Evidence map›Paper›PMID 32609726›Full record

ArticlePloS one2020

Comparison of efficacy and toxicity of intravitreal melphalan formulations for retinoblastoma.

Terry Hsieh, Albert Liao, Jasmine H Francis, Jessica A Lavery, Audrey Mauguen, Scott E Brodie, David H Abramson

Open access · goldAbstract readComparative Study
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Terry HsiehStein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.ORCID 0000-0002-7405-308X
Albert LiaoOphthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.
Jasmine H FrancisOphthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.
Jessica A LaveryDepartment of Epidemiology & Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.ORCID 0000-0002-2746-5647
Audrey MauguenDepartment of Epidemiology & Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.
Scott E BrodieDepartment of Ophthalmology, NYU Langone Health, New York, NY, United States of America.
David H AbramsonOphthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, United States of America.
Memorial Sloan Kettering Cancer Center · USNYU Langone Health · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

objectiveIntravitreal melphalan injections are commonly used in the treatment for intraocular retinoblastoma. This study compares retinal toxicity and ocular survival between two formulations, with and without propylene glycol (Alkeran vs. Evomela, respectively).

methodsA retrospective cohort study of retinoblastoma patients who received intravitreal injections of Alkeran and Evomela at 30 μg from September 2012 to January 2019 at a single tertiary care center were enrolled. Retinal toxicity was measured using electroretinogram (ERG) and compared using a multivariate analysis of 338 injections in 101 eyes of 96 patients. Ocular survival of 163 eyes in 150 patients was compared across formulations using Cox proportional hazards model. Eyes were censored at the time a patient received a dose other than 30 μg.

resultsOverall, ERG decline (mean, 95% CI) for each injection was -5.58 μV (-7.17, -3.99). No significant differences in ERG decrement were found between Alkeran (with alcohol) -5.52uV (-6.99, -4.05). and Evomela (without alcohol) -5.65uV (-8.31 to -2.98) formulations (p = 0.93). Ocular survival at 24 months was 93.6% (95% CI 86.2, 97.1) with alcohol and 91.7% (95% CI 53.9, 98.8) without alcohol. The hazard ratio (HR) for without vs with alcohol was 0.50 (95% CI 0.06 to 4.07); no significant difference in ocular survival was found between formulations (p = 0.52). CONCLUSIONS AND RELEVANCE: No differences were found in retinal toxicity and ocular survival between 30 μg intravitreal injections of Alkeran or Evomela for intraocular retinoblastoma. Given the increased stability of Evomela, intravitreal treatment could be expanded to centers without the ability to supply Alkeran due to its shorter safety window; however, Alkeran is less expensive. For those with existing infrastructure, Alkeran is a comparable, cost-effective alternative.

Indexed as

AdolescentAntineoplastic Agents, AlkylatingChildChild, PreschoolHumansInfantIntravitreal InjectionsMelphalanRetinaRetinal NeoplasmsRetinoblastomaTreatment OutcomeAntineoplastic Agents, AlkylatingMelphalan

Identifiers

PMID32609726
PMCPMC7329086
OpenAlexW3038204105

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.