scholarly journals Serum Mesothelin for Diagnosing Malignant Pleural Mesothelioma: An Individual Patient Data Meta-Analysis

2012 ◽  
Vol 30 (13) ◽  
pp. 1541-1549 ◽  
Author(s):  
Kevin Hollevoet ◽  
Johannes B. Reitsma ◽  
Jenette Creaney ◽  
Bogdan D. Grigoriu ◽  
Bruce W. Robinson ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Malignant Pleural Mesothelioma ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Pleural Mesothelioma ◽  
Histologic Subtype

Purpose Mesothelin is currently considered the best available serum biomarker of malignant pleural mesothelioma. To examine the diagnostic accuracy and use of serum mesothelin in early diagnosis, we performed an individual patient data (IPD) meta-analysis. Methods The literature search identified 16 diagnostic studies of serum mesothelin, measured with the Mesomark enzyme-linked immunosorbent assay. IPD of 4,491 individuals were collected, including several control groups and 1,026 patients with malignant pleural mesothelioma. Mesothelin levels were standardized for between-study differences and age, after which the diagnostic accuracy and the factors affecting it were examined with receiver operating characteristic (ROC) regression analysis. Results At a common diagnostic threshold of 2.00 nmol/L, the sensitivities and specificities of mesothelin in the different studies ranged widely from 19% to 68% and 88% to 100%, respectively. This heterogeneity can be explained by differences in study population, because type of control group, mesothelioma stage, and histologic subtype significantly affected the diagnostic accuracy. The use of mesothelin in early diagnosis was evaluated by differentiating 217 patients with stage I or II epithelioid and biphasic mesothelioma from 1,612 symptomatic or high-risk controls. The resulting area under the ROC curve was 0.77 (95% CI, 0.73 to 0.81). At 95% specificity, mesothelin displayed a sensitivity of 32% (95% CI, 26% to 40%). Conclusion In patients suspected of having mesothelioma, a positive blood test for mesothelin at a high-specificity threshold is a strong incentive to urge further diagnostic steps. However, the poor sensitivity of mesothelin clearly limits its added value to early diagnosis and emphasizes the need for further biomarker research.

An individual patient data meta-analysis of the immunochemotherapy using lentinan in patients with advanced gastric cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15136-15136
Author(s):  
K. Oba ◽  
S. Morita ◽  
T. Matsui ◽  
M. Kobayashi ◽  
K. Kondo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Treatment Effects ◽  
Tumor Response ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Control Group ◽  
Significant Heterogeneity ◽  
Inclusion Criteria ◽  
Objective Tumor Response

15136 Background: An anti-tumor effect of lentinan (LNT), a non-specific immunomodulator, via an immunological response has been reported and combination immunochemotherapy has been examined. However, the survival benefit of LNT for patients with advanced or recurrent gastric cancer (AGC) was unclear in the world. We performed an individual patient data (IPD) meta-analysis in order to evaluate the survival effect of immunochemotherapy using LNT. Methods: A computerized and a manual search procedure were performed to identify all randomized clinical trial (RCT) for chemotherapy in patients (pts) with AGC. Inclusion criteria were RCTs for AGC and to compare any chemotherapy (control group) with the same plus LNT (LNT group). The primary endpoint was overall survival, secondary endpoints includes objective tumor response and toxicity. All analyses were based on IPD. Treatment effects were displayed as hazard ratios estimated by Cox proportional hazard model. A ratio less than unity indicated benefit from LNT. Results: We analyzed IPD of 5 randomized clinical trials for AGC, which met the predetermined inclusion criteria. These 5 trials had a combined total of 650 pts (LNT: 339 pts median age=63, control: 311 pts median age=63). The number of deaths was 83.8% (286/334) in LNT group and 84.8% (262/309) in control group. The overall hazard ratio was 0.83 (95%CI, 0.70–0.98; p=0.03) with no significant heterogeneity between the treatment effects in different trials (χ2 for heterogeneity=3.69; p=0.45). Three hundred and fifty five pts were evaluable for objective tumor response and the response rate was 18.4% (21/185) in LNT group (CR, 0 pts; PR, 21 pts) and 6.3% (5/173) in control (CR, 0 pts; PR, 5 pts). There were no significant differences in the toxicity. Conclusions: This IPD meta-analysis demonstrated that LNT significantly improves both OS and tumor response in pts with AGC. No significant financial relationships to disclose.

