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324 results on '"Chinnaswamy, Girish"'

5. A National Cancer Grid pooled procurement initiative, India/Initiative d'achat groupe par le Reseau National de lutte contre le Cancer en Inde/Una iniciativa de adquisicion conjunta por parte de la Red Nacional de Cancer en la India

Author

Pramesh, C.S., Sengar, Manju, Patankar, Sumedha, Chinnaswamy, Girish, Gupta, Sudeep, Vijayakumar, M., Sood, Sanjeev, Sathe, Anil N., Radhakrishnan, Venkatraman, Ganesan, Prasanth, Mallavarapu, Krishna Mohan, and Badwe, Rajendra A.

Subjects
Medical care, Cost of -- Health aspects, Purchasing -- Health aspects, Antineoplastic agents -- Health aspects, Generic drugs -- Health aspects, Hospitals -- India, Cancer -- Care and treatment, Medical care -- Quality management, Evidence-based medicine -- Health aspects, Antimitotic agents -- Health aspects, Health, World Health Organization
Abstract

In health systems with little public funding and decentralized procurement processes, the pricing and quality of anti-cancer medicines directly affects access to effective anti-cancer therapy. Factors such as differential pricing, volume-dependent negotiation and reliance on low-priced generics without any evaluation of their quality can lead to supply and demand lags, high out-of-pocket expenditures for patients and poor treatment outcomes. While pooled procurement of medicines can help address some of these challenges, monitoring of the procurement process requires considerable administrative investment. Group negotiation to fix prices, issuing of uniform contracts with standardized terms and conditions, and procurement by individual hospitals also reduce costs and improve quality without significant investment. The National Cancer Grid, a network of more than 250 cancer centres in India, piloted pooled procurement to improve negotiability of high-value oncology and supportive care medicines. A total of 40 drugs were included in this pilot. The pooled demand for the drugs from 23 centres was equivalent to 15.6 billion Indian rupees (197 million United States dollars (US$)) based on maximum retail prices. The process included technical and financial evaluation followed by contracts between individual centres and the selected vendors. Savings of 13.2 billion Indian Rupees (US$ 166.7 million) were made compared to the maximum retail prices. The savings ranged from 23% to 99% (median: 82%) and were more with generics than innovator and newly patented medicines. This study reveals the advantages of group negotiation in pooled procurement for high-value medicines, an approach that can be applied to other health systems. Lorsque les systemes de sante recoivent peu de fonds publics et que leurs processus d'achat sont decentralises, le prix et la qualite des medicaments contre le cancer ont un impact direct sur l'acces aux traitements efficaces contre la maladie. Des facteurs tels que l'application de prix differencies, les negociations en fonction des volumes ainsi que la confiance placee dans des generiques bon marche dont la qualite n'a pas ete evaluee peuvent entrainer des decalages entre l'offre et la demande, d'enormes depenses non remboursables pour les patients et de pietres resultats therapeutiques. Bien que les acquisitions groupees de medicaments puissent contribuer a resoudre certains de ces problemes, le suivi du processus d'achat requiert un engagement considerable au niveau administrad Les negociations collectives en vue de fixer les tarifs, l'etablissement de contrats types assortis de conditions generales standardisees, mais aussi les achats effectues par des hopitaux en particulier peuvent egalement faire baisser les couts et ameliorer la qualite sans necessiter d'importants investissements. Le National Cancer Grid, un reseau reunissant plus de 250 centres d'oncologie en Inde, a teste un dispositif d'achat groupe visant a assurer une meilleure negociabilite pour des medicaments et soins de soutien essentiels contre le cancer. Au total, 40 substances ont ete prises en compte dans ce projet pilote. La demande groupee en medicaments emise par 23 centres equivalait a 15,6 milliards de roupies indiennes (197 millions de dollars americains) d'apres le prix maximal de vente au detail. Ce processus prevoyait une evaluation technique et financiere, puis des contrats entre chaque centre et les distributeurs selectionnes. Des economies de 13,2 milliards de roupies indiennes (166,7 millions de dollars americains) ont pu etre realisees par rapport au prix maximal de vente au detail. Ces economies etaient comprises entre 23 et 99% (mediane: 82%) et concernaient davantage les medicaments generiques que les marques et les medicaments recemment brevetes. La presente etude revele les avantages que representent les negociations collectives lors des achats groupes de medicaments essentiels, une approche applicable a d'autres systemes de sante. En los sistemas sanitarios con escasa financiacion publica y procesos de adquisicion descentralizados, el sistema de fijacion de precios y la calidad de los medicamentos contra el cancer afectan directamente al acceso a una terapia eficaz contra dicha enfermedad. Factores como los diferentes sistemas de determinacion de precios, la negociacion en funcion del volumen y la dependencia de genericos de bajo precio sin evaluacion de su calidad pueden generar retrasos en la oferta y la demanda, elevados gastos para los pacientes y malos resultados en el tratamiento. Aunque la adquisicion conjunta de medicamentos puede ayudar a abordar algunos de estos retos, el seguimiento del proceso de adquisicion requiere una inversion administrativa considerable. La negociacion colectiva a la hora de determinar los precios, la emision de contratos unificados con terminos y condiciones estandarizados y la adquisicion por parte de algunos hospitales tambien reducen los costes y mejoran la calidad sin necesidad de realizar una gran inversion. La Red Nacional de Cancer, una red que cuenta con mas de 250 centros oncologicos en la India, puso a prueba la adquisicion conjunta con el fin de mejorar la negociabilidad de medicamentos oncologicos y de tratamiento complementario que resultaban costosos. En esta prueba piloto se Incluyo un total de 40 medicamentos. La demanda conjunta de medicamentos por parte de 23 centros fue equivalente a 15 600 millones de rupias indias (197 millones USD) segun los precios minoristas maximos. El proceso incluyo una evaluacion tecnica y financiera, asi como contratos entre centros independientes y proveedores seleccionados. Se logro un ahorro de 13 200 millones de rupias indias (166,7 millones USD) en comparacion con los precios minoristas maximos. El ahorro oscilo entre el 23 y el 99% (media: 82%) y fue mas alto con los medicamentos genericos que con los de marca y los recien patentados. Este estudio pone de manifiesto las ventajas de la negociacion colectiva en lo que respecta a la adquisicion conjunta de medicamentos costosos, un enfoque que se puede aplicar a otros sistemas sanitarios. [phrase omitted], Introduction Systemic anti-cancer therapy constitutes a key component of cancer management. (1) Over the years, advances in our understanding of cancer biology, coupled with discovery of different classes of anti-cancer [...]

