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1. Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured

Author

Primm, Kristin M, Zhao, Hui, Adjei, Naomi N, Sun, Charlotte C, Haas, Alen, Meyer, Larissa A, and Chang, Shine

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Lung, Women's Health, Breast Cancer, Lung Cancer, Cancer, Colo-Rectal Cancer, Digestive Diseases, Good Health and Well Being, Humans, United States, Medicaid, Female, Medically Uninsured, Middle Aged, Male, Adult, Patient Protection and Affordable Care Act, Neoplasms, Insurance Coverage, Health Services Accessibility, breast cancer, colorectal cancer, epidemiology and prevention, non small cell lung cancer, medicaid expansion, survival, Biochemistry and Cell Biology, Oncology and carcinogenesis
Abstract

BackgroundThe Affordable Care Act expanded Medicaid coverage for people with low income in the United States. Expanded insurance coverage could promote more timely access to cancer treatment, which could improve overall survival (OS), yet the long-term effects of Medicaid expansion (ME) remain unknown. We evaluated whether ME was associated with improved timely treatment initiation (TTI) and 3-year OS among patients with breast, cervical, colon, and lung cancers who were affected by the policy.MethodsMedicaid-insured or uninsured patients aged 40-64 with stage I-III breast, cervical, colon, or non-small cell lung cancer within the National Cancer Database (NCDB). A difference-in-differences (DID) approach was used to compare changes in TTI (within 60 days) and 3-year OS between patients in ME states versus nonexpansion (NE) states before (2010-2013) and after (2015-2018) ME. Adjusted DID estimates for TTI and 3-year OS were calculated using multivariable linear regression and Cox proportional hazards regression models, respectively.ResultsME was associated with a relative increase in TTI within 60 days for breast (DID = 4.6; p

Published
2024

12. Low-grade serous ovarian cancer: State of the science

Author

Slomovitz, Brian, Gourley, Charlie, Carey, Mark S., Malpica, Anais, Shih, Ie-Ming, Huntsman, David, Fader, Amanda N., Grisham, Rachel N., Schlumbrecht, Matthew, Sun, Charlotte C., Ludemann, Jane, Cooney, Gail Austin, Coleman, Robert, Sood, Anil K., Mahdi, Haider, Wong, Kwong K., Covens, Allan, O'Malley, David M., Lecuru, Fabrice, Cobb, Lauren P., Caputo, Thomas A., May, Taymaa, Huang, Marilyn, Siemon, John, Fernández, Marta Llauradó, Ray-Coquard, Isabelle, and Gershenson, David M.

Published
2020
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14. Randomized phase 2 trial of tremelimumab and durvalumab in combination versus sequentially in recurrent platinum‐resistant ovarian cancer

Author

Hinchcliff, Emily M., primary, Knisely, Anne, additional, Adjei, Naomi, additional, Fellman, Bryan, additional, Yuan, Ying, additional, Patel, Ami, additional, Xu, Cai, additional, Westin, Shannon N., additional, Sood, Anil K., additional, Soliman, Pamela T., additional, Shafer, Aaron, additional, Fleming, Nicole D., additional, Gershenson, David M., additional, Vikram, Raghunandan, additional, Bathala, Tharakeswara, additional, Vining, David, additional, Ganeshan, Dhakshina M., additional, Lu, Karen H., additional, Sun, Charlotte C., additional, Meyer, Larissa A., additional, and Jazaeri, Amir A., additional

Published
2023
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22. Randomized phase 2 trial of tremelimumab and durvalumab in combination versus sequentially in recurrent platinum‐resistant ovarian cancer.

Author

Hinchcliff, Emily M., Knisely, Anne, Adjei, Naomi, Fellman, Bryan, Yuan, Ying, Patel, Ami, Xu, Cai, Westin, Shannon N., Sood, Anil K., Soliman, Pamela T., Shafer, Aaron, Fleming, Nicole D., Gershenson, David M., Vikram, Raghunandan, Bathala, Tharakeswara, Vining, David, Ganeshan, Dhakshina M., Lu, Karen H., Sun, Charlotte C., and Meyer, Larissa A.

