User login
Surgeon General: Public Health Investment is key to Economic Security
In December 2018, Federal Practitioner sat down with Surgeon General VADM Jerome M. Adams, MD, MPH to discuss recent initiatives to combat the opioid epidemic and to improve health care engagement and delivery in this exclusive video interview. During 2018, the Office of the Surgeon General took a number of steps to address the ongoing opioid crisis, releasing a public health advisory to urge increased use of naloxone, which can reverse the effects of an opioid overdose. In addition, the office of the Surgeon General released a postcard with 5 actions every person can take to address the opioid epidemic.
Increasing Health Care Engagement

Next: Community health and economic prosperity, What health care providers can do for prevention, expanding the PHS mission, the Surgeon General's challenge on opioids
Community Health and Economic Prosperity

Next: What health care providers can do for prevention, expanding the PHS mission, the Surgeon General's challenge on opioids
What Health Care Providers Can Do for Prevention

Next: Expanding the PHS mission, the Surgeon General's challenge on opioids
Expanding the PHS Mission

Next: The Surgeon General's challenge on opioids
The Surgeon General's Challenge on Opioids
In December 2018, Federal Practitioner sat down with Surgeon General VADM Jerome M. Adams, MD, MPH to discuss recent initiatives to combat the opioid epidemic and to improve health care engagement and delivery in this exclusive video interview. During 2018, the Office of the Surgeon General took a number of steps to address the ongoing opioid crisis, releasing a public health advisory to urge increased use of naloxone, which can reverse the effects of an opioid overdose. In addition, the office of the Surgeon General released a postcard with 5 actions every person can take to address the opioid epidemic.
Increasing Health Care Engagement

Next: Community health and economic prosperity, What health care providers can do for prevention, expanding the PHS mission, the Surgeon General's challenge on opioids
Community Health and Economic Prosperity

Next: What health care providers can do for prevention, expanding the PHS mission, the Surgeon General's challenge on opioids
What Health Care Providers Can Do for Prevention

Next: Expanding the PHS mission, the Surgeon General's challenge on opioids
Expanding the PHS Mission

Next: The Surgeon General's challenge on opioids
The Surgeon General's Challenge on Opioids
In December 2018, Federal Practitioner sat down with Surgeon General VADM Jerome M. Adams, MD, MPH to discuss recent initiatives to combat the opioid epidemic and to improve health care engagement and delivery in this exclusive video interview. During 2018, the Office of the Surgeon General took a number of steps to address the ongoing opioid crisis, releasing a public health advisory to urge increased use of naloxone, which can reverse the effects of an opioid overdose. In addition, the office of the Surgeon General released a postcard with 5 actions every person can take to address the opioid epidemic.
Increasing Health Care Engagement

Next: Community health and economic prosperity, What health care providers can do for prevention, expanding the PHS mission, the Surgeon General's challenge on opioids
Community Health and Economic Prosperity

Next: What health care providers can do for prevention, expanding the PHS mission, the Surgeon General's challenge on opioids
What Health Care Providers Can Do for Prevention

Next: Expanding the PHS mission, the Surgeon General's challenge on opioids
Expanding the PHS Mission

Next: The Surgeon General's challenge on opioids
The Surgeon General's Challenge on Opioids
Resting State Functional Connectivity Signals Medication Resistance
Altered thalamo-hippocampal resting state functional brain connectivity may serve as a biomarker to signal treatment resistance in patients with temporal lobe epilepsy (TLE) suggests a recent study of 286 patients with epilepsy.
- Researchers from Rockefeller University reviewed data from a database that included resting state functional MRI readings.
- The analysis included seizure characterization, EEG indications of lateralization, and localization of seizure foci.
- The investigators compared records from patients with well-controlled TLE to those with treatment resistant disease and healthy controls.
- Treatment resistant patients had a significant bilateral decrease in thalamo-hippocampal functional connectivity.
Pressl C, Brandner P, Schaffelhofer S, et al. Resting state functional connectivity patterns associated with pharmacological treatment resistance in temporal lobe epilepsy. Epilepsy Res. 2019;149:37-43.