Published
2023
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9. Evaluation of Metronomic Therapy as a Low-Cost, Sustainable, Standard-of-Care Option in Desmoid Fibromatosis: Real-World Data From a Tertiary Care Center in India

Author

Bajpai, Jyoti, Munot, Pritesh, Kota, Kishore, Gupta, Gaurav, Gala, Kunal, Gulia, Aashish, Rekhi, Bharat, Khanna, Nehal, Shetty, Nitin, Bhargava, Prabhat, Srinivas, Sujay, Ostwal, Vikas, Patil, Vijay, Noronha, Vanita, Kulkarni, Suyash, Laskar, Siddharth, Prabhash, Kumar, Chinnaswamy, Girish, Gupta, Sudeep, and Banavali, Shripad

Published
2024
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10. Epilepsia Partialis Continua as a Sequelae of Measles Infection in Children With Hematolymphoid Malignancies

Author

Sharma, Sudivya, Dhamne, Chetan, Bhosale, Shilpushp, Parambil, Badira, Divatia, Jigeeshu, Chinnaswamy, Girish, Patil, Vasundhara, Joshi, Rishikesh, Epari, Sridhar, Mahadevan, Anita, Vaidya, Sunil, Kulkarni, Shilpa, Kulkarni, Atul, Patil, Vijaya, Srinivasan, Shyam, Gollamudi, Venkata Rama Mohan, Roy Moulik, Nirmalya, Prasad, Maya, Narula, Gaurav, and Banavali, Shripad

Published
2024
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11. An assessment of childhood cancer care services in India - gaps, challenges and the way forward

Author

Nath, Anita, Mathur, Prashant, Sudarshan, K.L., Kaur Rajput, Gurpreet, Mascarenhas, Leena, Arora, Ramandeep Singh, Seth, Rachna, Kumar Dixit, Sanjiv, Chinnaswamy, Girish, Banipal, Raja Paramjeet Singh, Bhutia, Tseten W., Kumar Bodal, Vijay, Budukh, Atul, Kumar Chaudhary, Narendra, Vijay, C.R., Shikha Das, Deep, Gundeti, Sadashivudu, Harris, Caleb, Hazarika, Munlima, Natha Jondhale, Sunil, Gunaseelan, K., Khamo, Vinotsole, Konjengbam, Ratan, Kumar, Arun, Saroj Kumar, Das Majumdar, Majumdar, Gautam, Malik, Shikha, Mandal, Syamsundar, Najmi, Arshad Manzoor, Mohan Kumar, Chandra, Kumar Pandey, Awadhesh, Pandya, Shashank, Pareek, Puneet, Pautu, Jeremy L., Surya Rao, V., Ramesh, C., Rawal, Manoj, Radhakrishnan, Nita, Radhakrishnan, Venkatraman, Shah, Anand, Singh, S.B., Singh, Varinder, Singh, Pritanjali, Sundriyal, Deepak, Swaminathan, R., Avinash, T., Priya Kumari, T., Tawsik, Sopai, and Tiwari, Lokesh