Subjects
OVARIAN cancer, IMMUNE checkpoint inhibitors, IMMUNE checkpoint proteins, PROGRESSION-free survival, SALPINGECTOMY, CA 125 test
Abstract

Background: Single‐agent immune checkpoint inhibitors (ICIs) have demonstrated limited responses in recurrent ovarian cancer; however, 30%–40% of patients achieve stable disease. The primary objective was to estimate progression‐free survival (PFS) after sequential versus combination cytotoxic T‐lymphocyte antigen 4 and programmed death ligand 1 ICIs in patients with platinum‐resistant high‐grade serous ovarian cancer (HGSOC). Methods: Patients were randomized to a sequential arm (tremelimumab followed by durvalumab on progression) or a combination arm (tremelimumab plus durvalumab, followed by durvalumab) via a Bayesian adaptive design that made it more likely for patients to be randomized to the more effective arm. The primary end point was immune‐related PFS (irPFS). Results: Sixty‐one subjects were randomized to sequential (n = 38) or combination therapy (n = 23). Thirteen patients (34.2%) in the sequential arm received durvalumab. There was no difference in PFS in the sequential arm (1.84 months; 95% CI, 1.77–2.17 months) compared with the combination arm (1.87 months; 95% CI, 1.77–2.43 months) (p =.402). In the sequential arm, no responses were observed, although 12 patients (31.6%) demonstrated stable disease. In the combination arm, two patients (8.7%) had partial response, whereas one patient (4.4%) had stable disease. Adverse events were consistent with those previously reported for ICIs. Patient‐reported outcomes were similar in both arms. Conclusions: There was no difference in irPFS for combination tremelimumab plus durvalumab compared to tremelimumab alone (administered as part of a sequential treatment strategy) in a heavily pretreated population of patients with platinum‐resistant HGSOC. Response rates were comparable to prior reports, although the combination regimen did not add significant benefit, as has been previously described. There was no difference in the median progression‐free survival for combination tremelimumab plus durvalumab compared to tremelimumab alone (administered as part of a sequential treatment strategy) in a heavily pretreated population of patients with platinum‐resistant high‐grade serous ovarian cancer. The adverse event profile was consistent with that previously reported for immune checkpoint blockade, and patient‐reported outcomes were similar in both arms. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Serum CA 19-9 as a Marker of Resectability and Survival in Patients with Potentially Resectable Pancreatic Cancer Treated with Neoadjuvant Chemoradiation

Author

Katz, Matthew H., Varadhachary, Gauri R., Fleming, Jason B., Wolff, Robert A., Lee, Jeffrey E., Pisters, Peter W., Vauthey, Jean-Nicolas, Abdalla, Eddie K., Sun, Charlotte C., Wang, Huamin, Crane, Christopher H., Lee, Jeffrey H., Tamm, Eric P., Abbruzzese, James L., and Evans, Douglas B.

Subjects
Medicine & Public Health, Surgery, Oncology, Surgical Oncology
Abstract

The role of carbohydrate antigen (CA) 19-9 in the evaluation of patients with resectable pancreatic cancer treated with neoadjuvant therapy prior to planned surgical resection is unknown. We evaluated CA 19-9 as a marker of therapeutic response, completion of therapy, and survival in patients enrolled on two recently reported clinical trials.We analyzed patients with radiographically resectable adenocarcinoma of the head/uncinate process treated on two phase II trials of neoadjuvant chemoradiation. Patients without evidence of disease progression following chemoradiation underwent pancreaticoduodenectomy (PD). CA 19-9 was evaluated in patients with a normal bilirubin level.We enrolled 174 patients, and 119 (68%) completed all therapy including PD. Pretreatment CA 19-9

Published
2010

30. Long-Term Survival After Multidisciplinary Management of Resected Pancreatic Adenocarcinoma

Author

Katz, Matthew H., Wang, Huamin, Fleming, Jason B., Sun, Charlotte C., Hwang, Rosa F., Wolff, Robert A., Varadhachary, Gauri, Abbruzzese, James L., Crane, Christopher H., Krishnan, Sunil, Vauthey, Jean-Nicolas, Abdalla, Eddie K., Lee, Jeffrey E., Pisters, Peter W., and Evans, Douglas B.

