Publications by authors named "Samuel Rubinstein"
Background: Initial insights into oncology clinical trial outcomes are often gleaned manually from conference abstracts. We aimed to develop an automated system to extract safety and efficacy information from study abstracts with high precision and fine granularity, transforming them into computable data for timely clinical decision-making.
Methods: We collected clinical trial abstracts from key conferences and PubMed (2012-2023).
Article Synopsis
- VEXAS syndrome is a newly identified disorder caused by mutations in the UBA1 gene, leading to serious symptoms like recurrent fevers, inflammation, and organ issues, including potential end-organ damage and death.
- Treatment options are limited, but using the drug tocilizumab, which targets interleukin-6, has shown promise in managing the condition.
- A case study of a 71-year-old male patient highlights the effectiveness of tocilizumab followed by siltuximab, with positive outcomes and no relapses reported for over a year.
Article Synopsis
- *In a study of 27 patients, a specific genetic abnormality (translocation 11;14) was found in 45% of cases, affecting patient outcomes, including light-chain ratios and renal function.
- *Progression to end stage renal disease (ESRD) was significantly linked to low eGFR and high protein levels at diagnosis, suggesting the need for targeted therapies like BCL2 inhibitors for more effective management.
In clinical practice medications are often interchanged in treatment protocols when a patient negatively reacts to their first line of therapy. Although switching between medications is common, clinicians often lack structured guidance when choosing the initial dose and frequency of a new medication, given the former with respect to risk of adverse events. In this paper we propose to establish this dose toxo-equivalence relationship using published clinical trial results with one or both drugs of interest via a Bayesian meta-analysis model that accounts for both within- and between-study variances.
View Article and Find Full Text PDFThis study investigates the association between circulating microRNA (miRNA) expression and cardiovascular adverse events (CVAE) in multiple myeloma (MM) patients treated with a carfilzomib (CFZ)-based regimen. A cohort of 60 MM patients from the Prospective Observation of Cardiac Safety with Proteasome Inhibitor (PROTECT) study was analyzed. Among these, 31 patients (51.
View Article and Find Full Text PDFBackground: Initial insights into oncology clinical trial outcomes are often gleaned manually from conference abstracts. We aimed to develop an automated system to extract safety and efficacy information from study abstracts with high precision and fine granularity, transforming them into computable data for timely clinical decision-making.
Methods: We collected clinical trial abstracts from key conferences and PubMed (2012-2023).
As a treatment for relapsed or refractory multiple myeloma (MM), carfilzomib has been associated with a significant risk of cardiovascular adverse events (CVAE). The goals of our study were to evaluate the metabolomic profile of MM patients to identify those at high risk prior to carfilzomib treatment and to explore the mechanisms of carfilzomib-CVAE to inform potential strategies to protect patients from this cardiotoxicity. Global metabolomic profiling was performed on the baseline and post-baseline plasma samples of 60 MM patients treated with carfilzomib-based therapy, including 31 who experienced CVAE, in a prospective cohort study.
View Article and Find Full Text PDFSecond Line Therapy in Multiple Myeloma: A SEER Medicare Analysis.
Clin Lymphoma Myeloma Leuk
September 2024
Article Synopsis
- * A total of 9,822 patients were analyzed, revealing that by 2018, nearly half of the second-line therapies (2LT) included newer agents, and overall survival improved when treatments were initiated in later years.
- * While improvements in survival were noted, the costs of 2LT increased significantly, especially for regimens with newer agents, with costs rising markedly post-2012, indicating a growing financial burden in RRMM treatment.
Introduction: Geriatric assessment (GA)-guided supportive care programs have been successful in improving treatment outcomes for older adults with solid-organ cancers. This study aimed to evaluate the feasibility of a GA-guided supportive care program among older adults treated for multiple myeloma (MM).
Materials And Methods: The study utilized an existing registry of adults with plasma cell disorders at the University of North Carolina.
Background: Proteasome inhibitor Carfilzomib (CFZ) is effective in treating patients with refractory or relapsed multiple myeloma (MM) but has been associated with cardiovascular adverse events (CVAE) such as hypertension, cardiomyopathy, and heart failure. This study aimed to investigate the contribution of germline genetic variants in protein-coding genes in CFZ-CVAE among MM patients using whole-exome sequencing (WES) analysis.
Methods: Exome-wide single-variant association analysis, gene-based analysis, and rare variant analyses were performed on 603,920 variants in 247 patients with MM who have been treated with CFZ and enrolled in the Oncology Research Information Exchange Network (ORIEN) at the Moffitt Cancer Center.
