| 1. |
- Abildgaard, Niels, et al.
(author)
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Real-world treatment patterns and outcomes for patients with multiple myeloma in Denmark, Finland and Sweden : An analysis using linked Nordic registries
- 2024
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In: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 201
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Journal article (peer-reviewed)abstract
- Aim: The Health outcomes and Understanding of MyelomA multi-National Study (HUMANS) was a large-scale, retrospective study conducted across Denmark, Finland and Sweden using linked data from national registries. We describe the characteristics, treatment patterns and clinical outcomes for patients with newly diagnosed multiple myeloma (NDMM) over 2010–2018.Methods: Patients with NDMM who received MM-specific, first-line treatments, were categorised by treatment (autologous stem cell transplantation [ASCT] or a combination chemotherapy regimen based on bortezomib, lenalidomide or melphalan-prednisolone-thalidomide).Results: 11,023 patients received treatment over 2010–2018. Time between diagnosis and treatment was shortest in Denmark (0.9 months), then Sweden (2.9 months) and Finland (4.6 months). Around one third of patients underwent ASCT. Lenalidomide-based regimens were prescribed to 23–28% of patients in Denmark and Finland, versus 12% in Sweden. Patients receiving lenalidomide had the longest wait for treatment, from 3.2 months (Denmark) to 12.1 months (Sweden). Treatment persistence was highest among patients receiving melphalan-prednisolone-thalidomide (7–8 months) in Finland and Sweden and lowest among those receiving bortezomib (3.5 months) in Finland. Overall survival (OS) was longest among patients with ASCT (7–10 years). Among patients receiving chemotherapy, OS (from diagnosis/treatment initiation), varied between cohorts. In a sensitivity analysis excluding patients with smouldering MM, OS decreased for all; for patients receiving bortezomib or lenalidomide, OS from diagnosis was 40–49 and 27–54 months, respectively.Conclusions: This population-based study of patients with NDMM receiving first-line MM-specific treatment, provides real-world data on treatment patterns and outcomes to complement data from randomised clinical trials.
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| 2. |
- Abildgaard, Niels, et al.
(author)
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Use of Linked Nordic Registries for Population Studies in Hematologic Cancers: The Case of Multiple Myeloma
- 2023
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In: Clinical Epidemiology. - : Dove Medical Press. - 1179-1349. ; 15, s. 987-999
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Journal article (peer-reviewed)abstract
- Purpose: Linked health-care registries and high coverage in Nordic countries lend themselves well to epidemiologic research. Given its relatively high incidence in Western Europe, complexity in diagnosis, and challenges in registration, multiple myeloma (MM) wasselected to compare registries in Denmark, Finland, and Sweden.Patients and Methods: Data were obtained from four archetypal registries in each country (spanning January 2005–October 2018):National Patient Registry (NPR), Prescribed Drug Registry (PDR), Cancer Registry (CR), and Cause of Death Registry. Patients newlydiagnosed with MM who received MM-specific treatment were included. PDR/NPR treatment records were used to assess incidentNPR cases. The registration quality of MM-specific drugs in the PDR of each country was also evaluated.Results: In Denmark, only 6% of patients in the NPR were not registered in the CR; in Sweden, it was 16.9%. No systematicdifferences were identified that could explain this discrepancy. In Denmark, lenalidomide and bortezomib were registered in the NPRwith high coverage, but less expensive drugs typically given in combination with bortezomib were not covered in any of the registries.In Finland and Sweden, bortezomib records were not identified in the PDR, but some were in the NPR; other drugs had good coveragein the PDR.Conclusions: The registries evaluated in this study can be used to identify the MM population; however, given the gaps in MMregistration in the Finnish and Swedish CRs, Danish registries provide the most comprehensive datasets for research on treatmentpatterns for MM.
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| 3. |
- Giacobini, MaiBritt, et al.
