An evaluation of clinical remission and safety among Biologics for moderate-to-severe crohns disease: a Bayesian Network meta-analysis

Abstract

A221of SCT-ineligible patients; in second-line (post-onset of relapsed/refractory MM), lenalidomide/dexamethasone (33%) and bortezomib/dexamethasone (15%) were most common for patients previously receiving SCT (similar results reported for patients not receiving SCT). More than half of physicians estimated that typical second-line treatment duration is < 6 months, with progression cited (~75% of respondents) as the main reason for second-line discontinuation. For high-risk patients, 52% of physicians judged median survival to be < 10 months from RRMM onset. CONCLUSIONS: Bortezomib-based regimens are the predominant choice of first-line MM treatment; while bortezomib is also frequently chosen in second-line (post-RRMM onset), lenalidomide-based regimens are the most common. Survival prospects for RRMM patients remain limited, particularly for high-risk patients, and second-line therapy is typically of short duration (< 6 months). Patient-level studies are needed to formally characterize unmet medical needs suggested in our findings for European RRMM patients.OBJECTIVES: Initial endocrine therapy (ET) is preferred for most post-menopausal women with hormone receptor positive human epidermal growth factor receptor 2 negative metastatic breast cancer (HR+/HER2-mBC), and guidelines recommend reserving chemotherapy (CT) for patients with symptomatic visceral disease or no clinical benefit after 3 sequential ET regimens. This study describes treatment patterns among post-menopausal HR+/HER2-mBC patients previously treated with adjuvant therapy (recurrent patients) or not (de novo patients). METHODS: Charts from a network of US community-based oncology practices were reviewed for post-menopausal women with HR+/HER2-mBC who progressed to mBC between 1/1/2004 and 9/30/2010. Extracted chart data included demographic characteristics, treatment history, and outcomes. RESULTS: Patients (n= 144) had a median age of 65 years at mBC diagnosis. They received a median of 2 lines of ET, and < 10% had 3 or more lines of ET before receiving CT. De novo patients (n= 69) and recurrent patients (n= 75) received a median of 2 lines and 1 line of ET, respectively. The recurrent group had a lower proportion of patients receiving 1st-line single agent ET compared with the de novo group (65% vs. 71%). Unlike de novo patients, who had non-steroidal aromatase inhibitors (NSAIs) as the most frequent 1st-line ET (letrozole (35%), anastrozole (26%)), recurrent patients predominantly received fulvestrant (23%) in the 1st-line setting, possibly due to prior adjuvant NSAI. In addition, a higher proportion of recurrent patients received CT as 1st-line therapy compared with de novo patients (27% vs. 20%). CONCLUSIONS: The majority of de novo patients received 1st-line NSAIs, but recurrent patients were less likely to receive NSAIs and more likely to receive 1st-line CT. Recurrent patients also received fewer total lines of ET. Most mBC patients did not receive the guidelinerecommended 3 lines of ET. The unmet need for improved ET options was particular...