A real-world study on characteristics, treatments and outcomes in US patients with advanced stage ovarian cancer.

BACKGROUND: Detailed epidemiologic descriptions of large populations of advanced stage ovarian cancer patients have been lacking to date. This study aimed to describe the patient characteristics, treatment patterns, survival, and incidence rates of health outcomes of interest (HOI) in a large cohort of advanced stage ovarian cancer patients in the United States (US). METHODS: This cohort study identified incident advanced stage (III/IV) ovarian cancer patients in the US diagnosed from 2010 to 2018 in the HealthCore Integrated Research Database (HIRD) using a validated predictive model algorithm. Descriptive characteristics were presented overall and by treatment line. The incidence rates and 95% confidence intervals for pre-specified HOIs were evaluated after advanced stage diagnosis. Overall survival, time to treatment discontinuation or death (TTD), and time to next treatment or death (TTNT) were defined using treatment information in claims and linkage with the National Death Index. RESULTS: We identified 12,659 patients with incident advanced stage ovarian cancer during the study period. Most patients undergoing treatment received platinum agents (75%) and/or taxanes (70%). The most common HOIs (> 24 per 100 person-years) included abdominal pain, nausea and vomiting, anemia, and serious infections. The median overall survival from diagnosis was 4.5 years, while approximately half of the treated cohort had a first-line time to treatment discontinuation or death (TTD) within the first 4 months, and a time to next treatment or death (TTNT) from first to second-line of about 6 months. CONCLUSIONS: This study describes commercially insured US patients with advanced stage ovarian cancer from 2010 to 2018, and observed diverse treatment patterns, incidence of numerous HOIs, and limited survival in this population.

Subcutaneous drug delivery: a route to increased safety, patient satisfaction, and reduced costs.

The subcutaneous (SC) route of administration is generally preferred over intravenous administration because it enables at-home injection, improves quality of life, and reduces health care costs. In general, a volume of no greater than 1 to 2 mL is injected SC; however, for high-dose agents with limited solubility, such as monoclonal antibodies, larger volumes must be administered, which requires divided doses, smaller volumes, or more frequent dose administration. Therapeutics are being formulated with an enzyme, recombinant human hyaluronidase, to enhance the dispersion and absorption of SC administered therapeutics by transiently depolymerizing hyaluronan, a major component of the interstitial matrix.

Intravenous therapy: a review of complications and economic considerations of peripheral access.

Despite the growing frequency of intravenous (IV) injections, establishing peripheral IV access is challenging, particularly in patients with small or collapsed veins. Therefore, patients often endure failed attempts and eventually become venous depleted. Furthermore, maintaining patients' vascular access throughout treatment is difficult because a number of complications including phlebitis, infiltration, extravasation, and infections can occur. The aim of this article is to review the use of the IV route for administering therapy, identify and analyze key risks and complications associated with achieving and maintaining peripheral IV access, examine measures to reduce these risks, and discuss implications for nurses in clinical practice.