Published
2023
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12. Radiation Therapy Dose Escalation in Unresectable Ewing Sarcoma: Final Results of a Phase 3 Randomized Controlled Trial

Author

Laskar, Siddhartha, Sinha, Shwetabh, Chatterjee, Abhishek, Khanna, Nehal, Manjali, Jifmi Jose, Puri, Ajay, Gulia, Ashish, Nayak, Prakash, Vora, Tushar, Chinnaswamy, Girish, Prasad, Maya, Bajpai, Jyoti, Juvekar, Shashikant, Desai, Subhash, Janu, Amit, Rangarajan, Venkatesh, Purandare, Nilendu, Shah, Sneha, Rekhi, Bharat, Jambhekar, Nirmala, Muckaden, Mary Ann, and Kurkure, Purna

Published
2022
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13. Outcomes of COVID-19 and risk factors in patients with cancer

Author

Sengar, Manju, Chinnaswamy, Girish, Ranganathan, Priya, Ashok, Apurva, Bhosale, Shilpushp, Biswas, Sanjay, Chaturvedi, Pankaj, Dhamne, Chetan, Divatia, Jigeeshu, D’Sa, Karishma, Jain, Hasmukh, Laskar, Sarbani, Moulik, Nirmalya Roy, Mummudi, Naveen, Nair, Sindhu, Nayak, Lingaraj, Nayak, Prakash, Patkar, Shraddha, Pawaskar, Preeti, Ramaswamy, Anant, Shetty, Omshree, Singh, Arjun, Sridhar, Epari, Thorat, Jayashree, Badwe, Rajendra, and Pramesh, C. S.

Published
2022
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15. Priorities for cancer research in low- and middle-income countries: a global perspective

Author

Pramesh, C. S., Badwe, Rajendra A., Bhoo-Pathy, Nirmala, Booth, Christopher M., Chinnaswamy, Girish, Dare, Anna J., de Andrade, Victor Piana, Hunter, David J., Gopal, Satish, Gospodarowicz, Mary, Gunasekera, Sanjeeva, Ilbawi, Andre, Kapambwe, Sharon, Kingham, Peter, Kutluk, Tezer, Lamichhane, Nirmal, Mutebi, Miriam, Orem, Jackson, Parham, Groesbeck, Ranganathan, Priya, Sengar, Manju, Sullivan, Richard, Swaminathan, Soumya, Tannock, Ian F., Tomar, Vivek, Vanderpuye, Verna, Varghese, Cherian, and Weiderpass, Elisabete

Published
2022
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18. The International Collaboration for Research methods Development in Oncology (CReDO) workshops: shaping the future of global oncology research

Author

Ranganathan, Priya, Chinnaswamy, Girish, Sengar, Manju, Gadgil, Durga, Thiagarajan, Shivakumar, Bhargava, Balram, Booth, Christopher M, Buyse, Marc, Chopra, Sanjiv, Frampton, Chris, Gopal, Satish, Grant, Nick, Krailo, Mark, Langley, Ruth, Mathur, Prashant, Paoletti, Xavier, Parmar, Mahesh, Purushotham, Arnie, Pyle, Douglas, Rajaraman, Preetha, Stockler, Martin R, Sullivan, Richard, Swaminathan, Soumya, Tannock, Ian, Trimble, Edward, Badwe, Rajendra A, and Pramesh, C S

Published
2021
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19. Impact of COVID-19 on cancer care in India: a cohort study

