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Cancers
Volume 13
Issue 22
10.3390/cancers13225805
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Article
Peer-Review Record

Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England

Cancers 2021, 13(22), 5805; https://doi.org/10.3390/cancers13225805
by Matthew James Smith 1,*, Aurélien Belot 1, Matteo Quartagno 2, Miguel Angel Luque Fernandez 1,3,4, Audrey Bonaventure 5, Susan Gachau 6, Sara Benitez Majano 1, Bernard Rachet 1 and Edmund Njeru Njagi 1
Reviewer 1: Anonymous
Reviewer 2: Anonymous
Cancers 2021, 13(22), 5805; https://doi.org/10.3390/cancers13225805
Submission received: 1 October 2021 / Revised: 10 November 2021 / Accepted: 16 November 2021 / Published: 19 November 2021
(This article belongs to the Special Issue New Sights in Cancer Survival Analysis: Non-clinical Determinants of Survival for Patients with Cancer)

Round 1

Reviewer 1 Report

Multiple factors (age, comorbidity, socioeconomic factors, etc.) must influence the treatment for malignant lymphoma (i.e., intensive or mild chemotherapy or watch and wait (especially in case of FL), with or without rituximab, number of chemotherapy course completed, etc). Therefore, authors need to incorpolate data regariding treatment into the hazard ratio analysis.

Author Response

Please kindly see the attached response letter.

Author Response File: Author Response.docx

Reviewer 2 Report

Matthew J. Smith et al. uncovered cancer epidemiology from the standpoint of approaching the pts with  Diffuse Large B-cell Lymphoma and Follicular Lymphoma.

Points to be considered:

  1. One issue related to the strategy employed can be the lack of fully control for confounding by indication leading to model misspecification. This would be an issue even with a perfectly robust model. This confounding is best illustrated by the unexpected results for chemotherapy and immunological treatment: the variation explained by these models may be great, because they allow the effect of time‐varying variables to be modelled and, hence, measures of prognostic factors that are updated over time since the cancer diagnosis. Can the author comment on this?
  2. Since novel strategies are being developed in treating NHLs (refer to PMID: 26818572) how would the authors suggest to overcome the non clinical barriers to those approaches (i.e. BiTEs, CAR-T, ADCs, etc.)?

    3. The underlying message here is that more precision and individualized approaches need to be tested in well designed clinical trials – a challenge, but I would be interested in their perspective of how this might be done.

     

Author Response

Please kindly see the response letter attached.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

The revised manuscript has been improved.

Reviewer 2 Report

The authors have clarified several of the questions I raised in my previous review. Most of the major problems have been addressed by this revision.

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