Objectives: Patients with multiple myeloma (MM) enrolled in randomized control trials (RCTs) discontinue treatment for various reasons; however, no prior study has analyzed reasons for discontinuation. We performed a systematic review of MM RCTs to investigate reasons for treatment discontinuation, imbalances between trial cohorts, and reporting practices.
Methods: A comprehensive search for RCTs in MM from 2015 to 2021 identified 45 studies meeting inclusion criteria.
Article Synopsis
- Breakthrough SARS-CoV-2 infections post-vaccination are a major concern, particularly for cancer patients who are at higher risk of severe outcomes.
- A study analyzed 2,486 cancer patients with confirmed infections, focusing on the impact of receiving 2 or 3 doses of mRNA vaccines, looking at mortality and hospitalization rates.
- Results showed that vaccinated individuals had significantly lower 30-day mortality and hospitalization rates compared to unvaccinated patients, with those receiving 3 doses having the best outcomes.
Article Synopsis
- Chemotherapy-induced peripheral neuropathy (CIPN) is a common issue that negatively impacts the quality of life for cancer patients undergoing taxane treatments like paclitaxel and docetaxel.
- In a study of 3,387 patients at Vanderbilt University Medical Center, factors like being female, having a high body mass index (BMI), and diabetes were found to increase the risk of developing CIPN.
- The findings suggest that while obesity and diabetes enhance CIPN risk, concurrent chemotherapy and radiotherapy may lower it, highlighting a need for further research on prevention and treatment strategies.
Purpose: Residents of communities facing social vulnerability (eg, poverty) have limited access to clinical trials, leaving them susceptible to experiencing poor health outcomes. We examined the association between North Carolina county-level social vulnerability and available multiple myeloma (MM) trials.
Methods: Using a novel data linkage between ClinicalTrials.
Purpose: Localized amyloidosis is a condition characterized by deposits of fibrillary proteins confined to a single organ. The most common subtype is amyloid light chain amyloidosis, which is caused by secretion of amyloidogenic light chain by a monoclonal population of plasma cells. We present a review and discussion of the literature in the context of a case presentation of localized amyloid light chain amyloidosis of the nasopharynx treated with radiation alone.
View Article and Find Full Text PDFBackground: Cancer-related cognitive impairment (CRCI) has been largely unstudied in patients with multiple myeloma (MM). This study describes patient-reported cognition over time and patient factors associated with adverse cognitive outcomes in MM.
Methods: Participants enrolled in a registry in which they completed a geriatric assessment at study entry, and 3 & 6 months after entry.
Clonal hematopoiesis (CH) refers to the disproportionate expansion of hematopoietic stem cell clones and their corresponding progeny following the acquisition of somatic mutations. CH is common at the time of diagnosis in patients with blood cancers, including multiple myeloma (MM) and lymphoma. The presence of CH mutations correlates with IL-6 mediated inflammation and may result in lymphoma or MM modulation through microenvironment effects or by manifestations of the mutations themselves within the founding tumor clone.
View Article and Find Full Text PDFBackground: The plasma cell disorders (PCDs), multiple myeloma (MM), and light-chain amyloidosis (AL) are disproportionately diseases of older adults, whose care may be complicated by frailty associated with advancing age. We sought to evaluate the prevalence of functional deficits and symptoms in a cohort of persons with PCDs and associations of demographic, disease-related, functional, and psychosocial measures with quality of life (QoL).
Patients And Methods: Adults with PCDs were recruited into an observational registry in 2018-2020.
Introduction: Older adults with plasma cell disorders (PCDs) experience cognitive dysfunction that may be attributable to the disease and associated therapies. Yet, this has seldom been reported in the literature. Our objectives were to describe cognitive function (objective and patient-reported) in adults with PCDs and to explore clinical correlates of cognitive impairment.
View Article and Find Full Text PDFImportance: Hormone receptor-positive, ERBB2 (formerly HER2/neu)-negative metastatic breast cancer (HR-positive, ERBB2-negative MBC) is treated with targeted therapy, endocrine therapy, chemotherapy, or combinations of these modalities; however, evaluating the increasing number of treatment options is challenging because few regimens have been directly compared in randomized clinical trials (RCTs), and evidence has evolved over decades. Information theoretic network meta-analysis (IT-NMA) is a graph theory-based approach for regimen ranking that takes effect sizes and temporality of evidence into account.
Objective: To examine the performance of an IT-NMA approach to rank HR-positive, ERBB2-negative MBC treatment regimens.