Publications by authors named "Stukalin I"
Background: Colorectal cancer is the third most common malignancy globally. Early-onset colorectal cancer (EOCRC) is becoming a growing healthcare focus globally, particularly in North America. We estimated trends in incidence, mortality, and disability-adjusted life years (DALYs) for EOCRC in Canada between 1990 and 2019.
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- This study looked at how much money is spent on treating brain and nervous system cancers in the U.S. from 1996 to 2016.
- Spending jumped from $2.72 billion to $6.85 billion, but sadly, more people were still dying from these cancers during that time.
- The results show that even though more money was spent, it didn’t help people live longer, especially affecting older patients and those with private insurance.
Background: The aim of this study was to understand the experiences of young men with a diagnosis of testicular cancer (TC) using a narrative approach, with the intention of informing models of care and support in clinical services.
Methods: TC patients were recruited to participate in one of four focus groups examining their lived experiences from diagnosis. Focus groups were recorded and transcribed and analyzed using a narrative approach.
Background: Bone metastases (BoMs) are prevalent in patients with metastatic non-small-cell lung cancer (NSCLC) however, there are limited data detailing how BoMs respond to immune checkpoint inhibitors (ICIs). The purpose of this study was to compare the imaging response to ICIs of BoMs against visceral metastases and to evaluate the effect of BoMs on survival.
Materials And Methods: A retrospective, multicentre cohort study was conducted in patients with NSCLC treated with nivolumab or pembrolizumab in Alberta, Canada from 2015 to 2020.
Background: The association between objective imaging response and first line immune checkpoint inhibitor (ICI) therapy regimes in advanced melanoma remains uncharacterized in routine practice.
Methods: We conducted a multi-center retrospective cohort analysis of advanced melanoma patients receiving first line ICI therapy from August 2013-May 2020 in Alberta, Canada. The primary outcome was likelihood of RECIST v1.
Article Synopsis
- Immune-related adverse events (irAEs) linked to immune checkpoint inhibitor (ICI) therapy in non-small cell lung cancer (NSCLC) patients may enhance overall survival, though the relationship between irAE severity and survival is not well understood.
- This study analyzed data from 803 NSCLC patients treated with ICIs between March 2014 and November 2021 in Alberta, Canada, focusing on those who experienced clinically meaningful irAEs that affected their treatment regimen.
- The findings suggest a connection between the occurrence of irAEs and improved overall survival, with extensive data analysis conducted to determine factors influencing this outcome while avoiding biases in the evaluation.
The PACIFIC trial led to a new standard of care for patients with locally advanced lung cancer, but real-world practice has demonstrated that immune checkpoint inhibitor (ICI) pneumonitis can lead to significant clinical complications. This study aimed to examine the clinical predictors, outcomes, and healthcare utilization data in patients who received consolidation durvalumab. Using the Alberta Immunotherapy Database, NSCLC patients who received durvalumab in Alberta, Canada, from January 2018 to December 2021 were retrospectively evaluated.
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- A study analyzed the impact of age on survival rates in patients with advanced melanoma who received immunotherapy, focusing on two age groups: under 65 and 65 years or older.
- Out of 497 patients studied, younger patients (younger than 65) had a longer median overall survival (22.2 months) compared to older patients (17.1 months), particularly in cutaneous melanoma cases.
- The use of a combination treatment (nivolumab plus ipilimumab) significantly improved survival outcomes compared to single-agent PD-1 therapy, reflecting the importance of treatment choice in managing melanoma.
Small intestinal lipomatosis is a rare condition with a poorly understood epidemiology and pathophysiology. Cases of small intestinal lipomatosis have been documented in multiple countries over the last century, yet little has been published regarding the natural history of this disease. Therapeutic options are largely surgical and based on limited evidence.
View Article and Find Full Text PDFImportance: Treatment-free survival (TFS) represents an alternative time-to-event end point, accurately characterizing time spent free of systemic therapy, providing a more patient-centric view of immune checkpoint inhibitor (ICI) therapy regimens. There remains a lack of studies evaluating TFS outcomes among patients with advanced melanoma who are receiving immunotherapy, especially outside of the clinical trial setting.
Objective: To evaluate TFS outcomes for patients with advanced melanoma receiving first-line ICI therapy outside of a clinical trial setting.
Introduction: Landmark trials testing immune checkpoint inhibitors (ICIs) in advanced NSCLC are difficult to extrapolate to real-world practice given the exclusion of patients with poor (i.e., ≥2) Eastern Cooperative Oncology Group performance status (ECOG PS).
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- A new prognostic model has been developed to assess overall survival in patients with advanced melanoma who are being treated with immune checkpoint inhibitors, filling a gap in existing risk stratification tools.
- The model identifies key independent factors that impact survival: high white blood cell count, high lactate dehydrogenase, low albumin levels, worse performance status, and presence of liver metastases.
- Patients are categorized into three risk groups based on these factors, with survival rates drastically differing among them (52.9 months for favorable, 13 months for intermediate, and 2.7 months for poor prognosis).
