A5063835785- Economic and Financial Impacts of Cancer
- Health Systems, Economic Evaluations, Quality of Life
- Pancreatic and Hepatic Oncology Research
- Biosimilars and Bioanalytical Methods
- Pharmaceutical Economics and Policy
- Cancer Treatment and Pharmacology
- CAR-T cell therapy research
- HER2/EGFR in Cancer Research
- Chemotherapy-induced cardiotoxicity and mitigation
- Colorectal Cancer Treatments and Studies
- Breast Cancer Treatment Studies
- Cancer Genomics and Diagnostics
- Pharmaceutical studies and practices
- Clinical practice guidelines implementation
- Health and Medical Research Impacts
- COVID-19 and healthcare impacts
- Healthcare cost, quality, practices
- Lymphoma Diagnosis and Treatment
- vaccines and immunoinformatics approaches
- Gastric Cancer Management and Outcomes
- Social Media in Health Education
- Health Literacy and Information Accessibility
- Statistical Methods in Clinical Trials
- Acute Lymphoblastic Leukemia research
- Cancer Immunotherapy and Biomarkers
Cancer Care Ontario
2015-2024
Public Health Ontario
2024
Canadian Partnership Against Cancer
2024
Canadian Centre for Applied Research in Cancer Control
2016-2023
Impact
2022
Kingston General Hospital
2015-2016
Institute for Clinical Evaluative Sciences
2015-2016
Health Sciences Centre
2015-2016
University Health Network
2015-2016
University of Toronto
2015-2016
<h3>Importance</h3> The COVID-19 pandemic has impacted cancer systems worldwide. Quantifying the changes is critical to informing delivery of care while continues, as well for system recovery and future planning. <h3>Objective</h3> To quantify change in services across continuum during pandemic. <h3>Design, Setting, Participants</h3> This population-based cohort study assessed screening, imaging, diagnostic, treatment, psychosocial oncological delivered pediatric adult populations Ontario,...
Purpose: Evaluate inter-country variability in the reimbursement of publically funded cancer drugs, and identify factors such as cost containment measures that may contribute to variability. Methods: As February 28, 2010, licensed indications for 10 drugs (bevacizumab, bortezomib, cetuximab, erlotinib, imatinib, pemetrexed, rituximab, sorafenib, sunitinib, trastuzumab) were obtained from drug registries 6 licensing authorities corresponding 13 countries or regions: Australia, Canada...
The late cardiac effect of adjuvant trastuzumab and its potential interaction with anthracycline have not been well-studied on a population level. In this retrospective population-based cohort study, female breast cancer patients in Ontario, diagnosed between 2003 2009, were identified by the Ontario Cancer Registry linked to administrative databases ascertain demographics, risk factors, comorbidities, use other chemotherapy. Patients pre-existing heart failure (HF) excluded. main endpoint...
Abstract Background In Ontario, FOLFIRINOX (FFX) and gemcitabine + nab‐paclitaxel (GnP) have been publicly funded for first‐line unresectable locally advanced pancreatic cancer (uLAPC) or metastatic (mPC) since April 2015. We examined the real‐world effectiveness safety of FFX vs GnP cancer, in uLAPC mPC. Methods Patients receiving from 2015 to March 2017 were identified New Drug Funding Program database. Baseline characteristics outcomes obtained through Ontario Cancer Registry other...
Oncology therapy is becoming increasingly more expensive and challenging the affordability sustainability of drug programmes around world. When new drugs are evaluated, health technology assessment organisations rely on clinical trials to inform funding decisions. However, not able assess overall survival generalises evidence in a real-world setting. As result, policy makers have little information whether decisions based ultimately yield outcomes value for money that might be expected.The...
Abstract Background Current treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an expensive drug, combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. Economic models have predicted rituximab plus CHOP (RCHOP) to be a cost-effective alternative alone as first-line DLBCL, but it remains unclear what its real-world costs cost-effectiveness are in routine clinical practice. Methods We performed population-based retrospective cohort...
<h3>Importance</h3> In response to an increase in COVID-19 infection rates Ontario, several systemic treatment (ST) regimens delivered the adjuvant setting for breast cancer were temporarily permitted neoadjuvant-intent defer nonurgent surgical procedures. <h3>Objective</h3> To examine use and compare short-term outcomes of vs ST era compared with pre–COVID-19 era. <h3>Design, Setting, Participants</h3> This was a retrospective population-based cohort study Canada. Patients starting selected...
Background: Ontario publicly funds reference trastuzumab (Herceptin) and four biosimilar products for adjuvant treatment of HER2+ breast cancer. We assessed the real-world safety effectiveness compared to Herceptin patients with Methods: This was a population-based, retrospective study comparing neoadjuvant/adjuvant cancer from 2016 2021. Treatment started November 2019 June 2021; historical comparator October 2019. Safety outcomes death within 30 days last dose trastuzumab, direct...
