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Publications (119)
e21119
Background: Polypharmacy is an independent prognostic factor in older patients with lung cancer treated with immune checkpoint inhibitors (ICIs). Previous studies have shown that steroids, opioids, proton pump inhibitors, fluoroquinolone are associated with worsening overall survivals for lung cancer patients. The prevalence of drug use amon...
6590
Background: Immune checkpoint inhibitors (ICIs) have rapidly become the treatment of choice for multiple cancer types. However, the relationship between the timing of immunosuppressive agents, such as steroids use, preceding ICI initiation and subsequent treatment outcomes remains unknown due to lack of data. This study was undertaken to addre...
4530
Background: FGFRa appear in approximately 15% of cases of mUC. Data on whether FGFRa in mUC have a prognostic impact or predictive benefit for particular treatments have been limited by small sample sizes. The objective of this study was to evaluate the association between tumor FGFRa and clinical outcomes of patients with advanced UC or mUC r...
Background: Immune checkpoint inhibitors (ICIs) have revolutionized melanoma management and are now standard of care. While sex is associated with immune function and immune-related diseases, the interplay between sex and ICIs is under-studied. Therefore, we examined whether cancer immunotherapy effectiveness varied between female and male patients...
Polypharmacy poses a significant public health problem that disproportionately affects older adults (≥65 years) since this population represents the largest consumers of medications. Clinicians caring for older adults with cancer must rely on evidence to understand polypharmacy and its implications, not only to communicate with patients and other h...
e19020
Background: The rate of obesity in adults is 34% in the city of Philadelphia, with rates being highest among non-Hispanic blacks and Hispanics. We sought to evaluate how BMI varies by age and race/ethnicity at time of initial encounter for a breast cancer (BC) diagnosis (dx), and investigate factors predictive of BMI change in the first 2 ye...
9051
Background: Patients (pts) with resectable stage IB (≥4cm)-IIIA non-small-cell lung cancer (NSCLC) derive modest overall survival benefit with neoadjuvant or postoperative adjuvant chemotherapy. Neoadjuvant therapy can speed the discovery of promising regimens by using pathologic response as a surrogate for OS. Major pathologic response (MPR),...
Objectives
Polypharmacy (≥5 concurrent medications) is common among older patients with cancer (48%–80%) and associated with increased frailty, morbidity, and mortality. This study examined the relationship between polypharmacy and inpatient hospitalization among older adults with cancer treated with intravenous (IV) chemotherapy.
Materials and Me...
e16581
Background: Prostate cancer (PCa) incidence and mortality disproportionately burden African American (AA) men compared to Caucasian American (CA) men. An interplay of biological, social, and health care factors is blamed for this disparity. However, a recent multi-center study of the Veterans Affairs population found no differences in cancer...
e13118
Background: Immune checkpoint inhibitors (ICIs), especially ipilimumab (ipi) and nivolumab (nivo), have received approvals from the U.S. Food and Drug Administration for the treatment of multiple tumor types. These medications have shown great promise in the treatment of several malignancies but are associated with immune-related adverse eve...
6537
Background: Evidence suggests that cancer patients who receive palliative care early in their disease have improved quality of life, decreased emergency department (ED) visits, and less aggressive end-of-life care. In 2017, the Sidney Kimmel Cancer Center at Jefferson established the Neu Center for Supportive Medicine and Cancer Survivorship (...
9567
Background: The relationship between immunosuppressants and immunotherapy (IO) is an active area of research. Here we study the impact of pre-treatment steroid use on the completion of ipilimumab (ipi) therapy. Methods: This population-based study identified patients diagnosed with melanoma and treated with ipi (brand name Yervoy) in 2010-2014...
121
Background: It is uncertain whether the same criteria for active surveillance can be applied universally across races. This population-based study was undertaken to quantify racial differences in long-term risk of prostate cancer-specific mortality (PCSM) among patients with low-risk prostate cancer (PCa) receiving conservative management. Meth...