Subjects
Medicine & Public Health, Surgery, Oncology, Surgical Oncology
Abstract

Actual 5-year survival rates of 10–18% have been reported for patients with resected pancreatic adenocarcinoma (PC), but the use of multimodality therapy was uncommon in these series. We evaluated long-term survival and patterns of recurrence in patients treated for PC with contemporary staging and multimodality therapy.We analyzed 329 consecutive patients with PC evaluated between 1990 and 2002 who underwent resection. Each received a multidisciplinary evaluation and a standard operative approach. Pre- or postoperative chemotherapy and/or chemoradiation were routine. Surgical specimens of 5-year survivors were rereviewed. A multivariate model of factors associated with long-term survival was constructed.Patients underwent pancreaticoduodenectomy (n = 302; 92%), distal (n = 20; 6%), or total pancreatectomy (n = 7; 2%). A total of 108 patients (33%) underwent vascular reconstruction, 301 patients (91%) received neoadjuvant or adjuvant therapy, 157 specimens (48%) were node positive, and margins were microscopically positive in 52 patients (16%). Median overall survival and disease-specific survival was 23.9 and 26.5 months. Eighty-eight patients (27%) survived a minimum of 5 years and had a median overall survival of 11 years. Of these, 21 (24%) experienced recurrence, 7 (8%) after 5 years. Late recurrences occurred most frequently in the lungs, the latest at 6.7 years. Multivariate analysis identified disease-negative lymph nodes (P = .02) and no prior attempt at resection (P = 0.01) as associated with 5-year survival. Our 27% actual 5-year survival rate for patients with resected PC is superior to that previously reported, and it is influenced by our emphasis on detailed staging and patient selection, a standardized operative approach, and routine use of multimodality therapy.

Published
2009

38. Figure_S6 from Phase Ib Dose Expansion and Translational Analyses of Olaparib in Combination with Capivasertib in Recurrent Endometrial, Triple-Negative Breast, and Ovarian Cancer

Author

Westin, Shannon N., primary, Labrie, Marilyne, primary, Litton, Jennifer K., primary, Blucher, Aurora, primary, Fang, Yong, primary, Vellano, Christopher P., primary, Marszalek, Joseph R., primary, Feng, Ningping, primary, Ma, XiaoYan, primary, Creason, Allison, primary, Fellman, Bryan, primary, Yuan, Ying, primary, Lee, Sanghoon, primary, Kim, Tae-Beom, primary, Liu, Jinsong, primary, Chelariu-Raicu, Anca, primary, Chen, Tsun Hsuan, primary, Kabil, Nashwa, primary, Soliman, Pamela T., primary, Frumovitz, Michael, primary, Schmeler, Katheleen M., primary, Jazaeri, Amir, primary, Lu, Karen H., primary, Murthy, Rashmi, primary, Meyer, Larissa A., primary, Sun, Charlotte C., primary, Sood, Anil K., primary, Coleman, Robert L., primary, and Mills, Gordon B., primary

Published
2023
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39. Supplementary Tables from Phase Ib Dose Expansion and Translational Analyses of Olaparib in Combination with Capivasertib in Recurrent Endometrial, Triple-Negative Breast, and Ovarian Cancer

Author

Westin, Shannon N., primary, Labrie, Marilyne, primary, Litton, Jennifer K., primary, Blucher, Aurora, primary, Fang, Yong, primary, Vellano, Christopher P., primary, Marszalek, Joseph R., primary, Feng, Ningping, primary, Ma, XiaoYan, primary, Creason, Allison, primary, Fellman, Bryan, primary, Yuan, Ying, primary, Lee, Sanghoon, primary, Kim, Tae-Beom, primary, Liu, Jinsong, primary, Chelariu-Raicu, Anca, primary, Chen, Tsun Hsuan, primary, Kabil, Nashwa, primary, Soliman, Pamela T., primary, Frumovitz, Michael, primary, Schmeler, Katheleen M., primary, Jazaeri, Amir, primary, Lu, Karen H., primary, Murthy, Rashmi, primary, Meyer, Larissa A., primary, Sun, Charlotte C., primary, Sood, Anil K., primary, Coleman, Robert L., primary, and Mills, Gordon B., primary