Altered thalamo-hippocampal resting state functional brain connectivity may serve as a biomarker to signal treatment resistance in patients with temporal lobe epilepsy (TLE) suggests a recent study of 286 patients with epilepsy.
- Researchers from Rockefeller University reviewed data from a database that included resting state functional MRI readings.
- The analysis included seizure characterization, EEG indications of lateralization, and localization of seizure foci.
- The investigators compared records from patients with well-controlled TLE to those with treatment resistant disease and healthy controls.
- Treatment resistant patients had a significant bilateral decrease in thalamo-hippocampal functional connectivity.
Pressl C, Brandner P, Schaffelhofer S, et al. Resting state functional connectivity patterns associated with pharmacological treatment resistance in temporal lobe epilepsy. Epilepsy Res. 2019;149:37-43.
Altered thalamo-hippocampal resting state functional brain connectivity may serve as a biomarker to signal treatment resistance in patients with temporal lobe epilepsy (TLE) suggests a recent study of 286 patients with epilepsy.
- Researchers from Rockefeller University reviewed data from a database that included resting state functional MRI readings.
- The analysis included seizure characterization, EEG indications of lateralization, and localization of seizure foci.
- The investigators compared records from patients with well-controlled TLE to those with treatment resistant disease and healthy controls.
- Treatment resistant patients had a significant bilateral decrease in thalamo-hippocampal functional connectivity.
Pressl C, Brandner P, Schaffelhofer S, et al. Resting state functional connectivity patterns associated with pharmacological treatment resistance in temporal lobe epilepsy. Epilepsy Res. 2019;149:37-43.
Poor-prognosis cancers linked to highest suicide risk in first year
Suicide risk significantly increases within the first year of a cancer diagnosis, with risk varying by type of cancer, according to investigators who conducted a retrospective analysis representing nearly 4.7 million patients.
Risk of suicide in that first year after diagnosis was especially high in pancreatic and lung cancers, while by contrast, breast and prostate cancer did not increase suicide risk, reported the researchers, led by Hesham Hamoda, MD, MPH, of Boston Children’s Hospital/Harvard Medical School, and Ahmad Alfaar, MBBCh, MSc, of Charité–Universitätsmedizin Berlin.
That variation in suicide risk by cancer type suggests that prognosis and 5-year relative survival play a role in increasing suicide rates, according to Dr. Hamoda, Dr. Alfaar, and their coauthors.
“After the diagnosis, it is important that health care providers be vigilant in screening for suicide and ensuring that patients have access to social and emotional support,” they wrote in a report published in Cancer. Their analysis was based on 4,671,989 patients with a diagnosis of cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2014. Out of 1,005,825 of those patients who died within the first year of diagnosis, the cause of death was suicide for 1,585, or 0.16%.
Overall, the risk of suicide increased significantly among cancer patients versus the general population, with an observed-to-expected (O/E) ratio of 2.51 per 10,000 person-years, the investigators found. The risk was highest in the first 6 months, with an O/E mortality of 3.13 versus 1.8 in the latter 6 months.
The highest ratios were seen for pancreatic cancer, with an O/E ratio of 8.01, and lung cancer, with a ratio of 6.05, the researchers found in further analysis.
Significant increases in suicide risk were also seen for colorectal cancer (2.08) and melanoma (1.45), though rates were not significantly different versus the general population for breast (1.23) and prostate (0.99), according to the reported data.
Suicide risk was relatively high for any cancer with distant metastases (5.63), though still significantly higher at 1.65 in persons with localized/regional disease, the data show.
The increased suicide risk persisted more than 1 year after the cancer diagnosis, though not to the degree observed within that first year, they added.
Most patients with suicide as a cause of death were white (90.2%) and male (87%). Nearly 60% were between the ages of 65 and 84 at the time of suicide.
Social support plays an integral role in suicide prevention among cancer patients, the researchers noted.
Previous studies suggest that support programs may decrease suicide risk by making patients better aware of their prognosis, receptive to decreased social stigma, or less likely to have stress related to cost of care, they said.