Author

Ranganathan, Priya, Sengar, Manju, Chinnaswamy, Girish, Agrawal, Gaurav, Arumugham, Rajkumar, Bhatt, Rajiv, Bilimagga, Ramesh, Chakrabarti, Jayanta, Chandrasekharan, Arun, Chaturvedi, Harit Kumar, Choudhrie, Rajiv, Dandekar, Mitali, Das, Ashok, Goel, Vineeta, Harris, Caleb, Hegde, Sujai Kolnadguthu, Hulikal, Narendra, Joseph, Deepa, Kantharia, Rajesh, Khan, Azizullah, Kharde, Rohan, Khattry, Navin, Lone, Maqbool M, Mahantshetty, Umesh, Malhotra, Hemant, Menon, Hari, Mishra, Deepti, Nair, Rekha A, Pandya, Shashank J, Patni, Nidhi, Pautu, Jeremy, Pavamani, Simon, Pradhan, Satyajit, Thammineedi, Subramanyeshwar Rao, Selvaluxmy, G, Sharan, Krishna, Sharma, B K, Sharma, Jayesh, Singh, Suresh, Srungavarapu, Gowtham Chandra, Subramaniam, R, Toprani, Rajendra, Raman, Ramanan Venkat, Badwe, Rajendra Achyut, and Pramesh, C S

Published
2021
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20. Choosing Wisely for COVID-19: ten evidence-based recommendations for patients and physicians

Author

Pramesh, C. S., Babu, Giridhara R., Basu, Joyeeta, Bhushan, Indu, Booth, Christopher M., Chinnaswamy, Girish, and Guleria, Randeep

Subjects
Biological sciences, Health
Abstract

Author(s): C. S. Pramesh [sup.1] , Giridhara R. Babu [sup.2] , Joyeeta Basu [sup.3] , Indu Bhushan [sup.4] , Christopher M. Booth [sup.5] , Girish Chinnaswamy [sup.1] , Randeep Guleria [...]

Published
2021
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24. Risk-stratification for treatment de-intensification in WNT-pathway medulloblastoma: finding the optimal balance between survival and quality of survivorship.

Author

Gupta, Tejpal, Mani, Shakthivel, Chatterjee, Abhishek, Dasgupta, Archya, Epari, Sridhar, and Chinnaswamy, Girish

Subjects
MEDULLOBLASTOMA, MENINGEAL cancer, MOLECULAR biology, PROGNOSIS, CLINICAL trials
Abstract

Advances in molecular biology have led to consensus classification of medulloblastoma into four broad molecular subgroups – wingless (WNT), sonic hedgehog (SHH), Group 3, and Group 4, respectively. Traditionally, children >3 years of age, with no/minimal residual tumor (<1.5 cm2) and lack of metastasis were classified as average-risk disease with >80% long-term survival. Younger age (<3 years), large residual disease (≥1.5 cm2), and leptomeningeal metastases either alone or in combination were considered high-risk features yielding much worse 5-year survival (30–60%). This clinico-radiological risk-stratification has been refined by incorporating molecular/genetic information. Contemporary multi-modality management for non-infantile medulloblastoma entails maximal safe resection followed by risk-stratified adjuvant radio(chemo)therapy. Aggressive multi-modality management achieves good survival but is associated with substantial dose-dependent treatment-related toxicity prompting conduct of subgroup-specific prospective clinical trials. We conducted literature search on PubMed from 1969 till 2023 to identify putative prognostic factors and risk-stratification for medulloblastoma, including molecular subgrouping. Based on previously published data, including our own institutional experience, we discuss molecular risk-stratification focusing on WNT-pathway medulloblastoma to identify candidates suitable for treatment de-intensification to strike the optimal balance between survival and quality of survivorship. Prospective clinical trials and emerging biological information should further refine risk-stratification in WNT-pathway medulloblastoma. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Computational modeling of early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) to identify personalized therapy using genomics

Author

Kumar, Ansu, Drusbosky, Leylah M., Meacham, Amy, Turcotte, Madeleine, Bhargav, Priyanka, Vasista, Sumanth, Usmani, Shahabuddin, Pampana, Anusha, Basu, Kabya, Tyagi, Anuj, Lala, Deepak, Rajagopalan, Swaminathan, Birajdar, Shivgonda C., Alam, Aftab, Ghosh Roy, Kunal, Abbasi, Taher, Vali, Shireen, Sengar, Manju, Chinnaswamy, Girish, Shah, Bijal D., and Cogle, Christopher R.

Published
2019
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31. Clinico-Radiological Outcomes in WNT-Subgroup Medulloblastoma.

