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In 2011, ipilimumab was approved by the US Food and Drug Administration (FDA) for metastatic melanoma. Since its approval, numerous targeted therapies have been approved by the FDA. Population-based studies assessing the survival benefit from these agents are lacking. We therefore carried out this study to compare the 1-year, 2-year, and median overall survival (OS) among metastatic melanoma patients in pretargeted and post-targeted eras. This is a retrospective study that utilized the Surveillance, Epidemiology, and End Results (SEER-18) database, version 8.3.4 (22 March 2017). The patient groups were defined as the pretargeted era (2004–2010) and the post-targeted era (2011–2014) as ipilimumab was approved by the FDA in 2011. The database comprised of 5471 patients (3314 in the pretargeted era and 2157 in the post-targeted era). OS in the post-targeted era was found to be significantly better compared with the pretargeted era by Kaplan–Meier curve (1-year OS: 38.9 vs. 36.8%, 2-year OS: 28.3 vs. 23.5%, and median survival: 8 vs. 7 months, P=0.001 by the log-rank test). The survival was significantly better in the post-targeted era compared with the pretargeted era on multivariate analysis using a Cox proportional hazard model after adjusting for age, sex, race, and metasectomy status (adjusted hazard ratio of 0.889, 95% CI: of 0.832–0.951, P=0.001). There is significant survival benefit in metastatic melanoma patients since the introduction of immune checkpoint-blocking agents.

No relevant conflicts of interest to declare.

Background: Primary cutaneous diffuse large B cell lymphoma-leg type (DLBCL-LT) is relatively uncommon lymphoma accounting for about 1 to 3 % of all cutaneous lymphoma and about 10-20% of primary cutaneous B cell lymphomas. There is data for survival outcomes in primary cutaneous B cell lymphoma in general population after introduction of rituximab but little is known about outcomes in DLBCL-LT patients in general population. The available data on survival in DLBCL-LT are from small case series and single institution studies. We conducted this study to evaluate the survival outcome in patients with PCDLBCL-LT after introduction of rituximab.

No relevant conflicts of interest to declare.

Introduction:

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No relevant conflicts of interest to declare.

No relevant conflicts of interest to declare.

Background: Treatment and prognosis of diffuse large B cell lymphoma (DLBCL) depends on the stage of lymphoma. We conducted this study to examine unstaged DLBCL in the United States.

Background: Radiotherapy (RT) is a first line treatment option for stage I follicular lymphoma. In this population-based study, we evaluated disparities in receipt of radiotherapy and survival among patients with stage I follicular lymphoma.

Combination therapy with 3 cycles of chemotherapy followed by involved field radiotherapy has been a standard of care for treatment of localized diffuse large B-cell lymphoma (Miller TP NEJM 1998). This population based study evaluated ethnic disparities in receipt of radiotherapy (RT) and its effect on survival in patients with localized diffuse large B cell lymphoma (DLBCL) in the United States.The Surveillance, Epidemiology, and End Results database was reviewed to identify patients with stage I DLBCL diagnosed between 1998 and 2008. We used unadjusted and adjusted odds ratio (OR) to analyze association of receipt of radiotherapy with age (<60 and 60+ years), sex and ethnicity (White, Black and Others). We calculated relative survival rates for different cohorts using SEER*Stat software. We used cox’s proportional hazard model to investigate the impact of age, sex and ethnicity on survival rates.A total of 11763 patients with localized DLBCL as the only primary malignancy were included in the study. Of the cohort, 38.2% received radiotherapy. Receipt of radiotherapy varied significantly by patient ethnicity - whites were more likely to receive RT compared to blacks and others. Similarly, age <60 years and females were more likely to receive radiotherapy compared with older patients and males (Table – 1).The 1- and 5- year relative survival rates for patients receiving RT were higher compared to those who did not receive RT: 88.3±0.5% vs 73.4±0.6%, p-value <0.0001 at 1-year and 77.8±0.8% vs 62.5±0.7%, p-value <0.0001 at 5-years. Among patients who received RT, 1- and 5- year relative survival rates were significantly higher in whites compared to black or other- race patients.This population based study showed that only 38.2% of patients with localized DLBCL received radiotherapy. White patients were more likely to receive RT compared to blacks and others. Survival rates are significantly higher for patients who received RT.No relevant conflicts of interest to declare.