Effect and moderators of exercise on fatigue in patients with cancer: Meta-analysis of individual patient data.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 104-104 ◽  
Author(s):  
Jonna van Vulpen ◽  
Maike Sweegers ◽  
Petra H.M. Peeters ◽  
Robert Usher Newton ◽  
Neil K Aaronson ◽  
...  
Keyword(s):  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Control Group ◽  
Linear Mixed Effect Model ◽  
Delivery Mode ◽  
Mixed Effect ◽  
Patients With Cancer ◽  
Cancer Related Fatigue ◽  
Supervised Exercise

104 Background: Fatigue is a common and disabling complaint in patients with cancer and can be reduced by exercise. To further personalize exercise prescriptions, moderators of exercise effects on fatigue should be investigated. However, most randomized controlled trials (RCTs) are not adequately powered to identify heterogeneity in responses to exercise. Therefore, we conducted a meta-analysis using individual patient data (IPD) of exercise RCTs to investigate the effect and moderators of exercise on cancer-related fatigue. Methods: Within the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) consortium, principal investigators of 34 exercise RCTs worldwide have shared their IPD, including in total 4366 cancer patients. A 1-step IPD meta-analysis, using a linear mixed-effect model with a random intercept on study was undertaken to investigate effect on fatigue. The result, a between-group difference in standardized z-scores, corresponds to a Cohen’s d effect size. An interaction term was included in the model to assess potential moderators including demographic (sex, age, marital status, education), clinical (body mass index, distant metastasis), intervention-related (timing, delivery mode, duration) and exercise-related (type, frequency, intensity, duration) characteristics. Results: Exercise significantly reduced fatigue (β = -0.17, 95% CI -0.22;-0.12). The effect was not moderated by demographic, clinical or exercise-related characteristics. Supervised exercise had significantly larger effects on fatigue than unsupervised exercise (βdifference= -0.18, 95%CI -0.28;-0.08). Compared to the control group, supervised exercise significantly improved fatigue (β = -0.23, 95%CI = -0.29;-0.17), while unsupervised exercise did not (β = -0.04, 95%CI = -0.13;0.04). Conclusions: Exercise significantly reduces cancer-related fatigue across subgroups formed on the basis of demographic and clinical characteristics. The effect of exercise is significantly larger when performed under supervision. Hence, exercise, and preferably supervised exercise, represents a viable intervention for the prevention and treatment of fatigue among patients with cancer.

Diagnostic accuracy of osteopontin for malignant pleural mesothelioma: A systematic review and meta-analysis

2014 ◽  
Vol 433 ◽  
pp. 44-48 ◽  
Author(s):  
Zhi-De Hu ◽  
Xiao-Fei Liu ◽  
Xiao-Cui Liu ◽  
Chun-Mei Ding ◽  
Cheng-Jin Hu
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Malignant Pleural Mesothelioma ◽  
Meta Analysis ◽  
Pleural Mesothelioma

scholarly journals Influence of Control Group on Effect Size in Trials of Acupuncture for Chronic Pain: A Secondary Analysis of an Individual Patient Data Meta-Analysis