Background: Paradigm shifts in kidney cancer management have led to higher health care spending. Here, total and per capita health care spending and primary drivers of change in health expenditures for kidney cancer in the United States between 1996 and 2016 are estimated.
Methods: Public databases developed by the Institute for Health Metrics and Evaluation for the Disease Expenditure Project were used.
Article Synopsis
- Immune checkpoint inhibitors have transformed treatment for non-small cell lung cancer (NSCLC), and this study investigates baseline characteristics that predict overall survival in patients treated with ICI monotherapy.
- The research involved a multi-center study with two patient groups: one receiving first-line ICI for model training and another for external validation, analyzing 20 potential prognostic factors.
- Ultimately, three key characteristics formed the prognostic model, classifying patients into three risk groups, which correlated with median overall survival times, indicating that better risk categorization is linked to improved survival outcomes.
Background: Changes in clinical care for appendicitis have impacted healthcare use associated with treatment. We evaluated national trends and assessed factors associated with healthcare costs for appendicitis in the United States.
Design: The Disease Expenditure Project, the Global Burden of Disease study, and the National Inpatient Sample were used to estimate total national expenditures, per-capita costs for incident cases, and factors associated with inpatient costs for appendicitis management, respectively.
Importance: Immune-related adverse events (irAEs) due to immune checkpoint blockade (ICB) have been shown to be positively associated with survival. Among patients with metastatic melanoma, evidence supporting this association has been conflicting, while ipilimumab-nivolumab combination ICB has been examined only in small clinical cohorts.
Objective: To examine the association between irAEs and survival among patients with metastatic melanoma, in particular for those receiving combination ICB.
Immune checkpoint inhibitors (ICIs) for treatment of metastatic melanoma (MM) offer lasting overall survival (OS) benefit in a subset of patients. However, outcomes remain poor for non-responders. Clinical predictors of long-term survival remain elusive.
View Article and Find Full Text PDFBackground: There is little evidence describing the technical aspects of medical assistance in dying (MAiD) in Canada, such as medications, dosages and complications. Our objective was to describe clinical practice in providing MAiD in Ontario and Vancouver, Canada, and explore relations between medications used, time until death and complications.
Methods: We conducted a retrospective cohort study of a sample of adult (age ≥ 18 yr) patients who received MAiD in Ontario between 2016 and 2018, and patients who received MAiD in 1 of 3 Canadian academic hospitals (in Hamilton and Ottawa, Ontario, and Vancouver, British Colombia) between 2019 and 2020.
Background & Aims: The management of gastrointestinal (GI) cancers is associated with high health care spending. We estimated trends in United States (US) health care spending for patients with GI cancers between 1996 and 2016 and developed projections to 2030.
Methods: We used economic data, adjusted for inflation, developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project.
The emergence of immunotherapy revolutionized the treatment of non-small-cell-lung cancer (NSCLC), with multiple landmark clinical trials establishing the efficacy of these agents. However, many patients who receive immunotherapy in clinical practice would be considered clinical trial ineligible. One such population that is often under-represented in clinical trials is older adults.
View Article and Find Full Text PDFIntroduction: The management of chronic liver diseases (CLDs) and cirrhosis is associated with substantial healthcare costs. We aimed to estimate trends in national healthcare spending for patients with CLDs or cirrhosis between 1996 and 2016 in the United States.
Methods: National-level healthcare expenditure data developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project and prevalence of CLDs and cirrhosis derived from the Global Burden of Diseases Study were used to estimate temporal trends in inflation-adjusted US healthcare spending, stratified by setting of care (ambulatory, inpatient, emergency department, and nursing care).
Background: Immuno-oncology (IO)-based therapies have been approved based on randomised clinical trials, yet a significant proportion of real-world patients are not represented in these trials. We sought to compare the outcomes of trial-ineligible vs. -eligible patients with advanced solid tumours treated with first-line (1L) IO therapy.
View Article and Find Full Text PDFBackground: Limited data exist on the clinical effectiveness of second-line (2L) vascular endothelial growth factor (receptor) targeted inhibitor (VEGF(R)i) sunitinib after first-line (1L) immuno-oncology (IO) therapy for patients with metastatic renal cell carcinoma (mRCC) in real-world settings.
Methods: A retrospective cohort study among adult patients with mRCC treated with 2L sunitinib following 1L IO was conducted from select International mRCC Database Consortium (IMDC) centers. All analyses were performed overall and by 1L ipilimumab + nivolumab (IPI+NIVO) or 1L IO+VEGF(R)i.
Background: Metastatic uveal melanoma (MUM) is associated with poor survival and inferior response to immune checkpoint inhibitor (ICI) therapy when compared with metastatic cutaneous melanoma. Currently, prognostic biomarkers are lacking to guide treatment decisions.
Patients And Methods: We conducted a multicenter, retrospective cohort study using a centralized, province-wide cancer database in Alberta, Canada.