“Discussing the quality of life after diagnosis, the effectiveness of therapy, and the prognosis of the disease and maintaining a trusting relationship with health care professionals all decrease the likelihood of suicide immediately after a diagnosis of cancer,” they said.
Dr. Hamoda, Dr. Alfaar, and their coauthors reported no conflicts of interest. Funding for the study came in part from the German Academic Exchange Service (Dr. Alfaar).
SOURCE: Saad AM, et al. Cancer 2019 Jan 7. doi: 10.1002/cncr.31876.
Suicide risk significantly increases within the first year of a cancer diagnosis, with risk varying by type of cancer, according to investigators who conducted a retrospective analysis representing nearly 4.7 million patients.
Risk of suicide in that first year after diagnosis was especially high in pancreatic and lung cancers, while by contrast, breast and prostate cancer did not increase suicide risk, reported the researchers, led by Hesham Hamoda, MD, MPH, of Boston Children’s Hospital/Harvard Medical School, and Ahmad Alfaar, MBBCh, MSc, of Charité–Universitätsmedizin Berlin.
That variation in suicide risk by cancer type suggests that prognosis and 5-year relative survival play a role in increasing suicide rates, according to Dr. Hamoda, Dr. Alfaar, and their coauthors.
“After the diagnosis, it is important that health care providers be vigilant in screening for suicide and ensuring that patients have access to social and emotional support,” they wrote in a report published in Cancer. Their analysis was based on 4,671,989 patients with a diagnosis of cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2014. Out of 1,005,825 of those patients who died within the first year of diagnosis, the cause of death was suicide for 1,585, or 0.16%.
Overall, the risk of suicide increased significantly among cancer patients versus the general population, with an observed-to-expected (O/E) ratio of 2.51 per 10,000 person-years, the investigators found. The risk was highest in the first 6 months, with an O/E mortality of 3.13 versus 1.8 in the latter 6 months.
The highest ratios were seen for pancreatic cancer, with an O/E ratio of 8.01, and lung cancer, with a ratio of 6.05, the researchers found in further analysis.
Significant increases in suicide risk were also seen for colorectal cancer (2.08) and melanoma (1.45), though rates were not significantly different versus the general population for breast (1.23) and prostate (0.99), according to the reported data.
Suicide risk was relatively high for any cancer with distant metastases (5.63), though still significantly higher at 1.65 in persons with localized/regional disease, the data show.
The increased suicide risk persisted more than 1 year after the cancer diagnosis, though not to the degree observed within that first year, they added.
Most patients with suicide as a cause of death were white (90.2%) and male (87%). Nearly 60% were between the ages of 65 and 84 at the time of suicide.
Social support plays an integral role in suicide prevention among cancer patients, the researchers noted.
Previous studies suggest that support programs may decrease suicide risk by making patients better aware of their prognosis, receptive to decreased social stigma, or less likely to have stress related to cost of care, they said.
“Discussing the quality of life after diagnosis, the effectiveness of therapy, and the prognosis of the disease and maintaining a trusting relationship with health care professionals all decrease the likelihood of suicide immediately after a diagnosis of cancer,” they said.
Dr. Hamoda, Dr. Alfaar, and their coauthors reported no conflicts of interest. Funding for the study came in part from the German Academic Exchange Service (Dr. Alfaar).
SOURCE: Saad AM, et al. Cancer 2019 Jan 7. doi: 10.1002/cncr.31876.
Suicide risk significantly increases within the first year of a cancer diagnosis, with risk varying by type of cancer, according to investigators who conducted a retrospective analysis representing nearly 4.7 million patients.
Risk of suicide in that first year after diagnosis was especially high in pancreatic and lung cancers, while by contrast, breast and prostate cancer did not increase suicide risk, reported the researchers, led by Hesham Hamoda, MD, MPH, of Boston Children’s Hospital/Harvard Medical School, and Ahmad Alfaar, MBBCh, MSc, of Charité–Universitätsmedizin Berlin.