Multi-criteria decision analysis (MCDA) is a value assessment tool designed to help support complex decision-making by incorporating multiple factors and perspectives in transparent, structured approach. We developed an MCDA rating tool, consisting of seven criteria evaluating the importance feasibility conducting potential real-world evidence (RWE) studies aimed at addressing uncertainties stemming from initial cancer drug funding recommendations. In collaboration with Canadian Agency for...
Abstract Is it ethical to market complementary and alternative medicines? Complementary medicines (CAM) are medical products services outside the mainstream of practice. But they not just (or supposed medicines) offered provided for prevention treatment illness. They also – things sale in marketplace. Most discussion ethics CAM has focused on bioethical issues having do with therapeutic value, relationship between patients those purveyors CAM. This article aims instead consider from...
Background. Real-world evidence can be a valuable tool when clinical trial data are incomplete or uncertain. Bevacizumab was adopted as first-line therapy for metastatic colorectal cancer (mCRC) based on significant survival improvements in initial trials; however, benefit diminished subsequent analyses. Consequently, there is uncertainty surrounding the cost-effectiveness of bevacizumab achieved practice. Objective. To assess real-world with irinotecan-based chemotherapy versus alone mCRC...
Abstract Background Advanced pancreatic cancer (APC) patients often have substantial symptom burden. In Ontario, routinely complete the Edmonton Symptom Assessment Scale (ESAS), which screens for nine symptoms (scale: 0‐10), in clinics. We explored association between baseline patient‐reported outcomes, via ESAS, and overall survival (OS). Methods with ESAS records prior to receiving publicly funded drugs from November 2008 March 2016 were retrospectively identified Cancer Care Ontario's...
Abstract Background For novel cancer treatments, effectiveness in clinical practice is not always aligned with efficacy results. As such it important to understand a treatment’s real-world effectiveness. We examined population-based comparative of second-line ipilimumab versus non-ipilimumab treatments (chemotherapy or targeted treatments). Methods used cohort melanoma patients receiving systemic treatment for advanced disease since April 2005 from Ontario, Canada. Patients were identified...
Niraparib was recently funded in Canada for the maintenance treatment of ovarian cancer following platinum-based chemotherapy. However, drug’s safety profile real world remains uncertain. We conducted a cohort study to describe patient population using niraparib and proportion that experienced adverse events between June 2019 December 2022 four Canadian provinces (Ontario, Alberta, British Columbia [BC], Quebec). used administrative data electronic medical records from Ontario Health,...
<h3>Background:</h3> Adjuvant trastuzumab is the standard of care for patients with HER2 overexpressing breast cancer, but use may lead to cardiotoxicity. Our goal was evaluate relationship between hospital and physician case volume cardiac outcomes in this population. <h3>Methods:</h3> In retrospective cohort study, we identified all female Ontario a cancer diagnosis 2003-2009 who underwent treatment through provincial drug-funding program linked these administrative databases ascertain...
Abstract Background There are no randomized control trials (RCTs) comparing gemcitabine and nab-paclitaxel (Gem-Nab) fluorouracil, folinic acid, irinotecan, oxaliplatin (FOLFIRINOX) for advanced pancreatic cancer (APC). Although it is well known that RCT-based efficacy often does not translate to real-world effectiveness, there limited literature investigating comparative cost-effectiveness of Gem-Nab vs FOLFIRINOX APC. We aimed examine the APC in Ontario, Canada. Methods This study compared...
Abstract Background The efficacy‐effectiveness gap between randomized trial and real‐world evidence regarding the clinical benefit of ipilimumab for metastatic melanoma (MM) has been well characterized by previous literature, consistent with initial concerns raised health technology assessment agencies (HTAs). As these differences can significantly impact cost‐effectiveness, it is critical to assess cost‐effectiveness second‐line versus non‐ipilimumab treatments MM. Methods This was a...
The association between obesity and survival in non-Hodgkin lymphoma is unclear. Using the Ontario Cancer Registry we conducted a retrospective analysis of incident cases aggressive-histology B-cell treated with rituximab-containing regimen curative intent 2008–2016. 6246 patients were included. On multivariable rate all-cause mortality was lower for overweight body mass index (BMI 25–29.9 kg/m2) (HR 0.85; 95%CI 0.77–0.95) obese BMI (≥30 0.75; 0.67–0.85) groups compared to normal weight...
Second-line ipilimumab has been publicly funded in Ontario for metastatic melanoma (MM) since September 2012. We examined real-world toxicity of second-line compared to standard treatments prior funding. MM patients who received systemic treatment from April 2005 March 2015 were included. Patients receiving after 2012 considered as cases, and those the funding date included historical controls. Outcomes assessed include treatment-related mortality, any-cause hospital visits,...