Author

Mani, Shakthivel, Chatterjee, Abhishek, Dasgupta, Archya, Shirsat, Neelam, Pawar, Akash, Epari, Sridhar, Sahay, Ayushi, Sahu, Arpita, Moiyadi, Aliasgar, Prasad, Maya, Chinnaswamy, Girish, and Gupta, Tejpal

Subjects
MEDULLOBLASTOMA, GENETIC profile, PROGRESSION-free survival, SURVIVAL analysis (Biometry), OVERALL survival, MENINGEAL cancer
Abstract

Medulloblastoma (MB) comprises four broad molecular subgroups, namely wingless (WNT), sonic hedgehog (SHH), Group 3, and Group 4, respectively, with subgroup-specific developmental origins, unique genetic profiles, distinct clinico-demographic characteristics, and diverse clinical outcomes. This is a retrospective audit of clinical outcomes in molecularly confirmed WNT-MB patients treated with maximal safe resection followed by postoperative standard-of-care risk-stratified adjuvant radio(chemo)therapy at a tertiary-care comprehensive cancer centre. Of the 74 WNT-MB patients registered in a neuro-oncology unit between 2004 to 2020, 7 patients accrued on a prospective clinical trial of treatment deintensification were excluded, leaving 67 patients that constitute the present study cohort. The median age at presentation was 12 years, with a male preponderance (2:1). The survival analysis was restricted to 61 patients and excluded 6 patients (1 postoperative mortality plus 5 without adequate details of treatment or outcomes). At a median follow-up of 72 months, Kaplan–Meier estimates of 5-year progression-free survival and overall survival were 87.7% and 91.2%, respectively. Traditional high-risk features, large residual tumour (≥1.5 cm2), and leptomeningeal metastases (M+) did not significantly impact upon survival in this molecularly characterized WNT-MB cohort treated with risk-stratified contemporary multimodality therapy. The lack of a prognostic impact of conventional high-risk features suggests the need for refined risk stratification and potential deintensification of therapy. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Navigating the neutropenic abyss with granulocyte transfusions: Retrospective single‐center analysis of effectiveness and safety in India.

Author

Desai, Priti, Navkudkar, Anisha, Bagal, Bhausaheb, Dhamne, Chetan, Jain, Hasmukh, Sengar, Manju, Chinnaswamy, Girish, and Nayak, Lingaraj

Subjects
LEUKOCYTE count, GRANULOCYTE-colony stimulating factor, FEBRILE neutropenia, ACUTE myeloid leukemia
Abstract

Background: Hemato‐oncologic patients receiving intensive chemotherapy may develop severe neutropenia and serious bacterial and/or fungal infections. Granulocyte transfusions (GTs) may be beneficial as a bridging therapy in hemato‐oncologic patients with febrile neutropenia. Aim: To evaluate the clinical effectiveness of GTs in hemato‐oncologic patients with febrile neutropenia. Materials and Methods: This retrospective study evaluated the effectiveness of 150 GTs in 88 hemato‐oncologic patients. Donors were mobilized with granulocyte colony‐stimulating factors and dexamethasone. Patients' hematological parameters (pre‐ and post‐GT) and safety and effectiveness of GTs were analyzed. Results: The safety and effectiveness of GTs were assessed in the patients with various underlying conditions, including 78% with acute myeloid leukemia. In total, 150 GTs were administered, mostly during the chemotherapy induction phase. The GTs were well‐tolerated by the patients, and a significant increment in white blood cell count and absolute neutrophil count (ANC) was noticed in 95% of patients after the transfusion. The granulocyte dose was positively correlated with ANC after the transfusion. The average time to neutrophil recovery from the last day of GT was 6.7 days, and the 30‐day survival rate was 77%. The donors were all men, and a significant increase in WBC count was observed post‐mobilization. The median granulocyte yield was 2.28 × 1010/unit. All granulocyte products were crossmatched and irradiated before the transfusion. Conclusion: GTs can be a useful adjunctive treatment for febrile neutropenia in hemato‐oncologic patients with multidrug‐resistant sepsis. However, additional studies are required for confirming their effectiveness and establishing guidelines for their use. [ABSTRACT FROM AUTHOR]

Published
2023
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41. Management of Hepatoblastoma: ICMR Consensus Document

Author

Agarwala, Sandeep, Gupta, Alisha, Bansal, Deepak, Vora, Tushar, Prasad, Maya, Arora, Brijesh, Kapoor, Gauri, Chinnaswamy, Girish, Radhakrishnan, Venkatraman, Laskar, Siddharth, Kaur, Tanvir, Dhaliwal, Rupinder Singh, Rath, G. K., and Bakhshi, Sameer

Published
2017
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