That variation in suicide risk by cancer type suggests that prognosis and 5-year relative survival play a role in increasing suicide rates, according to Dr. Hamoda, Dr. Alfaar, and their coauthors.
“After the diagnosis, it is important that health care providers be vigilant in screening for suicide and ensuring that patients have access to social and emotional support,” they wrote in a report published in Cancer. Their analysis was based on 4,671,989 patients with a diagnosis of cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2014. Out of 1,005,825 of those patients who died within the first year of diagnosis, the cause of death was suicide for 1,585, or 0.16%.
Overall, the risk of suicide increased significantly among cancer patients versus the general population, with an observed-to-expected (O/E) ratio of 2.51 per 10,000 person-years, the investigators found. The risk was highest in the first 6 months, with an O/E mortality of 3.13 versus 1.8 in the latter 6 months.
The highest ratios were seen for pancreatic cancer, with an O/E ratio of 8.01, and lung cancer, with a ratio of 6.05, the researchers found in further analysis.
Significant increases in suicide risk were also seen for colorectal cancer (2.08) and melanoma (1.45), though rates were not significantly different versus the general population for breast (1.23) and prostate (0.99), according to the reported data.
Suicide risk was relatively high for any cancer with distant metastases (5.63), though still significantly higher at 1.65 in persons with localized/regional disease, the data show.
The increased suicide risk persisted more than 1 year after the cancer diagnosis, though not to the degree observed within that first year, they added.
Most patients with suicide as a cause of death were white (90.2%) and male (87%). Nearly 60% were between the ages of 65 and 84 at the time of suicide.
Social support plays an integral role in suicide prevention among cancer patients, the researchers noted.
Previous studies suggest that support programs may decrease suicide risk by making patients better aware of their prognosis, receptive to decreased social stigma, or less likely to have stress related to cost of care, they said.
“Discussing the quality of life after diagnosis, the effectiveness of therapy, and the prognosis of the disease and maintaining a trusting relationship with health care professionals all decrease the likelihood of suicide immediately after a diagnosis of cancer,” they said.
Dr. Hamoda, Dr. Alfaar, and their coauthors reported no conflicts of interest. Funding for the study came in part from the German Academic Exchange Service (Dr. Alfaar).
SOURCE: Saad AM, et al. Cancer 2019 Jan 7. doi: 10.1002/cncr.31876.
FROM CANCER
Key clinical point: A cancer diagnosis significantly increases risk of suicide in comparison to the general population, particularly for poorer-prognosis cancers.
Major finding: The observed-to-expected mortality ratio was substantially higher for pancreatic cancer (8.01), and lung cancer (6.05), but not significantly increased for breast (1.23) and prostate (0.99).
Study details: A retrospective population-based study of 4,671,989 cancer patients.
Disclosures: The authors reported no conflicts of interest. Funding for the study came in part from the German Academic Exchange Service.
Source: Saad AM et al. Cancer. 2019 Jan 7. doi: 10.1002/cncr.31876.
Don’t Delay Drug Therapy in Children with Status Epilepticus
Delaying the first dose of antiseizure medication in children with status epilepticus will likely prolong the condition, according a report published in Epilepsy Research.
- Investigators from the Division of Child Neurology at Children’s National Health System in Washington, DC, evaluated the timing and selection of antiseizure medication in children presenting at a pediatric emergency department.
- Among 141 patients with status epilepticus (SE), median age 45 months, SE lasted 61.5 min (median).
- Median time to receipt of the first dose of antiseizure drug was 25 min.
- Ninety two percent of patients received a benzodiazepine as the first drug.
- A benzodiazepine was the second dose antiseizure medication in 95% of patients.
- Among patients who received the first dose of medication in less than 5 minutes, seizures lasted 59.5 min (median) while children who did not receive their first dose for an hour or more after seizure experienced a duration of 151.5 min.
Cohen NT, Chamberlain JM, Gaillard WD. Timing and selection of first antiseizure medication in patients with pediatric status epilepticus. Epilepsy Res. 2019;149:21-25.
Delaying the first dose of antiseizure medication in children with status epilepticus will likely prolong the condition, according a report published in Epilepsy Research.
