Publications by authors named "Nora A Alexander"
Merkel cell carcinoma (MCC) is a neuroendocrine skin cancer with a high risk of recurrence and metastasis. Regular surveillance through physical exams and imaging studies is crucial for the timely detection of recurrences. MCC patients who produce antibodies to the Merkel cell polyomavirus oncoprotein may benefit from antibody testing in addition to routine imaging surveillance for the early detection of disease recurrence.
View Article and Find Full Text PDFBackground: Merkel cell carcinoma (MCC) is often treated with surgery and postoperative radiation therapy (PORT). The optimal time to initiate PORT (Time-to-PORT [ttPORT]) is unknown.
Purpose: We assessed if delays in ttPORT were associated with inferior outcomes.
Article Synopsis
- The study examines the connection between pre-existing inflammatory diseases (pIDs) and cutaneous immune-related adverse events (cirAEs) in patients receiving immune-checkpoint inhibitors (ICIs) at Mass General Brigham.
- Among 3607 ICI patients, those with cutaneous pIDs faced a significantly higher risk of developing cirAEs, with increased severity compared to those with non-cutaneous pIDs.
- Findings suggest that individuals with cutaneous pIDs should be monitored more closely due to the greater likelihood of earlier and more severe cirAEs.
Background: Emerging evidence suggests that cutaneous immune-related adverse events (cirAEs) are associated with a survival benefit in the setting of advanced melanoma treated with immune checkpoint inhibitor (ICI) therapy. Previous studies have not examined the role of melanoma subtypes on cirAE development and downstream therapeutic outcomes.
Objective: Examine the impact of melanoma subtypes on cirAE onset and survival among ICI recipients.
Article Synopsis
- Cutaneous immune-related adverse events (cirAEs) affect nearly 40% of patients receiving immune checkpoint inhibitors (ICI), with a focus on their impact on overall survival in this study.* -
- analysis of 3731 ICI recipients showed that 18.1% experienced cirAEs, and patients with these events had a lower mortality risk, particularly those with melanoma.* -
- Various specific skin reactions like lichenoid and acneiform eruptions were linked to significantly better survival rates, highlighting a potential relationship between cirAEs and improved outcomes.*
Article Synopsis
- Cutaneous immune-related adverse events (cirAEs), affecting up to 40% of patients receiving immune checkpoint inhibitors (ICIs), might play a role in enhancing survival rates for these patients.
- A study reviewed charts of 3,731 ICI recipients, finding that 18.1% developed cirAEs, which were linked to decreased mortality (HR=0.87, p=0.027), particularly among melanoma patients (HR=0.67, p=0.003).
- Various specific skin manifestations, like lichenoid and psoriasiform eruptions, showed significant associations with better survival outcomes in ICI recipients after adjustments for other factors.
Article Synopsis
- - Prognostic analysis for early-stage melanomas (stage I/II) is crucial for personalized treatment plans, especially with new immune checkpoint inhibitors approved for later stages.
- - This study evaluated machine-learning algorithms on 1720 early-stage melanoma cases to predict recurrence using clinical and histopathologic data from Electronic Health Records (EHRs).
- - The results showed strong prediction performance, with Breslow tumor thickness and mitotic rate emerging as key indicators, highlighting the potential for machine learning to identify patients who could benefit from additional treatments like immunotherapy.
Importance: Merkel cell carcinoma (MCC) often behaves aggressively; however, disease-recurrence data are not captured in national databases, and it is unclear what proportion of patients with MCC experience a recurrence (estimates vary from 27%-77%). Stage-specific recurrence data that includes time from diagnosis would provide more precise prognostic information and contribute to risk-appropriate clinical surveillance.
Objective: To estimate risk of stage-specific MCC recurrence and mortality over time since diagnosis.
Background: Merkel cell carcinoma (MCC) guidelines derive from melanoma and do not recommend baseline cross-sectional imaging for most patients. However, MCC is more likely to have metastasized at diagnosis than melanoma.
Objective: To determine how often baseline imaging identifies clinically occult MCC in patients with newly diagnosed disease with and without palpable nodal involvement.