Published
2023
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40. Supplementary materials from Phase Ib Dose Expansion and Translational Analyses of Olaparib in Combination with Capivasertib in Recurrent Endometrial, Triple-Negative Breast, and Ovarian Cancer

Author

Westin, Shannon N., primary, Labrie, Marilyne, primary, Litton, Jennifer K., primary, Blucher, Aurora, primary, Fang, Yong, primary, Vellano, Christopher P., primary, Marszalek, Joseph R., primary, Feng, Ningping, primary, Ma, XiaoYan, primary, Creason, Allison, primary, Fellman, Bryan, primary, Yuan, Ying, primary, Lee, Sanghoon, primary, Kim, Tae-Beom, primary, Liu, Jinsong, primary, Chelariu-Raicu, Anca, primary, Chen, Tsun Hsuan, primary, Kabil, Nashwa, primary, Soliman, Pamela T., primary, Frumovitz, Michael, primary, Schmeler, Katheleen M., primary, Jazaeri, Amir, primary, Lu, Karen H., primary, Murthy, Rashmi, primary, Meyer, Larissa A., primary, Sun, Charlotte C., primary, Sood, Anil K., primary, Coleman, Robert L., primary, and Mills, Gordon B., primary

Published
2023
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42. Secondary validation of an ovarian cancer-specific comorbidity index in a US population

Author

Vranes, Chelsey, Zhao, Hui, Noer, Mette Calundann, Fu, Shuangshuang, Sun, Charlotte C., Harrison, Ross, Ramirez, Pedro T., Høgdall, Claus Kim, Giordano, Sharon H., Meyer, Larissa A., Vranes, Chelsey, Zhao, Hui, Noer, Mette Calundann, Fu, Shuangshuang, Sun, Charlotte C., Harrison, Ross, Ramirez, Pedro T., Høgdall, Claus Kim, Giordano, Sharon H., and Meyer, Larissa A.

Abstract

Objectives The Ovarian Cancer Comorbidity Index (OCCI) is an age-specific index developed and previously found to be more predictive of overall and cancer-specific survival than the Charlson Comorbidity Index (CCI). The objective was to perform secondary validation of the OCCI in a US population. Methods A cohort of ovarian cancer patients undergoing primary or interval cytoreductive surgery from January 2005 to January 2012 was identified in SEER-Medicare. OCCI scores were calculated with the regression coefficients determined from the original developmental cohort for five comorbidities. Cox regression analyses were used to calculate associations between the OCCI risk groups and 5-year overall survival and 5-year cancer-specific survival in comparison to the CCI. Results A total of 5052 patients were included. Median age was 74 (range 66-82) years. 47% (n=2375) had stage III and 24% (n=1197) had stage IV disease at diagnosis. 67% had a serous histology subtype (n=3403). All patients were categorized as moderate (48.4%) or high risk (51.6%). The prevalence of the five predictive comorbidities were: coronary artery disease 3.7%, hypertension 67.5%, chronic obstructive pulmonary disease 16.7%, diabetes 21.8%, and dementia 1.2%. Controlling for histology, grade, and age-stratification, worse overall survival was associated with both a higher OCCI (hazard ratio (HR) 1.57; 95% confidence interval (CI) 1.46 to 1.69) and CCI (HR 1.96; 95% CI 1.66 to 2.32). Cancer-specific survival was associated with the OCCI (HR 1.33; 95% CI 1.22 to 1.44) but was not associated with the CCI (HR 1.15; 95% CI 0.93 to 1.43). Conclusions This internationally developed comorbidity score for ovarian cancer patients is predictive for both overall and cancer-specific survival in a US population. CCI was not predictive for cancer-specific survival. This score may have research applications when utilizing large administrative datasets.

Published
2023

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