Browsing by Author "Lyman, Gary H"

Now showing 1 - 3 of 3
  • Thumbnail Image
    ItemOpen Access
    Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study.
    (eLife, 2023-10) Nagaraj, Gayathri; Vinayak, Shaveta; Khaki, Ali Raza; Sun, Tianyi; Kuderer, Nicole M; Aboulafia, David M; Acoba, Jared D; Awosika, Joy; Bakouny, Ziad; Balmaceda, Nicole B; Bao, Ting; Bashir, Babar; Berg, Stephanie; Bilen, Mehmet A; Bindal, Poorva; Blau, Sibel; Bodin, Brianne E; Borno, Hala T; Castellano, Cecilia; Choi, Horyun; Deeken, John; Desai, Aakash; Edwin, Natasha; Feldman, Lawrence E; Flora, Daniel B; Friese, Christopher R; Galsky, Matthew D; Gonzalez, Cyndi J; Grivas, Petros; Gupta, Shilpa; Haynam, Marcy; Heilman, Hannah; Hershman, Dawn L; Hwang, Clara; Jani, Chinmay; Jhawar, Sachin R; Joshi, Monika; Kaklamani, Virginia; Klein, Elizabeth J; Knox, Natalie; Koshkin, Vadim S; Kulkarni, Amit A; Kwon, Daniel H; Labaki, Chris; Lammers, Philip E; Lathrop, Kate I; Lewis, Mark A; Li, Xuanyi; Lopes, Gilbert de Lima; Lyman, Gary H; Makower, Della F; Mansoor, Abdul-Hai; Markham, Merry-Jennifer; Mashru, Sandeep H; McKay, Rana R; Messing, Ian; Mico, Vasil; Nadkarni, Rajani; Namburi, Swathi; Nguyen, Ryan H; Nonato, Taylor Kristian; O'Connor, Tracey Lynn; Panagiotou, Orestis A; Park, Kyu; Patel, Jaymin M; Patel, Kanishka GopikaBimal; Peppercorn, Jeffrey; Polimera, Hyma; Puc, Matthew; Rao, Yuan James; Razavi, Pedram; Reid, Sonya A; Riess, Jonathan W; Rivera, Donna R; Robson, Mark; Rose, Suzanne J; Russ, Atlantis D; Schapira, Lidia; Shah, Pankil K; Shanahan, M Kelly; Shapiro, Lauren C; Smits, Melissa; Stover, Daniel G; Streckfuss, Mitrianna; Tachiki, Lisa; Thompson, Michael A; Tolaney, Sara M; Weissmann, Lisa B; Wilson, Grace; Wotman, Michael T; Wulff-Burchfield, Elizabeth M; Mishra, Sanjay; French, Benjamin; Warner, Jeremy L; Lustberg, Maryam B; Accordino, Melissa K; Shah, Dimpy P; COVID-19 and Cancer Consortium

    Background

    Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.

    Methods

    This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.

    Results

    1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32-1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70-6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83-12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63-3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20-2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66-3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89-22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.

    Conclusions

    Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients.

    Funding

    This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.

    Clinical trial number

    CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.
  • Thumbnail Image
    ItemOpen Access
    Hodgkin lymphoma treatment with ABVD in the US and the EU: neutropenia occurrence and impaired chemotherapy delivery.
    (J Hematol Oncol, 2010-08-19) Schwenkglenks, Matthias; Pettengell, Ruth; Szucs, Thomas D; Culakova, Eva; Lyman, Gary H
    BACKGROUND: In newly diagnosed patients with Hodgkin lymphoma (HL) the effect of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD)-related neutropenia on chemotherapy delivery is poorly documented. The aim of this analysis was to assess the impact of chemotherapy-induced neutropenia (CIN) on ABVD chemotherapy delivery in HL patients. STUDY DESIGN: Data from two similarly designed, prospective, observational studies conducted in the US and the EU were analysed. One hundred and fifteen HL patients who started a new course of ABVD during 2002-2005 were included. The primary objective was to document the effect of neutropenic complications on delivery of ABVD chemotherapy in HL patients. Secondary objectives were to investigate the incidence of CIN and febrile neutropenia (FN) and to compare US and EU practice with ABVD therapy in HL. Pooled data were analysed to explore univariate associations with neutropenic events. RESULTS: Chemotherapy delivery was suboptimal (with a relative dose intensity < or = 85%) in 18-22% of patients. The incidence of grade 4 CIN in cycles 1-4 was lower in US patients (US 24% vs. EU 32%). Patients in both the US and the EU experienced similar rates of FN across cycles 1-4 (US 12% vs. EU 11%). Use of primary colony-stimulating factor (CSF) prophylaxis and of any CSF was more common in the US than the EU (37% vs. 4% and 78% vs. 38%, respectively). The relative risk (RR) of dose delays was 1.54 (95% confidence interval [CI] 1.08-2.23, p = 0.036) for patients with vs. without grade 4 CIN and the RR of grade 4 CIN was 0.35 (95% CI 0.12-1.06, p = 0.046) for patients with vs. without primary CSF prophylaxis. CONCLUSIONS: In this population of HL patients, CIN was frequent and FN occurrence clinically relevant. Chemotherapy delivery was suboptimal. CSF prophylaxis appeared to reduce CIN rates.
  • Thumbnail Image
    ItemOpen Access
    Mitigating long-term and delayed adverse events associated with cancer treatment: implications for survivorship.
    (Nature reviews. Clinical oncology, 2023-08) Lustberg, Maryam B; Kuderer, Nicole M; Desai, Aakash; Bergerot, Cristiane; Lyman, Gary H
    Despite the importance of chemotherapy-associated adverse events in oncology practice and the broad range of interventions available to mitigate them, limited systematic efforts have been made to identify, critically appraise and summarize the totality of evidence on the effectiveness of these interventions. Herein, we review the most common long-term (continued beyond treatment) and late or delayed (following treatment) adverse events associated with chemotherapy and other anticancer treatments that pose major threats in terms of survival, quality of life and continuation of optimal therapy. These adverse effects often emerge during and continue beyond the course of therapy or arise among survivors in the months and years following treatment. For each of these adverse effects, we discuss and critically evaluate their underlying biological mechanisms, the most commonly used pharmacological and non-pharmacological treatment strategies, and evidence-based clinical practice guidelines for their appropriate management. Furthermore, we discuss risk factors and validated risk-assessment tools for identifying patients most likely to be harmed by chemotherapy and potentially benefit from effective interventions. Finally, we highlight promising emerging supportive-care opportunities for the ever-increasing number of cancer survivors at continuing risk of adverse treatment effects.