- Investigators from the Division of Child Neurology at Children’s National Health System in Washington, DC, evaluated the timing and selection of antiseizure medication in children presenting at a pediatric emergency department.
- Among 141 patients with status epilepticus (SE), median age 45 months, SE lasted 61.5 min (median).
- Median time to receipt of the first dose of antiseizure drug was 25 min.
- Ninety two percent of patients received a benzodiazepine as the first drug.
- A benzodiazepine was the second dose antiseizure medication in 95% of patients.
- Among patients who received the first dose of medication in less than 5 minutes, seizures lasted 59.5 min (median) while children who did not receive their first dose for an hour or more after seizure experienced a duration of 151.5 min.
Cohen NT, Chamberlain JM, Gaillard WD. Timing and selection of first antiseizure medication in patients with pediatric status epilepticus. Epilepsy Res. 2019;149:21-25.
Delaying the first dose of antiseizure medication in children with status epilepticus will likely prolong the condition, according a report published in Epilepsy Research.
- Investigators from the Division of Child Neurology at Children’s National Health System in Washington, DC, evaluated the timing and selection of antiseizure medication in children presenting at a pediatric emergency department.
- Among 141 patients with status epilepticus (SE), median age 45 months, SE lasted 61.5 min (median).
- Median time to receipt of the first dose of antiseizure drug was 25 min.
- Ninety two percent of patients received a benzodiazepine as the first drug.
- A benzodiazepine was the second dose antiseizure medication in 95% of patients.
- Among patients who received the first dose of medication in less than 5 minutes, seizures lasted 59.5 min (median) while children who did not receive their first dose for an hour or more after seizure experienced a duration of 151.5 min.
Cohen NT, Chamberlain JM, Gaillard WD. Timing and selection of first antiseizure medication in patients with pediatric status epilepticus. Epilepsy Res. 2019;149:21-25.
No link between sex and survival on checkpoint inhibitors in latest meta-analysis
Men and women with cancer may derive a similar survival benefit from immune checkpoint inhibitor therapy, results of a recent meta-analysis suggest.
Both men and women had an overall survival benefit from immunotherapy versus standard of care therapy, with no significant difference between the sexes, according to authors of this meta-analysis, which included 23 randomized clinical trials comprising nearly 14,000 patients.
The findings, reported in JAMA Oncology, contrast with those of another recent analysis, which suggested that men had a greater advantage of receiving immunotherapy versus standard of care than women did.
“We found no evidence that sex should be considered when deciding whether to offer immunotherapy to patients with advanced cancers,” said Christopher J.D. Wallis, MD, PhD, of the University of Toronto, and his coauthors said in their report.
The present meta-analysis was based on a “more contemporary and comprehensive” literature search strategy than the earlier one, according to Dr. Wallis and his coinvestigators.
Specifically, they considered immunotherapy agents not included in the previous analysis, added seven new studies published since the previous analysis, and excluded three trials that compared immunotherapy agents, rather than comparing immunotherapy with standard of care, they explained in their report.
Their resulting meta-analysis included a total of 9,322 men and 4,399 women, most of whom were in their 70s. Overall, they found that immune checkpoint inhibitor therapy offered a statistically significant overall survival advantage versus standard systemic therapy, with a hazard ratio of 0.75 (95% confidence interval, 0.70-0.81; P less than .001).
That overall survival advantage was found for both men, with a hazard ratio of 0.75 (95% CI, 0.69-0.81; P less than .001) and women, at 0.77 (95% CI, 0.67-0.88; P = .002), investigators further reported. There was no statistically significant difference in overall survival advantage between men and women, both overall (P = 0.60) and in subgroup analyses that accounted for tumor type, line of treatment, and prevalence of women in the study.
The previous meta-analysis, published in the Lancet, found an overall survival hazard ratio of 0.72 for men receiving checkpoint inhibitors and 0.86 for women receiving checkpoint inhibitors (P = .0019), prompting those investigators to conclude that the magnitude of benefit was sex-dependent and that different immunotherapeutic approaches may be needed for men versus women.