18
Background: Prostate specific antigen (PSA) detection in blood is widely used to screen for prostate cancer (PCa). However, PSA has limited utility in discriminating tumors at high risk of progression from indolent-low risk tumors, which leads to PCa overtreatment and highlights the need to identify better biomarkers for the detection of clinica...
Background
Men with locally advanced prostate cancer (LAPCa) or regionally advanced prostate cancer (RAPCa) are at high risk for death from their disease. Clinical guidelines support multimodal approaches, which include radical prostatectomy (RP) followed by radiotherapy (XRT) and XRT plus androgen deprivation therapy (ADT). However, there are limi...
202
Background: Metformin and statin together may delay prostate cancer (CaP) metastasis. However, the joint effects on CaP mortality remain unknown. This study is to quantify individual and joint effects of post diagnostic statin and metformin use on CaP mortality in survivors with high-risk CaP. Methods: This population-based study includes patie...
319
Background: Data from clinical trials has shown that octogenarians are at increased risk for prostate cancer specific mortality (PCSM). Patients with significant comorbidities were excluded from the trials; consequently, the findings from clinical trials may not be applicable to the general population. Data on patients age 80+ with metastatic p...
e16563
Background: This population-based study assesses the relationship between insurance status and survival outcomes among men with prostate cancer diagnosed before 65 years of age. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 114,871 prostate cancer patients diagnosed before age 65 in 2007-2013....
5048
Background: Disparity in prostate cancer (CaP) incidence and mortality for African American (AA) versus Caucasian American (CA) men may reflect tumor biology, comorbidity, treatment, follow-up care, and/or health care access. In a racially diverse cohort of patients undergoing radical prostatectomy (RP), this study examined how race, comorbidi...
e16553
Background: This population-based study assesses the relationship between insurance status and patterns of prostate cancer diagnosis and treatment among men under age 65. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 114,871 prostate cancer patients who were diagnosed before 65 between January...
This population-based study assesses whether a proposed five-tiered Gleason grade grouping (GGG) system predicts prostate cancer–specific mortality (PCSM). Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 331 320 prostate cancer patients who had primary and secondary Gleason patterns diagnosed between January 200...
Introduction: About 32% of men with high-risk prostate cancer have comorbidities, conditions that may be under-represented in randomized clinical trials (RCTs). Because men enrolled on RCTs are often excluded if they have multiple comorbidities, these patients may be at higher risk for serious toxicities from cancer therapies that the results of RC...
Purpose:
Certificate of Need (CON) laws are optional from state to state, and are meant to limit proliferation of certain unnecessary medical facilities. Theoretically, CON should limit the use of IMRT (intensity modulated radiation therapy) in the population who likely would benefit from it the least: older or debilitated men with low risk prosta...
Obesity-related dysregulation of the insulin-glucose axis is hypothesized in carcinogenesis. We studied impaired fasting glucose (IFG) and other markers of insulin-glucose metabolism in the Framingham Heart Study-Offspring Cohort, which uniquely tracks these markers and cancer >37 years.
Participants were recruited between 1971 and 1975 and followe...
BACKGROUND: Data regarding the difference in the clinical course from metastasis to prostate cancer-specific mortality (PCSM) following radical prostatectomy (RP) compared with radiation therapy (RT) are lacking. OBJECTIVE: To examine the association between primary treatment modality and prostate cancer-specific survival (PCSS) after metastasis. D...
Expert's summary: The Prostate Cancer Intervention Versus Observation Trial (PIVOT) randomized 731 men with localized prostate cancer (PCa) to radical prostatectomy or observation. After a median follow-up of 10.0 yr, 5.8% of patients in the radical prostatec-tomy arm and 8.4% of patients in the observation arm died of PCa (hazard ratio [HR]: 0.64;...
