Systematic review and network meta-analysis of overall survival comparing 3 mg/kg ipilimumab with alternative therapies in the management of pretreated patients with unresectable stage III or IV melanoma
Lorigan P.,The Christie NHS Foundation Trust |
Van Baardewijk M.,Bristol Myers Squibb |
Kotapati S.,Bristol Myers Squibb
Oncologist | Year: 2012
Objective. To compare the overall survival (OS) of patients treated with 3 mg/kg ipilimumab versus alternative systemic therapies in pretreated unresectable stage III or IV melanoma patients. Methods. A systematic literature search was performed to identify relevant randomized clinical trials. From these trials, Kaplan-Meier survival curves for each intervention were digitized and combined by means of a Bayesian network meta-analysis (NMA) to compare different drug classes. Results. Of 38 trials identified, 15 formed one interlinked network by drug class to allow for an NMA. Ipilimumab, at a dose of 3 mg/kg, was associated with a greater mean OS time (18.8 months; 95% credible interval [CrI], 15.5-23.0 months) than single-agent chemotherapy (12.3 months; 95% CrI, 6.3-28.0 months), chemotherapy combinations (12.2 months; 95% CrI, 7.1-23.3 months), biochemotherapies (11.9 months; 95% CrI, 7.0-22.0 months), singleagent immunotherapy (11.1 months; 95% CrI, 8.5-16.2 months), and immunotherapy combinations (14.1 months; 95% CrI, 9.0-23.8 months). Conclusion. Results of this NMA were in line with previous findings and suggest that OS with ipilimumab is expected to be greater than with alternative systemic therapies, alone or in combination, for the management of pretreated patients with unresectable stage III or IV melanoma. © AlphaMed Press. Source
So J.,The Christie NHS Foundation Trust
European Journal of Cancer Care | Year: 2010
There has been a plethora of oral chemotherapeutic agents introduced over recent years. For hospital pharmacies this has meant unprecedented activity. At the same time there is pressure to meet waiting time targets and to improve patient experience. The Cancer Centre had already used homecare services for trastuzumab (Herceptin) so it seemed reasonable to apply this to selected oral agents. A formal tender resulted in a contract award for homecare. The service has been running successfully for 3 years with imatinib in chronic myeloid leukaemia and in gastro-intestinal stromal tumour patients. Patients are informed about the homecare supply service in clinic by the nurse or pharmacist, with most patients opting for the service rather than a wait in pharmacy for their prescription. The drug is then delivered by post to the patient's home. We plan to extend the service in the coming months to include a second oral agent, erlotinib for the treatment of non small cell lung cancer. As well as avoiding a patient wait in pharmacy, provision through a homecare company offers a more cost effective way for the Trust to deliver an oral chemotherapy service. By reducing the number of patients arriving in pharmacy for prescriptions, it facilitates the achievement of outpatient waiting time targets and improves the overall patient experience. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd. Source
Nonaka D.,The Christie NHS Foundation Trust
Diagnostic Histopathology | Year: 2010
Immunohistochemistry is a powerful tool for classifying poorly differentiated cancers and metastatic tumours of unknown origin. Many useful immunohistochemistry stains target proteins unique to a particular organ or cell type, and examples of this group include thyroglobulin for thyroid follicular cells, and surfactant proteins for pulmonary type II pneumocytes and Clara cells. These proteins are closely related to the ultimate function of the particular cell type, and they are more likely expressed by well-differentiated tumours but not poorly differentiated ones. Transcription factors generally function to determine the fate of specification and differentiation in precursor cells, and absence of one transcription factor might result in agenesis of the particular organ and tissue. Due to its role in precursor cells, they are likely to be expressed even in poorly differentiated or undifferentiated tumours. This review article will discuss the combined application of differentiation markers as well as transcription factors to metastatic tumours. © 2010 Elsevier Ltd. Source
The Christie Nhs Foundation Trust | Date: 2012-06-21
The present invention relates to a phantom for use in the auditing or verification of a proposed radiation therapy regime for administration to a patient. The phantom comprises a housing which is shaped to simulate the anatomical shape of a human head and neck; and a radiation detector module configured to receive at least one radiation detector. The housing defines a cavity in which the radiation detector module can be removeably received such that the radiation detector module occupies a predetermined location within the simulated head and neck of the housing. Said predetermined location encompasses areas of the housing which simulate a target site to which it is proposed to administer radiation to the patient and a location of at least one organ that is susceptible to harm by administration of said radiation.
Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2013.2.4.1-3 | Award Amount: 7.82M | Year: 2013
Long-term side-effects of radiotherapy impact on the quality-of-life (QoL) of cancer survivors. These side-effects could be reduced if predicted in advance. Previous work identified clinical and biological predictors but a major, coordinated approach is needed to validate them so they can be used clinically. The EU has ~17.8 million people living with a prior diagnosis of cancer of whom ~7 million received radiotherapy. In the long-term, potentially 20% of those suffering with mild to severe side-effects (~1.4 million) might benefit from alleviation of symptoms, with resulting reductions in the cost of care in the EU. REQUITE aims to develop validated clinical models and incorporate biomarkers to identify before treatment cancer patients at risk of side-effects and use the models to design interventional trials aimed at reducing side-effects and improving QoL in cancer survivors who underwent radiotherapy. REQUITE will: 1. carry out a multi-centre, longitudinal, observational study to collect standardised data and samples in breast, prostate and lung cancer patients; 2. validate biomarkers with published evidence of predictive value; 3. replicate published clinical models and incorporate replicated biomarkers to create validated predictive algorithms; 4. use the prospectively validated models and biomarkers to design interventional trial protocols aiming to reduce side-effects and improve QoL in high-risk patients. REQUITE builds on collaborations with a proven history of data sharing, enlarged to a consortium with expertise in patient recruitment, knowledge management, biomarker testing and predictive model development. SME involvement for biomarker assays will facilitate future clinical implementation and commercial exploitation. The outcome of this project will be validated predictive models for three common cancers and trial protocols using the models to investigate interventions aimed at reducing long-term side-effects and improving the QoL of cancer survivors.