Background: The advent of targeted therapies and immunotherapies has revolutionized metastatic melanoma (MM) management but their use is associated with high daily costs compared to chemotherapies: €2 for dacarbazine versus €175 for immunotherapies and €413 for targeted therapies. While overall survival (OS) has increased, healthcare expenditures are expected to double by 2030.
Objectives: The aim of this study was to estimate the median OS and costs for MM patients in order to evaluate the effectiveness of new biological or targeted therapies (NT) used since 2013 compared to chemotherapies.
Materials & Methods: This was a retrospective monocentric cost-effectiveness analysis performed in CHU Nantes (Nantes University Hospital). All MM patients treated with conventional chemotherapy as first-line treatment between 2008 and 2012 were included (CHEMO group). The same number of patients treated with NT as first-line between 2013 and 2017 were included (NT group).
Results: In total, 161 patients were included in each group. The mean age at diagnosis was 64.7±2.4 years in the CHEMO group and 65.3±2.4 years in the NT group (not significant). The men/women ratio was 1.48 and 1.27, respectively, (not significant). The median OS was 158 days in the CHEMO group and 395 days in the NT group (p<0.001). Treatment cost was €10,280/patient versus €94,676/patient, respectively. The mean incremental cost-effectiveness ratio was €90,184/LY (95% CI: €59,637; €166,395).
Conclusion: Our study assessed clinical and economic features associated with MM management before and after the advent of NT. Costs and life expectancy have increased. NT appears to be cost-effective.
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http://dx.doi.org/10.1684/ejd.2023.4448 | DOI Listing |
Medicine (Baltimore)
January 2025
Department of Respiratory and Critical Care Medicine, Zhongshan City People's Hospital, Zhongshan, Guangdong Province, China.
Rationale: ROS proto-oncogene 1 (ROS1) fusion is a rare but important driver mutation in non-small cell lung cancer, which usually shows significant sensitivity to small molecule tyrosine kinase inhibitors. With the widespread application of next-generation sequencing (NGS), more fusions and co-mutations of ROS1 have been discovered. Non-muscle myosin heavy chain 9 (MYH9) is a rare fusion partner of ROS1 gene as reported.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
The Third Affiliated Hospital of Xinxiang Medical University, Henan, China.
Osteoarthritis (OA) is a chronic joint condition affecting millions worldwide, characterized by the gradual degeneration of joint cartilage, leading to pain, stiffness, and functional impairment. Although the pathogenesis of OA is not fully understood, the roles of inflammation, metabolic dysregulation, and biomechanical stress are increasingly recognized. Current treatments, including pharmacotherapy, physical therapy, and surgical interventions, aim to alleviate symptoms and improve quality of life, yet they face limitations and challenges.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Cardiovascular Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.
Background: Parkinson's disease is a progressive neurodegenerative disease and the care burden in informal caregivers is huge. Summarizing factors associated with the informal caregivers burden can improve our understanding of providing proactive support to informal caregivers caring for patients with Parkinson's disease (PwP) at risk, and provides evidence for clinical practice.
Methods: PRISMA guidelines were followed in this systematic review.
J Med Internet Res
January 2025
Department of Rehabilitation Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Sarcopenia is closely associated with a poor quality of life and mortality, and its prevention and treatment represent a critical area of research. Resistance training is an effective treatment for older adults with sarcopenia. However, they often face challenges when receiving traditional rehabilitation treatments at hospitals.
View Article and Find Full Text PDFJMIR Form Res
January 2025
Brown University, Department of Behavioral and Social Sciences, Providence, RI, United States.
Background: Physician burnout is widespread in health care systems, with harmful consequences on physicians, patients, and health care organizations. Mindfulness training (MT) has proven effective in reducing burnout; however, its time-consuming requirements often pose challenges for physicians who are already struggling with their busy schedules.
Objective: This study aimed to design a short and pragmatic digital MT program with input from clinicians specifically to address burnout and to test its efficacy in physicians.
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