(author)
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Epidemiology, treatment patterns, comorbidities, and concomitant medication in patients with ADHD in Sweden : a registry-based study (2018–2021)
- 2023
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In: Journal of Attention Disorders. - : Sage Publications. - 1087-0547 .- 1557-1246. ; 27:12, s. 1309-1321
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Journal article (peer-reviewed)abstract
- Objective: To evaluate treatment patterns for ADHD in Sweden.Method: Observational retrospective study of patients with ADHD from the Swedish National Patient Register and Prescribed Drug Register, 2018 to 2021. Cross-sectional analyses included incidence, prevalence, and psychiatric comorbidities. Longitudinal analyses (newly diagnosed patients) included medication, treatment lines, duration, time-to-treatment initiation, and switching.Results: Of 243,790 patients, 84.5% received an ADHD medication. Psychiatric comorbidities were common, particularly autism among children, and depression in adults. Most frequent first-/second-line treatments were methylphenidate (MPH; 81.6%) and lisdexamfetamine dimesylate (LDX; 46.0%), respectively. In the second-line, LDX was most frequently prescribed (46.0%), followed by MPH (34.9%), then atomoxetine (7.7%). Median treatment duration was longest for LDX (10.4 months), followed by amphetamine (9.1 months).Conclusion: This nationwide registry study provides real-life insights into the current epidemiology of ADHD and the changing treatment landscape for patients in Sweden.
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| 4. |
- Ma, Yuanjun
(author)
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A study of two major challenges in prostate cancer : effective chemo-prevention and overcoming resistance to hormonal and chemotherapy
- 2018
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Doctoral thesis (other academic/artistic)abstract
- For men, over the course of a lifetime the risk of developing prostate cancer is 1 in 9. Both the illness itself and treatment affect quality of life in multiple aspects, including urinary problems, pain, and sexual dysfunction. Current clinical challenges in this field include: inevitable drug resistance to treatments, lack of accurate diagnostic and prognostic biomarkers, as well as no common chemoprevention strategies. The aim of this thesis is therefore to identify transcript alternations associated with drug resistance (Study I and Study II), to evaluate potential drug targets for prostate cancer treatment (Study III), and to estimate the preventive effect of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) against prostate cancer (Study IV). Castration resistance and docetaxel resistance are two significant issues that arise during prostate cancer disease progression. We employed next generation RNA sequencing technology to compare hormone-resistant (Study II) and docetaxel-resistant (Study I) vs respective sensitive cell lines, aiming to discover a potential drug target with the capability of prolonging the duration of hormone and docetaxel treatments before the cancer cells becoming resistant. The results showed that a variety of transcript alterations were obtained during resistance development, including mutations, altered gene expressions, and fusion transcripts. These alterations might be associated with drug resistance in prostate cancer. As a rationale for Study III, we hypothesized that proteins that have never been reported as mutated in prostate cancer might play an important role in cancer progression through their essential function of maintaining cellular stability in cancer cells. Upon mutation, these genes would induce severe cellular instability such that the cells could not survive, and these cells would be erased through natural selection during cancer growth. In Study III, we therefore evaluated a non-mutated protein in prostate cancer, GPR89A, as a potential drug target with possible anti-cancer function. Low-dose aspirin has been recommended by the U.S. Preventive Services Task Force (USPSTF) to prevent cardiovascular disease and colorectal cancer. However, results published in scientific studies are controversial regarding prostate cancer. In Study IV, we assessed whether maintenance use of aspirin or other NSAIDs could reduce the risk of prostate cancer. Based on data from the Swedish Cancer Register, the Swedish Prescribed Drug Register and the Swedish Causes of Death Register (2005-2012), we conducted a nationwide cohort study and found a protective effect of aspirin and other NSAIDs against prostate cancer, especially after long-term intake. In sum, this thesis identified or assessed alternative methods against prostate cancer through exploring molecular approaches to develop more effective treatment methods, and by attempting to reduce the prevalence of cancer cases through chemoprevention.
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| 5. |
- Ma, Yuanjun, et al.