“The present meta-analysis provides a more specific assessment of the research question while including a greater number of immunotherapy agents and an updated search,” Dr. Wallis and his coauthors said in a discussion of their more recent findings.
Dr. Wallis reported no disclosures related to the study. Study coauthors provided disclosures related to Merck, AstraZeneca, Bristol-Myers Squibb, Illumina, Tempus, Novartis, Eli Lilly, Fate, Incyte, MedImmune, Pfizer, Roche/Genentech, Xcovery, Fate Therapeutics, Genocea, and Iovance.
SOURCE: Wallis CJD et al. JAMA Oncol. 2019 Jan 3. doi:10.1001/jamaoncol.2018.5904.
Men and women with cancer may derive a similar survival benefit from immune checkpoint inhibitor therapy, results of a recent meta-analysis suggest.
Both men and women had an overall survival benefit from immunotherapy versus standard of care therapy, with no significant difference between the sexes, according to authors of this meta-analysis, which included 23 randomized clinical trials comprising nearly 14,000 patients.
The findings, reported in JAMA Oncology, contrast with those of another recent analysis, which suggested that men had a greater advantage of receiving immunotherapy versus standard of care than women did.
“We found no evidence that sex should be considered when deciding whether to offer immunotherapy to patients with advanced cancers,” said Christopher J.D. Wallis, MD, PhD, of the University of Toronto, and his coauthors said in their report.
The present meta-analysis was based on a “more contemporary and comprehensive” literature search strategy than the earlier one, according to Dr. Wallis and his coinvestigators.
Specifically, they considered immunotherapy agents not included in the previous analysis, added seven new studies published since the previous analysis, and excluded three trials that compared immunotherapy agents, rather than comparing immunotherapy with standard of care, they explained in their report.
Their resulting meta-analysis included a total of 9,322 men and 4,399 women, most of whom were in their 70s. Overall, they found that immune checkpoint inhibitor therapy offered a statistically significant overall survival advantage versus standard systemic therapy, with a hazard ratio of 0.75 (95% confidence interval, 0.70-0.81; P less than .001).
That overall survival advantage was found for both men, with a hazard ratio of 0.75 (95% CI, 0.69-0.81; P less than .001) and women, at 0.77 (95% CI, 0.67-0.88; P = .002), investigators further reported. There was no statistically significant difference in overall survival advantage between men and women, both overall (P = 0.60) and in subgroup analyses that accounted for tumor type, line of treatment, and prevalence of women in the study.
The previous meta-analysis, published in the Lancet, found an overall survival hazard ratio of 0.72 for men receiving checkpoint inhibitors and 0.86 for women receiving checkpoint inhibitors (P = .0019), prompting those investigators to conclude that the magnitude of benefit was sex-dependent and that different immunotherapeutic approaches may be needed for men versus women.
“The present meta-analysis provides a more specific assessment of the research question while including a greater number of immunotherapy agents and an updated search,” Dr. Wallis and his coauthors said in a discussion of their more recent findings.
Dr. Wallis reported no disclosures related to the study. Study coauthors provided disclosures related to Merck, AstraZeneca, Bristol-Myers Squibb, Illumina, Tempus, Novartis, Eli Lilly, Fate, Incyte, MedImmune, Pfizer, Roche/Genentech, Xcovery, Fate Therapeutics, Genocea, and Iovance.
SOURCE: Wallis CJD et al. JAMA Oncol. 2019 Jan 3. doi:10.1001/jamaoncol.2018.5904.
Men and women with cancer may derive a similar survival benefit from immune checkpoint inhibitor therapy, results of a recent meta-analysis suggest.
Both men and women had an overall survival benefit from immunotherapy versus standard of care therapy, with no significant difference between the sexes, according to authors of this meta-analysis, which included 23 randomized clinical trials comprising nearly 14,000 patients.
The findings, reported in JAMA Oncology, contrast with those of another recent analysis, which suggested that men had a greater advantage of receiving immunotherapy versus standard of care than women did.
