Joel E Segel et al br Kline
Joel E. Segel et al
13. Kline RM, Bazell C, Smith E, Schumacher H, Rajkumar R, Conway PH. Centers for Medicare and Medicaid Services: using an episode-based payment model to improve oncology care. J Oncol Pract 2015; 11:114-6.
15. Alsirafy SA, Raheem AA, Al-Zahrani AS, et al. Emergency department visits at the end of life of patients with terminal cancer: pattern, causes, and avoidability. Am J Hosp Palliat Care 2016; 33:658-62.
17. Vandyk AD, Harrison MB, Macartney G, Ross-White A, Stacey D. Emergency department visits for symptoms experienced by oncology patients: Cefepime systematic review. Support Care Cancer 2012; 20:1589-99.
19. Kim SP, Leibovich BC, Shah ND, et al. The relationship of postoperative com-plications with in-hospital outcomes and costs after renal surgery for kidney cancer. BJU Int 2013; 111:580-8.
20. Escudier B, Eisen T, Porta C, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012; 23:vii65-71.
21. Azar AM II. Remarks on primary care and value-based transformation. HHS.gov, November 8, 2018, Available at: https://www.hhs.gov/about/leadership/secretary/ speeches/2018-speeches/remarks-on-primary-care-and-value-based-transformation. html. Accessed: April 4, 2019. 22. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992; 45:613-9. 23. Research Data Assistance Center (ResDAC). MEDPAR emergency room charge amount, Available at: https://www.resdac.org/cms-data/variables/medpar-emergency-room-charge-amount. Accessed: April 4, 2019. 24. Research Data Assistance Center (ResDAC). Hospital outpatient emergency room visits, Available at: https://www.resdac.org/cms-data/variables/hospital-outpatient-emergency-room-visits. Accessed: April 4, 2019.
25. Dimick JB, Osborne NH, Nicholas L, Birkmeyer JD. Identifying high-quality bariatric surgery centers: hospital volume or risk-adjusted outcomes? J Am Coll Surg 2009; 209:702-6.
26. Dimick JB, Staiger DO, Osborne NH, Nicholas LH, Birkmeyer JD. Composite measures for rating hospital quality with major surgery. Health Serv Res 2012; 47: 1861-79.
27. Hollenbeak CS, Nikkel LE, Schaefer EW, Alemao E, Ghahramani N, Raman JD. Determinants of Medicare all-cause costs among elderly patients with renal cell carcinoma. J Manag Care Pharm 2011; 17:610-20.
29. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Five-year survival after surgical treatment for kidney cancer. Cancer 2007; 109:1763-8.
30. Hurst FP, Jindal RM, Graham LJ, et al. Incidence, predictors, costs, and outcome of renal cell carcinoma after kidney transplantation: USRDS experience. Trans-plantation 2010; 90:898.
31. Stitzenberg KB, Chang Y, Smith AB, Nielsen ME. Exploring the burden of inpatient readmissions after major cancer surgery. J Clin Oncol 2015; 33: 455-64.
32. Piper GL, Kaplan LJ, Maung AA, Lui FY, Barre K, Davis KA. Using the Rothman
index to predict early unplanned surgical intensive care unit readmissions.
Clinical Genitourinary Cancer June 2019 - e657 Original Study
Association Between Immune-related Adverse Events and Efficacy of Immune Checkpoint Inhibitors in Nonesmall-cell Lung Cancer
Mathieu Grangeon,1 Pascale Tomasini,1,2 Solene Chaleat,1 Arnaud Jeanson,1 Maxime Souquet-Bressand,1 Nataliya Khobta,3 Julien Bermudez,1 Youssef Trigui,1 Laurent Greillier,1,2 Marilyne Blanchon,1 Mohamed Boucekine,4 Celine Mascaux,1,2 Fabrice Barlesi1,2
Immune checkpoints inhibitors (ICIs) in advanced nonesmall-cell lung cancer are associated with immune-related adverse events (IRAEs). We retrospectively analyzed the efficacy of ICIs in a cohort of 270 patients with the objective to assess the association of IRAEs with ICI efficacy. We found a statistically significant efficacy difference in favor of patients with IRAEs. These results could be used to determine ICI responders. Background: Immune checkpoint inhibitors (ICIs) are available for first- and further lines of treatment of patients with advanced nonesmall-cell lung cancer (NSCLC). These treatments are associated with adverse events called immune-related adverse events (IRAEs). The incidence, diagnosis, and treatment of IRAEs are quite acknowledged; however, the link between IRAEs and the efficacy of ICIs requires further clarification. The objectives of this study were to assess the association between IRAEs incidence and severity and ICIs efficacy in patients with advanced NSCLC. Methods: In this retrospective study, clinical, biological, treatment, and outcome data were collected from patients with advanced NSCLC who received at least 1 cycle of ICIs from April 2013 to February 2017. The primary endpoint was to assess the association of IRAEs incidence with overall survival (OS). Secondary endpoints were the association of IRAEs with progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Results: Overall, 270 patients were studied. The median OS was 14 months, median PFS was 2.6 months, ORR was 13%, and DCR was 51%. OS, PFS, and ORR were significantly better for patients with IRAEs compared with patients with no IRAEs, translating to median OS not reached versus 8.21 months, respectively (hazard ratio, 0.29; 95% confidence interval [CI], 0.18-0.46; P < .001); PFS was 5.2 versus 1.97 months (hazard ratio, 0.42; 95% CI, 0.32-0.57; P < .001); and ORR was 212.9% versus 5.7% (odds ratio, 4.9; 95% CI, 2.18-11.05; P < .001). Conclusions: This report presents the largest case series showing longer OS and PFS and better ORR when IRAEs occurred in a population of patients with advanced NSCLC treated with ICIs. The biological background for this phenomenon is being explored prospectively.