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3 result(s) for "Sarkar, Srawani"
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Risks of hypertension and thromboembolism in patients receiving bevacizumab with chemotherapy for colorectal cancer: A systematic review and meta‐analysis
Background Guidelines show that for metastatic colorectal cancer (mCRC), a combination of three‐drug regimens, fluorouracil, leucovorin, and oxaliplatin and bevacizumab (BVZ), is one of the first‐line standard therapies. BVZ is generally well tolerated; however, it is associated with infrequent, life‐threatening side effects such as severe hypertension (HTN) (5%–18%), Grade ≥3 arterial thromboembolism (ATE) (2.6%), Grade ≥3 hemorrhagic events (1.2%–4.6%), and gastrointestinal perforation (0.3%–2.4%). This meta‐analysis aims to evaluate the additive risk of BVZ‐induced severe HTN and thromboembolism when BVZ is combined with a standard chemotherapy regime in patients with mCRC. Methods Our search was conducted from January 29, 2022, to February 22, 2022, through databases of PubMed, clinicaltrial.gov, EMBASE, Web of Science, and Cochrane Library. Data analysis from randomized controlled trials (RCTs) and clinical trials was conducted using Review Manager V.5.4, comparing BVZ‐chemotherapy to chemotherapy only, focusing on cardiovascular AE such as HTN and arterial and venous thromboembolism. Results The analysis from 26 clinical trials and RCTs showed that the odds of HTN were about four times higher, and ATE subgroup analysis of 11 studies showed over two times higher odds of ATE in patients being treated with BVZ compared to the chemotherapy‐only group. Conclusion BVZ, when added to the standard chemotherapy regimen for mCRC, was associated with higher odds of developing HTN and thromboembolism, specifically ATE, than the chemotherapy‐only group. Our findings are significant as they provide vital information in analyzing the risk–benefit ratio of adding BVZ to the standard chemotherapy regime in patients with mCRC, especially in patients with vascular comorbidities.
Socioeconomic Disparities in Gastric Cancer and Identification of a Single SES Variable for Predicting Risk
IntroductionSocioeconomic status (SES) is a known risk factor for gastric cancer (GC). This study seeks to examine education, income, and occupation variables separately to identify the single variable that can be best used to assess SES risk for GC.MethodsData from a case-control survey study were used. Logistic regression models were created for education, income, and occupation adjusted for age, sex, and race. Models were compared using AIC, c-statistics, and pseudo-R square to determine the model that had the highest risk predictive ability.ResultsGC cases had lower education levels and more commonly held jobs in unskilled labor. Annual household income was lower in cases compared to controls. Age, gender, race, education, and occupation were associated with increased risk of GC. The education model adjusted for age, gender, and race found < high school (HS) education to have an OR of 3.18 (95% CI 1.09–9.25) for GC compared to > HS education. The occupation model demonstrated that employment in unskilled labor had OR of 4.32 (95% CI 1.05–17.76) for GC compared to professional occupation. Model fit was best for the education model (AIC: 113.583, lower AIC is better) compared to income (117.562) or occupation (117.032). Education contributed the most to model variability (% delta pseudo-R square (4.7%)) compared to occupation (4.0%) or income (3.8%).ConclusionEducation level was the single most reliable measure of GC risk among 3 SES variables and can be employed as an ideal single indicator of SES-related GC risk when multiple SES factors cannot be obtained.
Racial/ethnic differences in risk factors for non-cardia gastric cancer: an analysis of the Multiethnic Cohort (MEC) Study
Purpose Gastric cancer (GC) incidence rates show notable differences by racial/ethnic groups in the US. We sought to determine whether stratification by race/ethnicity would reveal unique risk factors for development of non-cardia gastric cancer (NCGC) for US population. Methods Analysis included 1,112 incident cases of NCGC and 190,883 controls from the Multiethnic Cohort Study, a prospective US cohort study that recruited individuals living in Hawaii and California, aged 45–75 years from 5 races/ethnicities. Descriptive analysis and Cox regression models examined the association of risk factors for GC and calculate hazard ratios for each race/ethnicity, adjusting for sociodemographic and dietary variables. Results Increasing age and male sex were risk factors for NCGC for most race/ethnicities. Higher risk was associated with: GC family history for Latino and Japanese American individuals [HRs range from 1.75 to 1.98]; foreign-born for Japanese American individuals [HR: 1.52, 95% CI 1.11–2.09]; lower education for African American, Japanese American, and Native Hawaiian individuals [HRs range from 1.30 to 1.74]; daily alcohol consumption for African American individuals[HR: 1.56, 95% CI 1.04–2.35]; current smoking for Latino and Japanese American individuals [HRs range from 1.89 to 1.94]; sodium consumption in the highest quartile for White individuals [HR: 2.55, 95% CI 1.23–5.26] compared to the lowest quartile; fruit consumption in the 2nd, 3rd, and 4th highest quartile for Native Hawaiian individuals [HRs range from 2.19 to 2.60] compared to the lowest quartile; diabetes for African American individuals [HR: 1.79, 95% CI 1.21–2.64]; and gastric/duodenal ulcers for Native Hawaiian individuals [HR: 1.82, 95% CI 1.04–3.18]. Conclusion Analyses by racial/ethnic group revealed differing risk factors for NCGC. Increased knowledge of the varying pathways to GC can support personalized GC prevention strategies and risk stratification tools for early detection.