Publications by authors named "Dranitsaris G"
Article Synopsis
- - Abiraterone acetate, apalutamide, darolutamide, and enzalutamide are androgen receptor axis-targeted therapies (ARATs) used to treat prostate cancer, often alongside oral antithrombotic therapies, which may lead to significant drug-drug interactions.
- - A multidisciplinary expert panel used a modified electronic Delphi process to reach consensus on which ARAT/antithrombotic pairs should be monitored and how to manage these interactions, ultimately recommending avoiding 11 pairs and modifying therapy for 8 others.
- - This process underscores the need for more research into the clinical outcomes of ARAT and antithrombotic interactions while providing clinicians with actionable guidance for safer therapeutic choices. *
Article Synopsis
- * A study examined the effects of a best practice program for patients with relapsed/refractory multiple myeloma undergoing treatment with selinexor, including starting dosages and use of antiemetics.
- * Results showed that patients post-implementation of the best practice program experienced longer time to treatment failure, longer therapy duration, and fewer drug-related toxicities compared to those before the program was introduced.
Article Synopsis
- Systemic mastocytosis (SM) is a rare blood disorder marked by the abnormal growth of mast cells in various organs, causing symptoms like flushing, itching, diarrhea, and headaches, with little known about treatment outcomes.
- A study involving 105 SM patients from 19 community hematology clinics in the U.S. examined their clinical features, treatment patterns, and overall disease progression.
- Findings showed that a majority (62%) did not receive targeted therapy, and patients with advanced SM had a significantly higher risk of death compared to those with indolent forms of the disease, indicating a serious need for effective treatment options.
Article Synopsis
- Chronic immune thrombocytopenic purpura (ITP) is an autoimmune disease in adults that leads to low platelet counts, risking bleeding, where corticosteroids are the first line of treatment, followed by thrombopoietic agents (TPOs) or fostamatinib for patients who do not respond to steroids.
- A study analyzed data from 179 ITP patients treated across 17 community hematology practices in the U.S., focusing on the effectiveness, safety, and costs associated with fostamatinib compared to TPOs.
- Results showed no significant differences in platelet count recovery after six months between fostamatinib and TPOs, while fostamatinib had a lower risk of thromboemb
Article Synopsis
- Alzheimer's disease is a significant global health challenge, and this study explores the preferences of caregivers and neurologists regarding new amyloid plaque-lowering therapies for the disease.
- Using a discrete choice experiment, the study evaluated seven key attributes of these therapies, focusing on aspects like clinical effects, adverse effects, and administration methods.
- Results indicated that both groups highly valued clinical effects and were significantly concerned about amyloid-related side effects, while factors like treatment duration and variability in effectiveness were less important to them.
Article Synopsis
- Alzheimer's disease is a complex illness with ongoing research focused on new treatments, particularly those targeting amyloid-beta, which is essential to its development.
- A study surveyed caregivers, neurologists, and payors in the U.S. to evaluate their preferences for treatment options using a multicriteria decision analysis, which broke down various decision factors and preferences.
- Results showed that all stakeholder groups prioritized drug efficacy and the benefits to patients, while cost considerations were deemed less significant in the decision-making process.
Article Synopsis
- Real-world evidence (RWE) is data from patients' actual experiences in healthcare, and it's becoming more important in decisions about drug approvals and funding in Canada.* -
- This article reviews the Canadian Agency for Drugs and Technology in Health (CADTH)'s recommendations for oncology drugs that were approved from 2019 to 2021, noting that priority review drugs generally received positive funding recommendations.* -
- The study found no significant differences in review times across different drug approval statuses, but highlighted that RWE played a role in funding decisions, particularly for drugs with conditional approvals, which often had negative outcomes in their first reviews.*
Article Synopsis
- - Malignant hyperthermia (MH) is a severe reaction during anesthesia, primarily triggered by certain anesthetic agents and linked to genetic mutations in the ryanodine receptor (RYR1) gene.
- - The study examined how factors like strenuous exercise and fever before surgery might influence the occurrence of MH events, analyzing cases from multiple referral centers.
- - Results showed a connection between recent strenuous exercise, elevated body temperature, and an increased risk of MH during general anesthesia, highlighting the need for careful pre-operative assessments.
Ibrutinib-associated dermatologic toxicities: A systematic review and meta-analysis.