“We found no evidence that sex should be considered when deciding whether to offer immunotherapy to patients with advanced cancers,” said Christopher J.D. Wallis, MD, PhD, of the University of Toronto, and his coauthors said in their report.
The present meta-analysis was based on a “more contemporary and comprehensive” literature search strategy than the earlier one, according to Dr. Wallis and his coinvestigators.
Specifically, they considered immunotherapy agents not included in the previous analysis, added seven new studies published since the previous analysis, and excluded three trials that compared immunotherapy agents, rather than comparing immunotherapy with standard of care, they explained in their report.
Their resulting meta-analysis included a total of 9,322 men and 4,399 women, most of whom were in their 70s. Overall, they found that immune checkpoint inhibitor therapy offered a statistically significant overall survival advantage versus standard systemic therapy, with a hazard ratio of 0.75 (95% confidence interval, 0.70-0.81; P less than .001).
That overall survival advantage was found for both men, with a hazard ratio of 0.75 (95% CI, 0.69-0.81; P less than .001) and women, at 0.77 (95% CI, 0.67-0.88; P = .002), investigators further reported. There was no statistically significant difference in overall survival advantage between men and women, both overall (P = 0.60) and in subgroup analyses that accounted for tumor type, line of treatment, and prevalence of women in the study.
The previous meta-analysis, published in the Lancet, found an overall survival hazard ratio of 0.72 for men receiving checkpoint inhibitors and 0.86 for women receiving checkpoint inhibitors (P = .0019), prompting those investigators to conclude that the magnitude of benefit was sex-dependent and that different immunotherapeutic approaches may be needed for men versus women.
“The present meta-analysis provides a more specific assessment of the research question while including a greater number of immunotherapy agents and an updated search,” Dr. Wallis and his coauthors said in a discussion of their more recent findings.
Dr. Wallis reported no disclosures related to the study. Study coauthors provided disclosures related to Merck, AstraZeneca, Bristol-Myers Squibb, Illumina, Tempus, Novartis, Eli Lilly, Fate, Incyte, MedImmune, Pfizer, Roche/Genentech, Xcovery, Fate Therapeutics, Genocea, and Iovance.
SOURCE: Wallis CJD et al. JAMA Oncol. 2019 Jan 3. doi:10.1001/jamaoncol.2018.5904.
FROM JAMA ONCOLOGY
Key clinical point: In contrast to an earlier meta-analysis, a more recent meta-analysis suggests no difference in overall survival benefit between men and women with cancer receiving immune checkpoint inhibitor therapy.
Major finding: An overall survival advantage was found for both men and women receiving checkpoint inhibitors versus standard therapy, with hazard ratios of 0.75 and 0.77, respectively (P = .60).
Study details: A systematic review and meta-analysis including nearly 14,000 patients in 23 randomized, clinical trials.
Disclosures: Study authors provided disclosures related to Merck, AstraZeneca, Bristol-Myers Squibb, Illumina, Tempus, Novartis, Eli Lilly, Fate, Incyte, MedImmune, Pfizer, Roche/Genentech, Xcovery, Fate Therapeutics, Genocea, and Iovance.
Source: Wallis CJD et al. JAMA Oncol. 2019 Jan 3. doi:10.1001/jamaoncol.2018.5904.
VAM Scholarships Available
Students and trainees can get financial help to attend the Vascular Annual Meeting in June. The Society for Vascular Surgery distributes dozens of travel scholarships to attend VAM, which is the perfect opportunity to meet other students as well as other members and leaders of the vascular surgical community. Recipients are eligible to receive complimentary meeting registration plus a travel scholarship. Two award categories are available, the General Surgery Resident/Medical Student Travel Scholarship and the Diversity Medical Student Travel Scholarship. Apply today.
Students and trainees can get financial help to attend the Vascular Annual Meeting in June. The Society for Vascular Surgery distributes dozens of travel scholarships to attend VAM, which is the perfect opportunity to meet other students as well as other members and leaders of the vascular surgical community. Recipients are eligible to receive complimentary meeting registration plus a travel scholarship. Two award categories are available, the General Surgery Resident/Medical Student Travel Scholarship and the Diversity Medical Student Travel Scholarship. Apply today.
