Critical reviews in oncology/hematology
-
Crit. Rev. Oncol. Hematol. · Jun 2020
Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence.
The novel coronavirus, also known as SARS-Cov-2 or COVID-19 has become a worldwide threat and the major healthcare concern of the year 2020. Cancer research was directly affected by the emerging of this disease. According to some Chinese studies, cancer patients are more vulnerable to COVID-19 complications. ⋯ Moreover, the COVID-19 manifestations as well as its diagnosis are particular in this special population. In this review paper we expose the challenges of cancer management in the era of SARS-CoV-2, the epidemiological, clinical, pathological and radiological characteristics of the disease in cancer patients and its outcomes on this population. Finally, we focus on strategies that are followed in cancer management with review of national and international guidelines.
-
Crit. Rev. Oncol. Hematol. · May 2020
Meta AnalysisAccuracy of the Multinational Association of Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for predicting serious complications in adult patients with febrile neutropenia: A systematic review and meta-analysis.
We compared the Multinational Association of Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for identifying serious complications in febrile neutropenia patients. We searched MEDLINE, PubMed, EMBASE, and Cochrane Database of Systematic Reviews from inception to March 19, 2019. Two reviewers independently screened citations, extracted data, and assessed quality. ⋯ Pooled sensitivity and specificity for CISNE ≥ 3 was 78.9 % (95 % CI: 65.3 %-88.1 %) and 64.9 % (95 % CI: 49.6 %-77.7 %), respectively. Pooled sensitivity and specificity for CISNE ≥ 1 was 96.7 % (95 % CI: 93.6 %-98.3 %) and 22.2 % (95 % CI: 15.6 %-30.4 %), respectively. The CISNE score had higher sensitivity and may be more useful than the MASCC score in the acute setting.
-
Crit. Rev. Oncol. Hematol. · Jan 2020
ReviewPrevention of chemotherapy-induced peripheral neuropathy: A review of recent findings.
Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of chemotherapy that is frequently experienced by patients receiving treatment for cancer. CIPN is caused by many of the most commonly used chemotherapeutic agents, including taxanes, vinca alkaloids, and bortezomib. ⋯ This review focuses on the etiology of CIPN and will highlight the various approaches developed for prevention and treatment. The goal is to guide studies to identify, test, and standardize approaches for managing CIPN.
-
Spin, the misrepresentation of research findings, in clinical trial abstract has been shown to influence how oncologist rate a drug's efficacy. ⋯ Spin is prevalent in the abstracts of oncology clinical trials that measure OS and a surrogate endpoint. The conclusion sections of abstracts were most prone to contain spin. When OS was the primary endpoint, spin was primarily used to distract from the nonsignificant OS data. To mitigate unintentional hype for cancer therapies, we recommend authors structure their conclusions around patient-important outcomes.
-
Crit. Rev. Oncol. Hematol. · Nov 2019
Meta AnalysisUpfront treatment for newly diagnosed transplant-ineligible multiple myeloma patients: A systematic review and network meta-analysis of 14,533 patients over 29 randomized clinical trials.
Choice of treatment for newly diagnosed transplant-ineligible multiple myeloma poses a difficult task due to an ever-increasing plethora of different regimens. Attempting to clarify this subject, we performed a systematic review and Bayesian network meta-analysis of 29 randomized clinical trials, enrolling 14,533 patients, and comparing 25 different treatment regimens regarding overall survival(OS), progression-free survival(PFS), complete response(CR), overall response rate(ORR) and toxicity. Head-to-head comparisons for all regimens and ranking of best treatments are reported. ⋯ These results confirm obsolescence of classical regimens (such as VAD and MP) while pointing out benefits in efficacy resulting from incorporation of quadruplets and triplets combining new agents (Dara-VMP, VRd and VMPT-VT) and supports current rational of treatment until progression or prohibitive toxicity, especially when including lenalidomide. Based on this data, we would recommended incorporation of strategies combining novel agents (monoclonal antibodies, immunomodulatory imide drugs and proteasome inhibitors) in triplets or quadruplets and/or those comprising long term use of lenalidomide as standard frontline treatments. Moreover, this study settles daratumumab's place as an attractive alternative for upfront treatment.