Real-World Outcomes of Incurable Cancer Patients Treated with Unlisted Anticancer Treatments in an Academic Center in Quebec, Canada
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Collected Data
2.3. Outcome Description and Statistical Analysis
3. Results
3.1. Description of the Patients Receiving an Unlisted Anticancer Prescription
3.2. Clinical Outcomes in Patients Receiving an Unlisted Anticancer Prescription
3.3. Analysis of Outcomes According to the Level of Evidence Supporting the Request
3.4. Analysis of Outcomes if the Medication Was Subsequently Reimbursed in Quebec
3.5. Analysis of Outcomes According to the Type of Anticancer Medication
3.6. Analysis of Outcomes in Comparison to the Published Literature
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Features | N (%) |
---|---|
Sex | |
Male | 57 (50%) |
Female | 56 (50%) |
Age (years) | |
18–50 | 18 (16%) |
51–71 | 62 (55%) |
≥71 | 35 (31%) |
Type of cancer | |
Solid malignancy | 59 (52%) |
Breast | 10 (9%) |
Pancreatic | 8 (7%) |
Colorectal | 7 (6%) |
Ovarian | 6 (5%) |
Skin, melanoma | 6 (5%) |
Renal cell | 6 (5%) |
Lung cancer, non-small cell lung cancer | 4 (4%) |
Skin, squamous carcinoma | 3 (3%) |
Head and neck, squamous carcinoma | 2 (2%) |
Bladder | 2 (2%) |
Angiosarcoma, prostate, leiomyosarcoma, cervix, endometrium | 1 (1%) each |
Hematological malignancy | 54 (48%) |
Indolent B-cell lymphoma | 25 (22%) |
Multiple myeloma | 10 (9%) |
Acute myeloid leukemia | 5 (4%) |
Hodgkin lymphoma | 3 (3%) |
Chronic myelocytic leukemia | 2 (2%) |
Large B-cell lymphoma | 2 (2%) |
Myelodysplastic syndrome | 2 (2%) |
Blastic plasmacytoid dendritic cell neoplasm, lymphoplasmacytic lymphoma, peripheral T cell lymphoma, other monoclonal plasma cell disorder, Castleman disease | 1 (1%) each |
Variable | N (%) |
---|---|
Type of treatment | |
Targeted therapy | 60 (53%) |
Chemotherapy | 38 (34%) |
Immune checkpoint inhibitor | 15 (13%) |
Evidence supporting the request | |
Phase III randomized clinical trial | 62 (55%) |
Others | 51 (45%) |
Subsequently reimbursed by the public health system in Quebec | |
Yes | 50 (44%) |
No | 63 (56%) |
Line of therapy | |
First line | 31 (27%) |
Second line | 24 (21%) |
Third line | 26 (23%) |
Fourth line | 17 (15%) |
Fifth line | 6 (5%) |
Sixth to tenth line | 9 (8%) |
Types of Evidence | All Types of Evidence N = 113 (100%) | Phase III Clinical Trial N = 62 (54.8%) | Other Types of Evidence N = 51 (45%) |
---|---|---|---|
Subsequently reimbursed | 50 (44%) | 40 (65%) | 10 (20%) |
Number of Patients in Our Real-World Cohort | Type of Cancer | Previous Line of Treatment | Drug Name | Type of Comparator Trial, Reference | Outcomes in the Comparator Trial | Outcomes in Our Unlisted Cohort |
---|---|---|---|---|---|---|
14 | Indolent B-cell lymphoma | 0 | Bendamustine-rituximab | Phase III, [12] | PFS at 5 years: 65% | PFS at 5 years: 9/14 (64%) |
6 | Melanoma | 0 | Ipilimumab-nivolumab | Phase III, [13] | Median PFS: 11.5 months Median OS: not reached | Median PFS: 12 months Median OS: not reached (3/6 still alive at five years) |
5 | Breast cancer | 4 to 9 | Liposomal doxorubicin | Retrospective analysis, [14] | Median PFS: 5.8 months Median OS: 14.2 months | Median PFS: 3 months Median OS: 6 months |
5 | Renal cell cancer | 2 to 3 | Cabozantinib | Phase III, [15] | Median PFS: 7.4 months Median OS: 21.4 months | Median PFS: 7 months Median OS: 28 months |
5 | Pancreatic cancer | 2 to 3 | Liposomal irinotecan with 5-FU * | Retrospective data, [16] | Median PFS: 3.5 months Median OS: 9.4 months | Median PFS: 3 months Median OS: 6 months |
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Miller, A.; Panet, F.; Korsos, V.; Miller, W.H., Jr.; Batist, G. Real-World Outcomes of Incurable Cancer Patients Treated with Unlisted Anticancer Treatments in an Academic Center in Quebec, Canada. Curr. Oncol. 2024, 31, 5908-5918. https://doi.org/10.3390/curroncol31100440
Miller A, Panet F, Korsos V, Miller WH Jr., Batist G. Real-World Outcomes of Incurable Cancer Patients Treated with Unlisted Anticancer Treatments in an Academic Center in Quebec, Canada. Current Oncology. 2024; 31(10):5908-5918. https://doi.org/10.3390/curroncol31100440
Chicago/Turabian StyleMiller, Adam, Francois Panet, Victoria Korsos, Wilson H. Miller, Jr., and Gerald Batist. 2024. "Real-World Outcomes of Incurable Cancer Patients Treated with Unlisted Anticancer Treatments in an Academic Center in Quebec, Canada" Current Oncology 31, no. 10: 5908-5918. https://doi.org/10.3390/curroncol31100440