Students and trainees can get financial help to attend the Vascular Annual Meeting in June. The Society for Vascular Surgery distributes dozens of travel scholarships to attend VAM, which is the perfect opportunity to meet other students as well as other members and leaders of the vascular surgical community. Recipients are eligible to receive complimentary meeting registration plus a travel scholarship. Two award categories are available, the General Surgery Resident/Medical Student Travel Scholarship and the Diversity Medical Student Travel Scholarship. Apply today.
Surgeons: Urge PAs to Join SVS
The SVS has a section dedicated solely to vascular physician assistants. All surgeons are encouraged to urge their PAs to join the section. This “professional home” for PAs has grown to 138 members in just one short year and more are always welcome. Benefits include PA-specific education at the Vascular Annual Meeting, leadership development, networking and mentoring opportunities, discounts on SVS events and our JVS subscription and more. Membership applications are processes quarterly. 2019 deadlines are March 1, June 1, Sep. 1 and Dec. 1. Learn more about the PA Section here.
The SVS has a section dedicated solely to vascular physician assistants. All surgeons are encouraged to urge their PAs to join the section. This “professional home” for PAs has grown to 138 members in just one short year and more are always welcome. Benefits include PA-specific education at the Vascular Annual Meeting, leadership development, networking and mentoring opportunities, discounts on SVS events and our JVS subscription and more. Membership applications are processes quarterly. 2019 deadlines are March 1, June 1, Sep. 1 and Dec. 1. Learn more about the PA Section here.
The SVS has a section dedicated solely to vascular physician assistants. All surgeons are encouraged to urge their PAs to join the section. This “professional home” for PAs has grown to 138 members in just one short year and more are always welcome. Benefits include PA-specific education at the Vascular Annual Meeting, leadership development, networking and mentoring opportunities, discounts on SVS events and our JVS subscription and more. Membership applications are processes quarterly. 2019 deadlines are March 1, June 1, Sep. 1 and Dec. 1. Learn more about the PA Section here.
Cerebral small vessel and cognitive impairment
greater hip fracture incidence, a hospital readmission reduction program may be doing more harm than good, and the flu season rages on with 19 states showing high activity in the final week of 2018.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify Also today, antidepressants are tied to
greater hip fracture incidence, a hospital readmission reduction program may be doing more harm than good, and the flu season rages on with 19 states showing high activity in the final week of 2018.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify Also today, antidepressants are tied to
greater hip fracture incidence, a hospital readmission reduction program may be doing more harm than good, and the flu season rages on with 19 states showing high activity in the final week of 2018.
Amazon Alexa
Apple Podcasts
Google Podcasts
Spotify Also today, antidepressants are tied to
Nominate an Outstanding Surgeon for the Community Excellence Award
This year, the Society for Vascular Surgery will recognize a member in community practice who excels, leads and contributes. If you know of such a surgeon, make your nominations for the SVS Excellence in Community Service Award by Feb. 1. The first recipient will be announced at the 2019 Vascular Annual Meeting in June. Applicants must have a minimum of 20 years as a practicing vascular surgeon and a minimum of five years as an SVS member. Learn more about the award here.
This year, the Society for Vascular Surgery will recognize a member in community practice who excels, leads and contributes. If you know of such a surgeon, make your nominations for the SVS Excellence in Community Service Award by Feb. 1. The first recipient will be announced at the 2019 Vascular Annual Meeting in June. Applicants must have a minimum of 20 years as a practicing vascular surgeon and a minimum of five years as an SVS member. Learn more about the award here.
This year, the Society for Vascular Surgery will recognize a member in community practice who excels, leads and contributes. If you know of such a surgeon, make your nominations for the SVS Excellence in Community Service Award by Feb. 1. The first recipient will be announced at the 2019 Vascular Annual Meeting in June. Applicants must have a minimum of 20 years as a practicing vascular surgeon and a minimum of five years as an SVS member. Learn more about the award here.