical benefit in daily practice and in patients who are underrepresented in phase III trials. MATERIALS AND METHODS: From the initial introduction of checkpoint inhibitors in the Netherlands patients were centrally registered. Educational programs and quality control were provided under supervision of NVALT. The largest immunotherapy providing hospitals were compared to hospitals who provided less checkpoint inhibitors as marker of experience. Patients characteristics, treatment and side effects, response rate and survival were studied. RESULTS: A total of 2676 patients were registered, 2302 with follow up data were evaluated. Between October 2015 and December 2017 a gradual increase from 12 to 30 qualified hospitals showed no major toxicity differences. Toxicity led to a hospital admission rate of 9.1 with an average duration of 10.4 days. Overall tumor response was 21.8 % and median overall survival 12.6 months. Overall survival was not significantly different for patients aged ≥ 75 years, those having brain metastases or selected auto-immune diseases before start checkpoint inhibitors compared to younger patients or those without, respectively. Survival outcomes were worse in patients with PS 2+, non-smokers, and patients who received any palliative radiotherapy (HR 2.1, 95 % CI 1.7-2.7; 1.3, 95 % CI 1.0-1.6 and 1.2, 95 % CI 1.1-1.4, respectively). CONCLUSIONS: Changes in the therapeutic landscape did not lead to major differences in quality of care between hospitals. Elderly patients, those with brain metastases or selected auto-immune disease underrepresented in clinical trials did not do worse on checkpoint inhibitors, except for those with PS 2 + .
Authors: Christine M Cramer-van der Welle; Marjon V Verschueren; Merel Tonn; Bas J M Peters; Franz M N H Schramel; Olaf H Klungel; Harry J M Groen; Ewoudt M W van de Garde Journal: Sci Rep Date: 2021-03-18 Impact factor: 4.379
Authors: Nam Phong Nguyen; Brigitta G Baumert; Eromosele Oboite; Micaela Motta; Gokula Kumar Appalanaido; Meritxell Arenas; Pedro Carlos Lara; Marta Bonet; Alice Zamagni; Te Vuong; Tiberiu Popescu; Ulf Karlsson; Lurdes Trigo; Arthur Sun Myint; Juliette Thariat; Vincent Vinh-Hung Journal: Gerontology Date: 2021-03-30 Impact factor: 5.140
Authors: Mathias Schlögl; Anand S Iyer; Florian Riese; David Blum; Lanier O'Hare; Tejaswini Kulkarni; Sophie Pautex; Jan Schildmann; Keith M Swetz; Pallavi Kumar; Christopher A Jones Journal: J Palliat Med Date: 2021-07-14 Impact factor: 2.947