Comparison of Stage I Non-Small-Cell Lung Cancer Treatments for Patients Living With HIV : A Simulation Study
Copyright © 2023 Elsevier Inc. All rights reserved..
INTRODUCTION: Non-small-cell lung cancer (NSCLC) is a leading cause of death for people living with HIV (PWH). Nevertheless, there are no clinical trial data regarding the management of early-stage lung cancer in PWH. Using data from large HIV and cancer cohorts we parameterized a simulation model to compare treatments for stage I NSCLC according to patient characteristics.
MATERIALS AND METHODS: To parameterize the model we analyzed PWH and NSCLC patient outcomes and quality of life data from several large cohort studies. Comparative effectiveness of 4 stage I NSCLC treatments (lobectomy, segmentectomy, wedge resection, and stereotactic body radiotherapy) was estimated using evidence synthesis methods. We then simulated trials comparing treatments according to quality adjusted life year (QALY) gains by age, tumor size and histology, HIV disease characteristics and major comorbidities.
RESULTS: Lobectomy and segmentectomy yielded the greatest QALY gains among all simulated age, tumor size and comorbidity groups. Optimal treatment strategies differed by patient sex, age, and HIV disease status; wedge resection was among the optimal strategies for women aged 80 to 84 years with tumors 0 to 2 cm in size. Stereotactic body radiotherapy was included in some optimal strategies for patients aged 80 to 84 years with multimorbidity and in sensitivity analyses was a non-inferior option for many older patients or those with poor HIV disease control.
CONCLUSION: In simulated comparative trials of treatments for stage I NSCLC in PWH, extensive surgical resection was often associated with the greatest projected QALY gains although less aggressive strategies were predicted to be non-inferior in some older, comorbid patient groups.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
|---|---|
| Enthalten in: |
Clinical lung cancer - 24(2023), 7 vom: 05. Nov., Seite e259-e267.e8 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Sigel, Keith [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Comorbidities |
|---|
| Anmerkungen: |
Date Completed 03.11.2023 Date Revised 22.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.cllc.2023.06.004 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM359084419 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM359084419 | ||
| 003 | DE-627 | ||
| 005 | 20240323000038.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.cllc.2023.06.004 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1341.xml |
| 035 | |a (DE-627)NLM359084419 | ||
| 035 | |a (NLM)37407294 | ||
| 035 | |a (PII)S1525-7304(23)00122-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Sigel, Keith |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of Stage I Non-Small-Cell Lung Cancer Treatments for Patients Living With HIV |b A Simulation Study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.11.2023 | ||
| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: Non-small-cell lung cancer (NSCLC) is a leading cause of death for people living with HIV (PWH). Nevertheless, there are no clinical trial data regarding the management of early-stage lung cancer in PWH. Using data from large HIV and cancer cohorts we parameterized a simulation model to compare treatments for stage I NSCLC according to patient characteristics | ||
| 520 | |a MATERIALS AND METHODS: To parameterize the model we analyzed PWH and NSCLC patient outcomes and quality of life data from several large cohort studies. Comparative effectiveness of 4 stage I NSCLC treatments (lobectomy, segmentectomy, wedge resection, and stereotactic body radiotherapy) was estimated using evidence synthesis methods. We then simulated trials comparing treatments according to quality adjusted life year (QALY) gains by age, tumor size and histology, HIV disease characteristics and major comorbidities | ||
| 520 | |a RESULTS: Lobectomy and segmentectomy yielded the greatest QALY gains among all simulated age, tumor size and comorbidity groups. Optimal treatment strategies differed by patient sex, age, and HIV disease status; wedge resection was among the optimal strategies for women aged 80 to 84 years with tumors 0 to 2 cm in size. Stereotactic body radiotherapy was included in some optimal strategies for patients aged 80 to 84 years with multimorbidity and in sensitivity analyses was a non-inferior option for many older patients or those with poor HIV disease control | ||
| 520 | |a CONCLUSION: In simulated comparative trials of treatments for stage I NSCLC in PWH, extensive surgical resection was often associated with the greatest projected QALY gains although less aggressive strategies were predicted to be non-inferior in some older, comorbid patient groups | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Comorbidities | |
| 650 | 4 | |a Lobectomy | |
| 650 | 4 | |a Microsimulation | |
| 650 | 4 | |a Segmentectomy | |
| 650 | 4 | |a Stereotactic body radiation | |
| 650 | 4 | |a Wedge resection | |
| 700 | 1 | |a Silverberg, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Crothers, Kristina |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Lesley |e verfasserin |4 aut | |
| 700 | 1 | |a Lishchenko, Inna |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Xuesong |e verfasserin |4 aut | |
| 700 | 1 | |a Leyden, Wendy |e verfasserin |4 aut | |
| 700 | 1 | |a Kale, Minal |e verfasserin |4 aut | |
| 700 | 1 | |a Stone, Kimberly |e verfasserin |4 aut | |
| 700 | 1 | |a Sigel, Carlie |e verfasserin |4 aut | |
| 700 | 1 | |a Wisnivesky, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Kong, Chung Yin |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical lung cancer |d 1999 |g 24(2023), 7 vom: 05. Nov., Seite e259-e267.e8 |w (DE-627)NLM143155229 |x 1938-0690 |7 nnns |
| 773 | 1 | 8 | |g volume:24 |g year:2023 |g number:7 |g day:05 |g month:11 |g pages:e259-e267.e8 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.cllc.2023.06.004 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 24 |j 2023 |e 7 |b 05 |c 11 |h e259-e267.e8 | ||