Browsing by Author "Ghabach, Bassam"
Now showing 1 - 2 of 2
- Results Per Page
- Sort Options
Item Smoking cessation and survival among people diagnosed with non-metastatic cancer(BioMed Central Ltd., 2020-08-05) Barnett, Tracey E.; Lu, Yan; Gehr, Aaron W.; Ghabach, Bassam; Ojha, Rohit P.BACKGROUND: We aimed to estimate the effects of smoking cessation on survival among people diagnosed with cancer. METHODS: We used data from a Comprehensive Community Cancer Program that is part of a large urban safety-net hospital system. Eligible patients were diagnosed with primary invasive solid tumors between 2013 and 2015, and were current smokers at time of diagnosis. Our exposure of interest was initiation of smoking cessation within 6 months of cancer diagnosis. We estimated inverse probability weighted restricted mean survival time (RMST) differences and risk ratio (RR) for all cause 3-year mortality. RESULTS: Our study population comprised 369 patients, of whom 42% were aged < 55 years, 59% were male, 44% were racial/ethnic minorities, and 59% were uninsured. The 3-year RMST was 1.8 (95% CL: - 1.5, 5.1) months longer for individuals who initiated smoking cessation within 6 months of cancer diagnosis. The point estimate for risk of 3-year mortality was lower for initiation of smoking cessation within 6 months of diagnosis compared with no initiation within 6 months (RR = 0.72, 95% CL: 0.37, 1.4). CONCLUSIONS: Our point estimates suggest longer 3-year survival, but the results are compatible with 1.5 month shorter or 5.1 longer 3-year overall survival after smoking cessation within 6 months of cancer diagnosis. Future studies with larger sample sizes that test the comparative effectiveness of different smoking cessation strategies are needed for more detailed evidence to inform decision-making about the effect of smoking cessation on survival among cancer patients. IMPLICATIONS FOR CANCER SURVIVORS: The benefits of smoking cessation after cancer diagnosis may include longer survival, but the magnitude of benefit is unclear.Item Treatment Patterns and Survival Outcomes of Immune Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer Survival at a Safety-Net Hospital(2024-03-21) Sabloak, Krishti; Derton, Abigail; Teigan, Kari; Gonzalez, Mario; Ghabach, Bassam; Narra, KalyaniBackground: Immune checkpoint inhibitors (ICI) have transformed the treatment of advanced non-small cell lung cancer (aNSCLC) without driver mutations. KEYNOTE 189 trial showed median overall survival (OS) of 21.8 months (m) for chemotherapy with ICI (CT-ICI) compared to 12.1m for chemotherapy (CT). Since a large percentage of underserved cancer patients in the United States receive care from safety-net hospitals (SNH), this poses the question: Are these patients benefitting from ICI? Herein, we report the treatment and survival patterns of patients with aNSCLC at John Peter Smith Hospital (JPS), a SNH in North Texas. Methods: Patient data were obtained from the JPS tumor registry for this retrospective study. Eligible patients were diagnosed at JPS from 1/1/2017 to 12/31/2021 with stages IIIB/IIIC/IV NSCLC. Patients with driver mutations were excluded. Electronic records were reviewed for programmed death ligand 1 (PD-L1) testing and first-line treatments. OS was calculated from diagnosis to death (if applicable) or the last chart entry before 5/31/2023. Covariates were sex, race, age at diagnosis, stage, histology and PDL-1. Log-rank tests were used to compare survival distributions. OS probability within each treatment group was modeled using a Kaplan-Meier curve. The log-normal accelerated failure time model was used to estimate the effects of covariates on survival. Results: 195 patients were included: 48% Non-Hispanic White, 35% Black, 12% Hispanic, and 6% Asian. 59% were males. 81% of patients had stage IV disease. Treatments were as follows: 29 CT, 27 CT-ICI, 15 ICI, and 15 chemoradiation (CRT). 106 (54%) patients did not receive any treatment (NT). CRT was used in 75% of treated stages IIIB/IIIC. Median OS for CT, CT-ICI, ICI, CRT, and NT were 6.6m, 22.6m, 23.6m, 23.4m, and 2.7m, respectively. The log-rank test detected a statistically significant difference in OS between CT-ICI and CT (p < 0.001) and between ICI and CT (p=0.003) but no difference between CT-ICI and ICI (p=1). 66% of patients underwent PDL-1 testing: PDL-1 <1%, PDL-1 1-49%, and PDL-1 ≥ 50% had longer OS with p=0.02, p=0.01 and p<0.001 respectively compared to those not tested. Conclusions: Our study is the first in SNH population, with OS similar to published trials. aNSCLC patients who received first-line CT-ICI or ICI had better survival compared to CT alone regardless of PDL-1 results. We should study the reasons why most patients did not receive any treatment and extend the benefit of ICIs to as many patients with aNSCLC as possible.