204
Background: Certificate of Need (CON) laws are optional from state to state, and are meant to limit proliferation of certain unnecessary medical facilities. Theoretically, CON should limit the use of IMRT (intensity modulated radiation therapy) in the population who likely would benefit from it the least: older or debilitated men with low risk...
98
Background: This study addresses whether the recent favorable survival trends observed among contemporary prostate cancer patients can be extended to African American men who have historically suffered excess prostate cancer mortality. Methods: The study cohort consisted of men over age 65, who resided in the SEER catchment area and were diagnos...
Unlabelled:
WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Receipt of androgen deprivation therapy (ADT) has been associated with an increased risk of skeletal-associated complications, such as a decrease in bone mineral density and an increase in fracture risk. Many men with pre-existing health conditions receive ADT as their primary...
Purpose:
Radiation therapy is a common treatment for localized prostate cancer but long-term data are sparse on treatment related toxicity compared to observation. We evaluated the time course of grade 2-4 genitourinary toxicities in men treated with primary radiation or observation for T1-T2 prostate cancer.
Materials and methods:
We performed...
Background
Metastasis is a crucial endpoint for patients with prostate cancer (PCa), but currently lacks a validated claims-based algorithm for detection.
Objective
To develop an algorithm using ICD-9 codes to facilitate accurate reporting of PCa metastases.
Methods
Medical records from 300 men hospitalized at Robert Wood Johnson University Hospi...
Longitudinal associations between leisure-time physical activity (LTPA) and overall cancer mortality were evaluated within the Third National Health and Nutrition Examination Survey (NHANES III; 1988–2006;
n
=
15,535). Mortality status was ascertained using the National Death Index. Self-reported LTPA was divided into inactive, regular low-to-mod...
Background:
Despite evidence that shows no survival advantage, many older patients receive primary androgen-deprivation therapy (PADT) shortly after the diagnosis of localized prostate cancer (PCa).
Objective:
This study evaluates whether the early use of PADT affects the subsequent receipt of additional palliative cancer treatments such as chem...
To quantify the downstream impact of PSA testing on cancer characteristics and utilization of cancer therapies among men aged 70 or older, we utilized patients diagnosed with prostate cancer in 2004-2005 in the Surveillance, Epidemiology and End Results (SEER)-Medicare and their Medicare claims before their cancer diagnosis during 2000-2005. Among...
Radiation therapy is commonly used to treat localized prostate cancer; however, representative data regarding treatment-related toxicities compared with conservative management are sparse.
To evaluate gastrointestinal (GI) toxicities in men treated with either primary radiation or conservative management for T1-T2 prostate cancer.
We performed a po...
The aim of this study was to assess the treatment patterns and 3-12-month complication rates associated with receiving prostate cryotherapy in a population-based study. Men >65 years diagnosed with incident localized prostate cancer in Surveillance Epidemiology End Results (SEER)-Medicare-linked database from 2004 to 2005 were identified. A total o...
- [...]
73
Background: Radiation therapy is commonly employed for localized prostate cancer; however, there is little data regarding the comparative effectiveness of radiation therapy (RAD) vs. conservative management (CM).
Methods: We performed a population-based cohort study, using Medicare claims data linked to the Surveillance, Epidemiology, and End Re...
64
Background: Radiation therapy (RAD) is commonly employed to treat localized prostate cancer; however, representative data regarding treatment related toxicities compared to conservative management (CM) is sparse.
Methods: We performed a population-based cohort study, using Medicare claims data linked to the Surveillance, Epidemiology, and End Re...
Although elderly men, particularly patients with low-risk prostate cancer and a life expectancy less than 10 years, are unlikely to benefit from prostate cancer active therapy, treatment rates in this group are high.
By using the population-based Surveillance, Epidemiology, and End Results program linked to Medicare data from 2004 to 2005, we exami...
To provide patients and clinicians more accurate estimates of comorbidity-specific survival stratified by patient age, tumor stage, and tumor grade.