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e93739 ◽  
Author(s):  
Hugh MacPherson ◽  
Emily Vertosick ◽  
George Lewith ◽  
Klaus Linde ◽  
Karen J. Sherman ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Effect Size ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Secondary Analysis ◽  
Patient Data ◽  
Control Group

scholarly journals Efficacy of bisphosphonates in specific knee osteoarthritis subpopulations: protocol for an OA Trial Bank systematic review and individual patient data meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023889 ◽  
Author(s):  
Leticia A Deveza ◽  
Sita M A Bierma-Zeinstra ◽  
Willem Evert van Spil ◽  
Win Min Oo ◽  
Bruno T Saragiotto ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Bone Turnover ◽  
Knee Osteoarthritis ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Randomised Clinical Trials ◽  
Control Group ◽  
Cochrane Central Register ◽  
Mineral Density

IntroductionRandomised clinical trials to date investigating the efficacy of bisphosphonates in knee osteoarthritis (OA) have found divergent results, with a recent meta-analysis finding no superiority of these drugs over placebo. Whether particular patient subgroups are more likely to benefit from this therapy than others is still unclear. We aim to investigate the effects of bisphosphonates compared with a control group (placebo, no treatment, another active treatment) on clinical and structural outcomes in specific knee OA subpopulations with possible distinct rates of subchondral bone turnover.Methods and analysisMedline, Embase, Scopus, Web of Sciences and Cochrane Central Register of Controlled Trials will be searched from inception to February 2018. Randomised clinical trials will be eligible if they reported at least one potential treatment effect modifier at baseline: gender, menopausal status, age, body mass index, radiographic stage, knee pain severity, presence of bone marrow lesions, levels of biochemical markers of bone turnover (serum and/or urinary) and systemic bone mineral density status. Authors of original trials will be contacted to obtain individual patient data from each study. Risk of bias will be assessed using the Cochrane Collaboration’s tool. The primary outcomes will include pain and radiographic joint space width loss. Studies using other MRI-based assessment of disease progression will also be eligible. Outcomes will be grouped into short-term (≤3 months), intermediate-term (>3 months; ≤12 months) and long-term (>12 months). Regression models will be used, adding an interaction term for each subgroup of interest to determine possible subgroup effects. There was no source of funding for this study.Ethics and disseminationDissemination of our findings is planned to occur through conference presentations, publication in peer-reviewed journals and social media. No formal ethics approval is generally required as no new data collection will be undertaken.PROSPERO registration numberCRD42018093327.

Osteopontin is not a Specific Marker in Malignant Pleural Mesothelioma

2009 ◽  
Vol 24 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Laura Paleari ◽  
Nicola Rotolo ◽  
Andrea Imperatori ◽  
Roberto Puzone ◽  
Fausto Sessa ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Immunohistochemical Analysis ◽  
Staining Intensity ◽  
Experimental Models ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Specific Marker ◽  
Pleural Mesothelioma

Background and aims: Osteopontin (OPN) is an integrin-binding protein recently shown to be related to tumorigenesis, progression and metastasis in different experimental models of malignancy. Malignant pleural mesothelioma (MPM) is a fatal disease in which the prognosis remains very poor and the knowledge of predictive factors for outcome is insufficient. The identification of new molecules involved in cancer initiation and development is a fundamental step for improving the curability of this kind of tumor. The purpose of this study is to define the role of OPN in the diagnosis of MPM by determining its prognostic and diagnostic value. Methods: a group of 24 surgically staged MPM subjects was compared with a group of 31 subjects with non-malignant pulmonary diseases, and with 37 healthy controls. Tumor tissue was analyzed for OPN by immunohistochemical tests, and plasma OPN levels were measured by an enzyme-linked immunosorbent assay. Results: Plasma OPN levels were not significantly higher in either of the patient groups compared with the control group. Immunohistochemical analysis revealed OPN staining of tumor cells in 21 of 24 MPMs. Receiver operating characteristic curve/area under the curve (ROC/AUC) analysis comparing the plasma OPN levels in the healthy group with those of MPM patients showed 40% sensitivity and 100% specificity at a cutoff value of 60.8 ng of OPN per milliliter (AUC 0.6). Conclusion: Plasma OPN levels do not discriminate between chronic inflammatory and malignant lung diseases and staining intensity in MPM specimens does not correlate with OPN plasma levels.

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