Rituximab was approved by FDA as first line agent for treatment of advanced diffuse large B-cell lymphoma (DLBCL) on February 2006. We conducted this population based study to determine if the results from clinical trials have translated into survival benefit in general population.We selected patients with advanced diffuse large B cell lymphoma (Distant stage based on LRD Summary Staging 1998+ in SEER*Stat) from Surveillance, Epidemiology, and End Results (SEER) 18 database (1973-2010), and calculated relative survival rates for patients diagnosed from 2002-2005(pre-rituximab) and March 2006 to 2009 (post-rituximab). We used Z-test in the SEER*Stat to compare the relative survival rates in cohorts categorized by race (white, black and other), gender, and age groups (<60 and 60+). The “Cansurv” software, and specifically, Cox proportional hazard function were used to investigate the influence of age (<60 ; 60+ years), sex (male; female), race (white; black; others) and marital status (married; single; separated/divorced/widowed) on the relative survival.A total of 15627 patients with advanced stage DLBCL as the only primary cancer were identified. Patients were predominantly white of non-Hispanic, non-Spanish/non-Latino origin, males, belonging to the older age category and married. The median age at the diagnosis was 65 years. One-year relative survival in ‘Whites’ and ‘Others’ improved significantly in post-rituximab era compared to pre-rituximab era (64.80 ± 0.6% vs 61.3 ± 0.6%; p= 0.0002 and 64.5 ± 1.9% vs 54.9 ± 2.2%; p= 0.0011, respectively). Also, three year relative survival improved significantly in ‘Whites’ and ‘Others’ in post-rituximab era compared to pre-rituximab era (53.7 ± 0.7% vs 50.3 ± 0.7%; p= 0.0001 and 52.0 ± 2.3% vs 40.8 ± 2.3%; p= 0.0002, respectively). However, no significant improvement were observed in one-year and three-year relative survival in blacks, during post rituximab era comapared to pre-rituximab era. Interestingly, in pre-rituximab era, relative survival in blacks was comparable to that of whites, but it was significantly better than that of others (p<.05).Although there was significant improvement in one- and three-year relative survival in young females, old males and old females, no significant improvement (p>.05) in survival was observed in the young males. Factors such as young age, female sex, non-Hispanic origin, white race, married status and post-rituximab era were associated with significantly better survival (p<.05).The relative survival rates among young males and black patients with advanced diffuse large B cell lymphoma has not improved during post-rituximab era.No relevant conflicts of interest to declare.

There is scarcity of data on differences in survival in acute myeloid leukemia (AML) patients by ethnicity. We utilized data from the Surveillance Epidemiology and End Result (SEER) database to investigate the ethnic disparities of survival in general U.S. population.The SEER-18 Registry was used to identify adult (>=18) patients with AML as the only or the first primary cancer diagnosed from 1992 to 2010. We only included cases which were microscopically confirmed and actively followed. Cases that were alive without survival time, those resulted in death certificate/autopsy, and those with ethnicity recorded as unknown were excluded from this study. A total of 29,477 patients (54.5% males) were identified. For the subsequent analyses, various cohorts were formed. Age group cohorts included: 18-44 (5394; 18.3%), 45-54 (3751; 12.7%), 55-64 (4913; 16.7%), 65-74 (6513; 22.1%) and 75+ (8906; 30.2%). The total study period was divided into four groups, 1992-1995 (3409; 11.6%), 1996-2000 (5816; 19.7%), 2001-2005 (9984; 33.9%) and 2006-2010 (10268; 34.8%) for the survival analyses over time. Ethnic stratification used included White (21338; 72.4%), African American (AA: 2322; 7.9%), Asians/Pacific Islanders (A/PI: 2389; 8.1%), Native American/Alaskan Natives (NA/AN: 137; 0.5%) and Hispanics (3291; 11.2%). NA/AN categories were excluded from the final analysis due to their small numbers. Kaplan Meier (KM) curve and log rank test were used to evaluate association between patient characteristics and survival in overall population, OS, and AML-specific survival(AMLSS). Cox proportional hazards model was used for the analysis of association between patient characteristics and survival. Statistical analyses were carried out using SPSS version 16.0.0Median age at diagnosis for the patient population was 66 years. Median follow-up period was 6.17 years for the whole population.Median OS for whole population was 6 months with highest survival among Hispanics and lowest among Whites (10 months versus 5 months, p <0.001). The AMLSS was highest for Hispanics and lowest for Whites (24 months versus 12 months, p <0.001). Median OS and AMLSS deteriorated significantly with advancing age (p<0.001). The median OS and AMLSS were the same for males and females (p>0.05), in overall population. OS for females were better than males among AA and Hispanic patients (p value <0.001). AMLS survival was better for A/PI females compared to males (median AMLSS 22 months vs. 17 months, p =0.015). When comparing survival among year of diagnosis cohorts, OS as well as AMLSS were comparable among 1992-1995 and 1996-2000 cohorts, (p>0.05); however, there was a gradual improvement in the more recent time period cohorts.Results of the proportional hazard models indicated that when compared to Whites, the OS was best for A/PI and worst for AA patients (HR= 0.933, p= 0.006, and HR = 1.139, p <0.001 ,respectively). The OS was higher for females, younger patients, and for patients diagnosed during recent time period cohorts. Similarly, AMLS survival among Hispanics and AA was comparable to whites and, best for Asians/PI (HR 0.911, p =0.003).This study demonstrated significant differences in survival rates among AML patients belonging to various ethnic groups with highest OS and AMLSS among A/PI AML patients.No relevant conflicts of interest to declare.

Rituximab was approved by FDA as first line agent for treatment of advanced diffuse large B-cell lymphoma (DLBCL) on February 2006. We conducted this population based study to determine if the results from clinical trials have translated into survival benefit in general population.

There is scarcity of data on differences in survival in acute myeloid leukemia (AML) patients by ethnicity. We utilized data from the Surveillance Epidemiology and End Result (SEER) database to investigate the ethnic disparities of survival in general U.S. population.

Combination therapy with 3 cycles of chemotherapy followed by involved field radiotherapy has been a standard of care for treatment of localized diffuse large B-cell lymphoma (Miller TP NEJM 1998). This population based study evaluated ethnic disparities in receipt of radiotherapy (RT) and its effect on survival in patients with localized diffuse large B cell lymphoma (DLBCL) in the United States.