Limited real-world evidence exists on the economic burden of adverse events (AEs) to the healthcare system among patients with non-metastatic castration-resistant prostate cancer (nmCRPC) treated with second-generation androgen receptor antagonists (ARAs). Current data is needed to understand real-world clinical event rates among ARAs and the cost of these events. Describe the incidence of non-central nervous system (CNS)-related AEs and CNS-related AEs among nmCRPC patients treated in the United States with second-generation ARAs (apalutamide and enzalutamide) and evaluate healthcare resource utilization (HCRU) and costs for these patients. This was a retrospective observational cohort study using claims data from Optum Clinformatics Data Mart to identify adult males with prostate cancer, castration, no metastases, and >1 claim for apalutamide or enzalutamide. The study was conducted from January 2017 to March 2020, with a patient index identification period from January 2018 to December 2019. AEs were classified as CNS-related or non-CNS-related. Of 605 patients (156 apalutamide and 449 enzalutamide), most were ≥65 years (94%) and had ≥1 non-CNS-related AE (55%). Many had ≥1 CNS-related AE (32%). Pain (12%) and arthralgia (11%) were the most frequently reported non-CNS-related AEs. Fatigue/asthenia (14%) and dizziness (7%) were the most frequently reported CNS-related AEs. Among patients with versus without non-CNS-related AEs, 34% versus 8% had emergency room (ER) events, and 25% versus 2% had inpatient events. Among patients with versus without CNS-related AEs, 41% versus 14% had ER events, and 38% versus 4% had inpatient events. Adjusted per-patient per-year cost (in 2020 USD) differences were significant between patients with and without non-CNS-related AEs ($30,765, p = 0.0018) and between patients with and without CNS-related AEs ($40,689, p = 0.0017). There is significant HCRU and cost burden among nmCRPC patients treated with ARAs developing AEs, highlighting the need for treatments with improved tolerability. Additional studies are warranted to include recently approved agents.

Human papillomavirus (HPV) cause cancers in a variety of anatomic sites presenting at various stages of disease. Current economic assessments rely on HPV-related cancer cost estimates from data prior to the launch of the nonavalent HPV vaccine (2014). The goal of the present study was to assess and describe the current direct medical care burden of HPV-related cancers in the US. Using Clinformatics Data Mart, patients in the US who were newly diagnosed with cervical, vulvar, vaginal, anal, and oropharyngeal cancers between 2012 and 2015 were compared to non-cancer matched (propensity score) controls. Health care resource utilization and direct medical cost (2020 USD) were assessed over a 2-year follow-up period following index diagnosis from a payer perspective. The cost for censored time was estimated using generalized linear model while adjusting for survival probability using cox-proportional hazard model. Confidence intervals were calculated with bootstrapping technique. The analyses included 4128 cervical, 1580 vulvar, 538 vaginal, 1827 anal, and 6106 oropharyngeal cancers and matched controls. Cases and controls had similar baseline clinical characteristics and length of follow-up. The 2-year incremental direct medical costs were $93,272, $81,676, $141,096, $129,366, and $134,045 for cervical, vulvar, vaginal, anal, and oropharyngeal cancers respectively. Outpatient care costs was the biggest driver of the total incremental medical costs. Most cancer costs were incurred during the first 6 months of follow-up and then stabilized during follow-up. HPV-related cancers are responsible for substantial health care expenditure each year.

This collection contains 406 ROI masks in MATLAB format defining the low grade glioma (LGG) tumour region on T1-weighted (T1W), T2-weighted (T2W), T1-weighted post-contrast (T1CE) and T2-flair (T2F) MR images of 108 different patients from the TCGA-LGG collection. From this subset of 108 patients, 81 patients have ROI masks drawn for the four MRI sequences (T1W, T2W, T1CE and T2F), and 27 patients have ROI masks drawn for three or less of the four MRI sequences. The ROI masks were used to extract texture features in order to develop radiomic-based multivariable models for the prediction of isocitrate dehydrogenase 1 (IDH1) mutation, 1p/19q codeletion status, histological grade and tumour progression. Clinical data (188 patients in total from the TCGA-LGG collection, some incomplete depending on the clinical attribute), VASARI scores (188 patients in total from the TCGA-LGG collection, 178 complete) with feature keys, and source code used in this study are also available with this collection. Please contact Martin Vallières (mart.vallieres@gmail.com) of the Medical Physics Unit of McGill University for any scientific inquiries about this dataset.

PurposeInvestigating the association between red cell distribution width (RDW) and all-cause mortality in patients with breast cancer, to evaluate the potential clinical prognostic value of RDW.MethodsBased on the RDW index, patients with breast cancer in the Medical Information Mart for Intensive Care (MIMIC-IV) database were categorized into quartiles. The primary outcomes included in-hospital mortality from all causes during the first six months, the first year, and the first three years. Cox hazards regression and restricted cubic spline (RCS) models were developed to investigate the effects of RDW on primary outcomes.ResultsThe study included 939 patients (female). The 6-month, 1-year, and 3-year mortality rates were 14.0%, 21.4%, and 28.4%, respectively. Multivariate Cox proportional hazards analyses demonstrated that RDW exhibited an autonomous association with an increased risk of all-cause mortality. After adjusting for confounders, higher RDW quartiles were significantly associated with 6-month mortality (adjusted hazard ratio (HR), 3.197; 95% confidence interval (CI), 1.745–5.762; P < 0.001), 1-year mortality (adjusted HR, 2.978; 95% CI, 1.867–4.748; P < 0.001), and 3-year mortality (adjusted HR, 2.526; 95% CI, 1.701–3.750; P < 0.001). The RCS curves demonstrated that high RDW (> 14.6) was associated with a greater risk of all-cause mortality. Subgroup analyses revealed no statistically significant differences in the interactions between the subgroups.ConclusionThe study revealed a highly pronounced relationship between RDW and overall mortality, indicating its potential as an autonomous prognostic factor for increased mortality among patients with breast cancer.

