PMID- 36358844
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221117
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 14
IP  - 21
DP  - 2022 Nov 3
TI  - Application of Electronic Health Record Text Mining: Real-World Tolerability, 
      Safety, and Efficacy of Adjuvant Melanoma Treatments.
LID - 10.3390/cancers14215426 [doi]
LID - 5426
AB  - Introduction: Nivolumab (N), pembrolizumab (P), and dabrafenib plus trametinib (D 
      + T) have been registered as adjuvant treatments for resected stage III and IV 
      melanoma since 2018. Electronic health records (EHRs) are a real-world data 
      source that can be used to review treatments in clinical practice. In this study, 
      we applied EHR text-mining software to evaluate the real-world tolerability, 
      safety, and efficacy of adjuvant melanoma treatments. Methods: Adult melanoma 
      patients receiving adjuvant treatment between January 2019 and October 2021 at 
      the Leiden University Medical Center, the Netherlands, were included. CTcue 
      text-mining software (v3.1.0, CTcue B.V., Amsterdam, The Netherlands) was used to 
      construct rule-based queries and perform context analysis for patient inclusion 
      and data collection from structured and unstructured EHR data. Results: In total, 
      122 patients were included: 54 patients treated with nivolumab, 48 with 
      pembrolizumab, and 20 with D + T. Significantly more patients discontinued 
      treatment due to toxicity on D + T (N: 16%, P: 6%, D + T: 40%), and X(2) (6, n = 
      122) = 14.6 and p = 0.024. Immune checkpoint inhibitors (ICIs) mainly showed 
      immune-related treatment-limiting adverse events (AEs), and chronic 
      thyroid-related AE occurred frequently (hyperthyroidism: N: 15%, P: 13%, 
      hypothyroidism: N: 20%, P: 19%). Treatment-limiting toxicity from D + T was 
      primarily a combination of reversible AEs, including pyrexia and fatigue. The 
      1-year recurrence-free survival was 70.3% after nivolumab, 72.4% after 
      pembrolizumab, and 83.0% after D + T. Conclusions: Text-mining EHR is a valuable 
      method to collect real-world data to evaluate adjuvant melanoma treatments. ICIs 
      were better tolerated than D + T, in line with RCT results. For BRAF+ patients, 
      physicians must weigh the higher risk of reversible treatment-limiting AEs of D + 
      T against the risk of long-term immune-related AEs.
FAU - van Laar, Sylvia A
AU  - van Laar SA
AD  - Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 
      2333 ZA Leiden, The Netherlands.
FAU - Kapiteijn, Ellen
AU  - Kapiteijn E
AUID- ORCID: 0000-0002-4814-6426
AD  - Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, 
      The Netherlands.
FAU - Gombert-Handoko, Kim B
AU  - Gombert-Handoko KB
AUID- ORCID: 0000-0002-5044-262X
AD  - Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 
      2333 ZA Leiden, The Netherlands.
FAU - Guchelaar, Henk-Jan
AU  - Guchelaar HJ
AUID- ORCID: 0000-0002-7085-1383
AD  - Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 
      2333 ZA Leiden, The Netherlands.
FAU - Zwaveling, Juliette
AU  - Zwaveling J
AUID- ORCID: 0000-0002-6080-6183
AD  - Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 
      2333 ZA Leiden, The Netherlands.
LA  - eng
GR  - CSO 21.026 / P3 238002/Novartis (Netherlands)/
PT  - Journal Article
DEP - 20221103
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC9657798
OTO - NOTNLM
OT  - adjuvant treatment
OT  - electronic health record
OT  - immune-checkpoint inhibitors
OT  - melanoma
OT  - real-world data
OT  - targeted therapy
OT  - text mining
COIS- E.K. has consultancy/advisory relationships with Bristol Myers Squibb, Novartis, 
      Merck, Pierre Fabre, and received research grants not related to this paper from 
      Bristol Myers Squibb and Pierre Fabre. The other authors have no conflicts of 
      interests to declare.
EDAT- 2022/11/12 06:00
MHDA- 2022/11/12 06:01
PMCR- 2022/11/03
CRDT- 2022/11/11 01:07
PHST- 2022/09/06 00:00 [received]
PHST- 2022/10/31 00:00 [revised]
PHST- 2022/11/02 00:00 [accepted]
PHST- 2022/11/11 01:07 [entrez]
PHST- 2022/11/12 06:00 [pubmed]
PHST- 2022/11/12 06:01 [medline]
PHST- 2022/11/03 00:00 [pmc-release]
AID - cancers14215426 [pii]
AID - cancers-14-05426 [pii]
AID - 10.3390/cancers14215426 [doi]
PST - epublish
SO  - Cancers (Basel). 2022 Nov 3;14(21):5426. doi: 10.3390/cancers14215426.