Crit Rev Oncol Hematol
June 2022
Article Synopsis
- - The study investigates the incidence and severity of skin-related side effects associated with ibrutinib, a treatment for cancer and chronic graft-versus-host disease, using data from 32 studies involving 2,258 patients up to June 2020.
- - Common dermatologic toxicities identified include cutaneous bleeds (24.8%), various rashes (10.8%), mucositis (6%), and nail changes (17.8%), while high-grade toxicities were relatively rare.
- - The authors emphasize the importance for healthcare providers to understand these side effects in order to effectively manage them, prevent treatment discontinuation, and enhance patient outcomes.
Article Synopsis
- The study compared three injectable neurokinin-1 (NK-1) receptor antagonists—CINVANTI®, intravenous Emend®, and generic formulations of fosaprepitant—on their effectiveness in controlling nausea and vomiting caused by chemotherapy.
- It analyzed data from 294 patients undergoing chemotherapy to see how well these medications controlled nausea and vomiting, reduced the use of rescue therapy, and caused infusion reactions.
- Results indicated that CINVANTI® led to less need for additional medication for nausea (rescue therapy) and had fewer infusion reactions compared to Emend®, suggesting it may be a better option for chemotherapy-related nausea management.
Article Synopsis
- Patients with prostate cancer treated with apalutamide often experience dermatological adverse events (dAEs), with a notable frequency of rashes and skin issues.
- A study of 303 patients revealed that 23.4% developed dAEs, most commonly maculopapular rashes and xerosis, typically occurring around 77 days after treatment initiation.
- Management primarily involved topical and oral steroids, with clinical trial participants being more likely to report dAEs, especially those also receiving abiraterone/prednisone.
Article Synopsis
- A study was conducted to create a tool that predicts the mortality risk for COVID-19 patients on ventilators in intensive care units (ICUs) to help with decision-making and resource distribution during the pandemic.
- The retrospective cohort study analyzed data from 127 mechanically ventilated COVID-19 patients in Toronto, identifying key factors such as age, temperature, and lactate levels that forecast mortality rates over a 15-day period.
- The developed risk score demonstrated strong predictive ability, with a 90% accuracy rate, indicating that as the score increases, the likelihood of death also rises significantly, though further validation is needed before it can be widely used.
Article Synopsis
- A personalized risk model (PRM) was previously developed to classify patients based on their risk for significant chemotherapy-induced nausea and vomiting (CINV).
- The study evaluated the PRM's effectiveness in predicting various CINV outcomes in breast cancer patients undergoing specific chemotherapy regimens, analyzing data from 242 patients over 819 cycles.
- Results showed that high-risk patients identified by the PRM were significantly more likely to experience significant nausea (4.73 times more) compared to low-risk patients, but the model did not show differences in vomiting, complete treatment response, or use of rescue medications.
Purpose: To compare healthcare resource utilization (HRU) and costs associated with dose-dense methotrexate, vinblastine, doxorubicin, cisplatin (ddMVAC) and gemcitabine, cisplatin (GC) as neoadjuvant chemotherapy for muscle-invasive bladder cancer (MIBC).
Methods: Patient treated at Dana-Farber Cancer Institute from 2010 to 2019 were identified. HRU data on chemotherapy administered, supportive medications, patient monitoring, clinic, infusion, emergency department (ED) visits and hospitalization were collected retrospectively.
Article Synopsis
- The study investigates how community oncologists rely on absolute neutrophil count (ANC) when deciding to administer adjuvant mFOLFOX6 chemotherapy for colorectal cancer, focusing on its impact on treatment delays and G-CSF usage.
- A chart review over six years revealed that higher pretreatment ANC levels correlated with increased chemotherapy administration and that G-CSF was used in nearly 25% of cycles, rising to 44% by the 12th cycle.
- The findings indicate that low ANC leads to chemotherapy delays regardless of G-CSF support, negatively affecting dose intensity and highlighting the challenges in managing ANC levels during treatment.
Background: We evaluated feasibility, safety, and total resource use of subcutaneous immunoglobulin (SCIG) in a pilot study of patients who underwent allogeneic hematopoietic cell transplant (HCT) over a 6-month period.
Methods: A total of 20 eligible patients were treated with SCIG at 0.1 g/kg/week for up to 6 months.
Article Synopsis
- * Following cannabis legalization, there was a significant reduction in the average opioid dosage prescribed and total monthly spending on opioids, with a more pronounced effect seen in private drug plans.
