Esophagogastric cancer (EGC) remains a major cause of cancer-related mortality. Overall survival in the metastatic setting remains poor, with few molecular targeted approaches having been successfully incorporated into routine care to-date: only first line anti-HER2 therapy in ERBB2-expressing tumors, second line anti-VEGFR2 therapy with ramucirumab in unselected patients, and pembrolizumab in PD-L1 expressing or MSI-H patients. EGFR inhibitors were extensively studied in EGC, including phase III trials with cetuximab (EXPAND), panitumumab (REAL3), and gefitinib (COG). All three trials were conducted in unselected populations, and therefore, failed to demonstrate clinical benefit. Here, we review previous attempts at targeting EGFR in EGC and potential future biomarkers for targeting this pathway in patients with EGFR-amplified tumors.

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Background: Value-based orthopedic surgery and reimbursement changes for total knee arthroplasty (TKA) are potential factors shaping arthroplasty practice nationwide. This study aimed to evaluate: (1) trends in discharge disposition (home versus non-home discharge), (2) episode-of-care outcomes for home and non-home discharge cohorts, and (3) predictors of non-home discharge among patients undergoing TKA from 2011 to 2020. Methods: The National Surgical Quality Improvement Program database was reviewed for all primary TKAs from 2011 to 2020. A total of 462,858 patients were identified and grouped into home discharge(n=378,771) and non-home discharge(n=84,087) cohorts. The primary outcome was the annual rate of home/non-home discharges. Secondary outcomes included trends in healthcare utilization parameters, readmissions, and complications. Multivariable logistic regression analyses were performed to evaluate factors associated with non-home discharge. Results: Overall, 82% were discharged home, and 18% were discharged to a non-home facility. Home discharge rates increased from 65.5% in 2011 to 94% in 2020. Non-home discharge rates decreased from 34.5% in 2011 to 6% in 2020. Thirty-day readmissions decreased from 3.2% to 2.4% for the homedischarge cohort but increased from 5.6% to 6.1% for the non-home discharge cohort. Female sex, Asian or Black Race, Hispanic ethnicity, ASA class >II, Charlson Comorbidity Index scores > 0, smoking, dependent functional status, and age >60 were associated with higher odds of non-home discharge. Conclusion: Over the last decade there has been a major shift to home discharge after TKA. Future work is needed to further assess if perioperative interventions may have a positive effect in decreasing adverse outcomes in non-home discharge patients. Keywords: Knee Arthroplasty; nationwide trends; discharge disposition; predictors; outcomes

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