(author)
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Identification of mutations, gene expression changes and fusion transcripts by whole transcriptome RNAseq in docetaxel resistant prostate cancer cells
- 2016
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In: SpringerPlus. - : Springer Science and Business Media LLC. - 2193-1801. ; 5
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Journal article (peer-reviewed)abstract
- Docetaxel has been the standard first-line therapy in metastatic castration resistant prostate cancer. The survival benefit is, however, limited by either primary or acquired resistance. In this study, Du145 prostate cancer cells were converted to docetaxel-resistant cells Du145-R and Du145-RB by in vitro culturing. Next generation RNAseq was employed to analyze these cell lines. Forty-two genes were identified to have acquired mutations after the resistance development, of which thirty-four were found to have mutations in published sequencing studies using prostate cancer samples from patients. Fourteen novel and 2 previously known fusion genes were inferred from the RNA-seq data, and 13 of these were validated by RT-PCR and/or re-sequencing. Four in-frame fusion transcripts could be transcribed into fusion proteins in stably transfected HEK293 cells, including MYH9-EIF3D and LDLR-RPL31P11, which were specific identified or up-regulated in the docetaxel resistant DU145 cells. A panel of 615 gene transcripts was identified to have significantly changed expression profile in the docetaxel resistant cells. These transcriptional changes have potential for further study as predictive biomarkers and as targets of docetaxel treatment.
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| 6. |
- Shen, Qing, et al.
(author)
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Psychiatric Disorders and Cardiovascular Diseases During the Diagnostic Workup of Suspected Prostate Cancer
- 2021
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In: JNCI Cancer Spectrum. - : Oxford University Press. - 2515-5091. ; 5:1
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Journal article (peer-reviewed)abstract
- Background: It is unknown whether the rate of psychiatric disorders and cardiovascular disease increases during the diagnostic workup of suspected prostate cancer.Methods: We designed a population-based cohort study including 579 992 men living during 2005-2014 in Skåne, Sweden, according to the Swedish Total Population Register and the Skåne Healthcare Register (SHR). We used the Swedish Cancer Register and the SHR to identify all men with a new diagnosis of prostate cancer (N = 10 996), and all men underwent a prostate biopsy without receiving a cancer diagnosis (biopsy group, N = 20 482) as exposed to a diagnostic workup. Using Poisson regression, we compared the rates of psychiatric disorders and cardiovascular disease during the period before diagnosis or biopsy of exposed men with the corresponding rates of unexposed men.Results: We found an increased rate of psychiatric disorders during the period before diagnosis or biopsy among men with prostate cancer (incidence rate ratio [IRR] = 1.87, 95% confidence interval [CI] = 1.67 to 2.10) and men in the biopsy group (IRR = 2.22, 95% CI = 2.08 to 2.37). The rate of cardiovascular disease increased during the period before diagnosis or biopsy among men with prostate cancer (IRR = 2.22, 95% CI = 2.12 to 2.32) and men in the biopsy group (IRR = 2.56, 95% CI = 2.49 to 2.63). Greater rate increases were noted for a diagnostic workup due to symptoms than due to other reasons.Conclusions: There was an increased risk of psychiatric disorders and cardiovascular disease during the diagnostic workup of suspected prostate cancer regardless of the final cancer diagnosis.
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| 7. |
- Valachis, Antonis, 1984-, et al.
(author)
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Overall survival of patients with metastatic breast cancer in Sweden : a nationwide study
- 2022
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In: British Journal of Cancer. - : Nature Publishing Group. - 0007-0920 .- 1532-1827. ; 127:4, s. 720-725
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Journal article (peer-reviewed)abstract
- Background: Breast cancer is the most common cancer among women in Sweden. Whereas survival for the overall breast cancer population is well-documented, survival of patients with metastatic breast cancer (MBC) is harder to quantify due to the lack of reliable data on disease recurrence in national cancer registers.Methods: This study used machine learning to classify the total MBC population in Sweden diagnosed between 2009 and 2016 using national registers, with the aim to estimate overall survival (OS).Results: The total population consisted of 13,832 patients-2528 (18.3%) had de novo MBC whereas 11,304 (81.7%) were classed as having a recurrent MBC. Median OS for patients with MBC was found to be 29.8 months 95% confidence interval (CI) [28.9, 30.6]. Hormone-receptor (HR)-positive MBC had a median OS of 37.0 months 95% CI [35.9, 38.3] compared to 9.9 months 95% CI [9.1, 11.0] for patients with HR-negative MBC.Conclusion: This study covered the entire MBC population in Sweden during the study time and may serve as a baseline for assessing the effect of new treatment strategies in MBC introduced after the study period.
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