AimTo identify predictors for in-hospital mortality in patients with metastatic cancer in intensive care units (ICUs) and established a prediction model for in-hospital mortality in those patients.MethodsIn this cohort study, the data of 2,462 patients with metastatic cancer in ICUs were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Least absolute shrinkage and selection operator (LASSO) regression analysis was applied to identify the predictors for in-hospital mortality in metastatic cancer patients. Participants were randomly divided into the training set (n = 1,723) and the testing set (n = 739). Patients with metastatic cancer in ICUs from MIMIC-IV were used as the validation set (n = 1,726). The prediction model was constructed in the training set. The area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were employed for measuring the predictive performance of the model. The predictive performance of the model was validated in the testing set and external validation was performed in the validation set.ResultsIn total, 656 (26.65%) metastatic cancer patients were dead in hospital. Age, respiratory failure, the sequential organ failure assessment (SOFA) score, the Simplified Acute Physiology Score II (SAPS II) score, glucose, red cell distribution width (RDW) and lactate were predictors for the in-hospital mortality in patients with metastatic cancer in ICUs. The equation of the prediction model was ln(P/(1 + P)) = −5.9830 + 0.0174 × age + 1.3686 × respiratory failure + 0.0537 × SAPS II + 0.0312 × SOFA + 0.1278 × lactate − 0.0026 × glucose + 0.0772 × RDW. The AUCs of the prediction model was 0.797 (95% CI,0.776–0.825) in the training set, 0.778 (95% CI, 0.740–0.817) in the testing set and 0.811 (95% CI, 0.789–0.833) in the validation set. The predictive values of the model in lymphoma, myeloma, brain/spinal cord, lung, liver, peritoneum/pleura, enteroncus and other cancer populations were also assessed.ConclusionThe prediction model for in-hospital mortality in ICU patients with metastatic cancer exhibited good predictive ability, which might help identify patients with high risk of in-hospital death and provide timely interventions to those patients.

I denne Eurobarometerrunde blev respondenternes holdninger til typiske Eurobarometer-foranstaltninger som f.eks. offentlighedens bevidsthed om og holdninger til Den Europæiske Union (EU) undersøgt. Desuden var der fokus på forbrug på tværs af grænserne, tobaksvaner og kræftrisiko. Respondenterne blev spurgt om deres køb af forbrugerprodukter fra andre medlemsstater, deres tilfredshed med dem og eventuelle klager vedrørende deres køb. Der blev også stillet spørgsmål om holdninger til rygning og faktiske rygevaner. Mere specifikt blev der stillet spørgsmål om, hvilke typer tobaksvarer der anvendes, antallet af cigaretter, der forbruges dagligt, rygernes ønske om at begrænse deres forbrug, rygeres og ikke-rygeres holdning til brugen af tobaksvarer på offentlige steder, udtalelser om rygeforbud på visse offentlige steder, holdninger til rygning på arbejdspladsen og tobaksreklamer. En række spørgsmål vedrørende alvorlige sygdomme, kræftforebyggelse, omstændigheder, der øger risikoen for kræft, og viden om den europæiske kræfthandlingsplan "Den Europæiske Kræftkodeks" (et sæt grundforordninger udarbejdet af et udvalg af kræfteksperter til forebyggelse af kræft). Der blev indsamlet demografiske oplysninger om antallet af personer i husstanden, bystørrelse, husstandsindkomst og tilknyttet region. Andre baggrundsoplysninger, der blev indsamlet, var respondentens alder, køn, civilstand, alder ved afslutningen af uddannelse, nuværende og tidligere erhverv og selvstilling på venstrefløjens politiske skala. I denne Eurobarometerrunde blev respondenternes holdninger til typiske Eurobarometer-foranstaltninger som f.eks. offentlighedens bevidsthed om og holdninger til Den Europæiske Union (EU) undersøgt. Desuden var der fokus på forbrug på tværs af grænserne, tobaksvaner og kræftrisiko. Respondenterne blev spurgt om deres køb af forbrugerprodukter fra andre medlemsstater, deres tilfredshed med dem og eventuelle klager vedrørende deres køb. Der blev også stillet spørgsmål om holdninger til rygning og faktiske rygevaner. Mere specifikt blev der stillet spørgsmål om, hvilke typer tobaksvarer der anvendes, antallet af cigaretter, der forbruges dagligt, rygernes ønske om at begrænse deres forbrug, rygeres og ikke-rygeres holdning til brugen af tobaksvarer på offentlige steder, udtalelser om rygeforbud på visse offentlige steder, holdninger til rygning på arbejdspladsen og tobaksreklamer. En række spørgsmål vedrørende alvorlige sygdomme, kræftforebyggelse, omstændigheder, der øger risikoen for kræft, og viden om den europæiske kræfthandlingsplan "Den Europæiske Kræftkodeks" (et sæt grundforordninger udarbejdet af et udvalg af kræfteksperter til forebyggelse af kræft). Der blev indsamlet demografiske oplysninger om antallet af personer i husstanden, bystørrelse, husstandsindkomst og tilknyttet region. Andre baggrundsoplysninger, der blev indsamlet, var respondentens alder, køn, civilstand, alder ved afslutningen af uddannelse, nuværende og tidligere erhverv og selvstilling på venstrefløjens politiske skala.