We conducted a 10-year competing risk analysis of 19,639 men 66 years of age and older identified by the Surveillance, Epidemiology, and End Results (SEER) program linked to Medicare program files. All...
Previous studies suggest that obesity is associated with higher prostate cancer progression and mortality despite an association with lower prostate cancer incidence. This study aims to better understand these apparently inconsistent relationships among obese men by combining evidence from 3 nationally representative cross-sectional surveys.
We eva...
Despite controversy over the benefit of prostate-specific antigen (PSA) screening, little is known about risk profiles and treatment patterns in men diagnosed as having prostate cancer who have a PSA value less than or equal to 4.0 ng/mL.
We used data from the Surveillance, Epidemiology, and End Results system to describe patient characteristics an...
Perhaps more so than with almost any other common cancer over the past one or two decades, we have witnessed an extraordinary change in the presenting characteristics of men with prostate cancer. Whereas disease was often disseminated at diagnosis 20 years ago, it is now often organ confined. Whereas disease was often evident, it is now frequently...
Insulin and glucose may influence cancer mortality via their proliferative and anti-apoptotic properties. Using longitudinal data from the nationally representative Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994), with an average follow-up of 8.5 years to death, we evaluated markers of glucose and insulin metabolism,...
Epidemiologic studies suggest that insulin-like growth factor-1 (IGF-1) is associated with obesity and, more recently, cancer. This study investigates multiple lifestyle, physiologic, and anthropometric determinants of circulating IGF-1 concentrations.
Nationally representative data were used from the cross-sectional Third National Health and Nutri...
In Reply: We agree with Dr Froehner that the potential relationship between age and prostate cancer survival may warrant further study. Although the randomized Scandinavian prostatectomy study by Bill-Axelson et al that Froehner cited may be interpreted as suggesting a potential relationship between age and cancer-specific mortality, the authors of...
The number of cancer survivors is steadily on the rise. The American Cancer Society (ACS) recently reported that the 5-year relative survival rate for all cancers combined is 66% (1). The National Cancer Institute estimates that there are approximately 11 million cancer survivors, defined as individuals with a cancer diagnosis regardless of the cou...
National-level data that characterize contemporary prostate cancer patients are limited. We used 2004–2005 data from the Surveillance,
Epidemiology, and End Results Program to generate a contemporary profile of prostate cancer patients (N = 82 541) and compared
patient characteristics of this 2004–2005 population with those of patients diagnosed in...
Most newly diagnosed prostate cancers are clinically localized, and major treatment options include surgery, radiation, or conservative management. Although conservative management can be a reasonable choice, there is little contemporary prostate-specific antigen (PSA)-era data on outcomes with this approach.
To evaluate the outcomes of clinically...
Controversy surrounds prostate-specific antigen (PSA) testing for prostate cancer screening, especially among elderly men aged 75 and older. This study examines whether patient age results in differential use of PSA testing and if organizational attributes such as communication, stress, decision making, and practice history of change predict PSA te...
To the Editor: We would like to apologize to the readers and editors of JAMA for a difference in understanding of the JAMA policy for reporting financial disclosures and resultant failure to report our disclosure information in our article.1 The basis of our omission of financial information was that we did not foresee a reasonable likelihood of fi...
Decisions to screen older patients for cancer are complicated by the fact that aging populations are heterogeneous with respect to life expectancy.
To examine national trends in the association between cervical cancer screening and age, health and hysterectomy status.
Cross-sectional data from the 1993, 1998, 2000, and 2005 National Health Intervie...
Prior to introduction of the prostate-specific antigen (PSA) test, the Seattle-Puget Sound and Connecticut Surveillance, Epidemiology and End Results (SEER) areas had similar prostate cancer mortality rates. Early in the PSA era (1987-1990), men in the Seattle area were screened and treated more intensively for prostate cancer than men in Connectic...