- * The results suggest that increased access to cannabis for pain management may lead to a decrease in opioid use across both public and private health insurance plans.
Purpose: Despite triple antiemetic therapy use for breast cancer patients receiving emetogenic chemotherapy, nausea remains a clinical challenge. We evaluated adding olanzapine (5 mg) to triple therapy on nausea control in patients at high personal risk of chemotherapy-induced nausea and vomiting (CINV).
Methods: This multi-centre, placebo-controlled, double-blind trial randomized breast cancer patients scheduled to receive neo/adjuvant chemotherapy with anthracycline-cyclophosphamide or platinum-based chemotherapy to olanzapine (5 mg, days 1-4) or placebo.
Article Synopsis
- AI identified baricitinib as an effective treatment for SARS-CoV-2 pneumonia, showing a 71% mortality benefit in severely ill patients while indicating low adverse effects.
- In elderly patients (median age 81), a majority were able to recover, and additional cases with mild symptoms also showed positive outcomes.
- The drug works by inhibiting certain host proteins, impacting virus entry and replication, and has revealed mechanisms that justify further clinical trials to confirm its effectiveness.
Article Synopsis
- A country-level exploratory analysis evaluated how timing and types of national health policies influenced COVID-19 mortality and health outcomes by examining data from the top 50 countries with the highest case counts.
- Findings revealed that higher obesity rates, older population age, and delayed border closures contributed to increased COVID-19 case loads and mortality, while better income distribution helped reduce these rates.
- Rapid border closures, lockdowns, and extensive testing didn't significantly lower mortality, but full lockdowns and better resilience to health threats were linked to higher patient recovery rates.*
Article Synopsis
- Existing economic models may not accurately reflect how patients respond to immuno-oncology (I-O) treatments compared to standard therapies, potentially overlooking their full clinical value.
- A cost-effectiveness analysis was conducted on the I-O Regimen (nivolumab/ipilimumab) versus ipilimumab alone for advanced melanoma using a more detailed 5-state survival model, which differentiates between patient responses.
- This new model demonstrated a better understanding of treatment outcomes and quality-adjusted life years (QALYs), offering a more comprehensive view of patient health across different treatment paths than the traditional 3-state model.
Background: Lanreotide and octreotide acetate suspension for injectable (LAR) are both recommended for clinical use in patients with locally advanced or metastatic gastroenteropancreatic neuroendocrine tumors. However, each agent possesses unique attributes in terms of their drug-delivery characteristics. The study objective was to compare overall drug-delivery efficiency between lanreotide and octreotide LAR in gastroenteropancreatic neuroendocrine tumor patients.
View Article and Find Full Text PDFArticle Synopsis
- The text discusses the challenges and importance of model structure in economic evaluations of cancer treatments, highlighting the need for innovative frameworks in light of new immuno-oncology therapies.
- It compares traditional models (partitioned survival models and Markov models) with patient level simulation (PLS) models using data from the CheckMate 067 trial on nivolumab/ipilimumab and ipilimumab alone.
- The results indicate that while both PSMs and Markov models produce similar short-term outcomes, the PLS model showed a greater long-term benefit, yielding more quality adjusted life years (QALYs) at a lower incremental cost-effectiveness ratio.
Article Synopsis
- There has been a significant rise in new oncology drug approvals, but many were based on limited trials, raising concerns about potential side effects as more patients use these treatments.
- A survey of oncology pharmacists in Atlantic Canada found that only 58% of respondents had a formal patient monitoring program at their institutions, often due to staffing and training challenges.
- Despite these limitations, all surveyed pharmacists supported the establishment of formal monitoring programs in hospitals that frequently prescribe anticancer drugs.
Cost effectiveness vs. affordability in the age of immuno-oncology cancer drugs.
Expert Rev Pharmacoecon Outcomes Res
August 2018
Article Synopsis
- Cancer immunotherapy, also known as immuno-oncology, is providing new and effective treatment options for various types of cancer, offering patients better survival rates and quality of life.
- Clinical trials show promising results for immunotherapy agents in treating multiple cancers, including advanced melanoma, lung cancer, and Hodgkin's lymphoma.
- However, the high cost of these treatments, potentially exceeding $100,000 annually per patient, raises concerns about their affordability and sustainability within healthcare systems, prompting discussions on cost-effectiveness and patient access.