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  • 00:01

    SPEAKER 1: OK, so this is another articlethat I have here as an example.And I thought I'd try to approach itas a clinician or an MD treating patients with brentuximab.And the background on this is that hodgkin's lymphoma,which is a cancer that really impacts people in their 20s

  • 00:22

    SPEAKER 1 [continued]: usually--so there is a type of chemotherapy regimenthat's the gold standard, which is ABVD.And it's doxorubicin, bleomycin, vinblastine, and dacarbazine--so ABVD.And this study evaluates whether it's worthadding brentuximab to the mix in terms of the outcomes.

  • 00:45

    SPEAKER 1 [continued]: So brentuximab was approved by the FDAfor this treatment back in March the 20th, 2018.So it was approved for adult patientswith previously untreated stage 3 or 4 classical Hodgkin'slymphoma in combination with chemotherapy.And that was on the basis of this study, whichwas published in the New England Journal of Medicine,

  • 01:07

    SPEAKER 1 [continued]: January 2018.If I'm a clinician and I'm treating patientswith Hodgkin's lymphoma, I've alwaysgiven them ABVDs, the chemotherapy regimen.And so we're going to start giving them brentuximab.I want to maybe delve into this paper a little further.So how would I approach that?

  • 01:27

    SPEAKER 1 [continued]: Well, I already kind of know what's going on.So I'm going to skip over the abstract,but then I'm going to go into the full text.And I want to see a few things.So I'm going to look down into the study design.I'm going to make sure that it's equivalent-- is

  • 01:47

    SPEAKER 1 [continued]: this the type of regimen, ABVD, that patients normally get?And how was the brentuximab administered?I'm going to look at the patient demographics.So what age group are we looking at here?So they're Ann Arbor stage II or IV.So can I extrapolate these results

  • 02:09

    SPEAKER 1 [continued]: to patients with a lower stage of disease?Probably not.It would be the same expected outcome.So you have to make sure that you're treatingthe same type of patient.What are the co-morbidities, what is the age group,and that kind of thing-- so you can find all that in the methodsection of the paper.And then I'm going to want to look

  • 02:30

    SPEAKER 1 [continued]: at definitely the outcomes.So we had 24.9 month median follow-up.OK, we had a two-year modified progression free survivalrate of 82.1% with brentuximab versus 77.2%for no brentuximab.

  • 02:52

    SPEAKER 1 [continued]: And so we have a hazard ratio for progression deathor modified progression of 0.77--so 23% risk reduction.And it is statistically significant, p-value of 0.03.So here's a Kaplan Meier estimate,just like we had in the course materials.

  • 03:14

    SPEAKER 1 [continued]: And there's the progression-free survival on this curve.So it looks like there is a survivaladvantage with A plus AVD.So that's adcetris plus three of the chemotherapiesversus the gold standard of ABVD--so that's no brentuximab or adcetris.

  • 03:35

    SPEAKER 1 [continued]: So the survival was better.All right, so there's a whole bunch of statistics here.And then, if I am a clinician, I mightlook a little more at the different subgroupsand how those scored.But they may not be statistically relevantbecause of the number of the people in each subgroup.

  • 03:56

    SPEAKER 1 [continued]: You can see A plus AVD is better on this side,and then ABVD is better.And you can see in almost all the subgroupsthat there's a benefit for patients with brentuximab.All right, so that's interesting.And then we're going to look at the safety.That's important.There's also a supplementary appendix.

  • 04:16

    SPEAKER 1 [continued]: And I might look at that, sit and read that.And I want to see what adverse events we have.And you can see, actually, in these groupsthat the number of adverse eventswere actually very similar.So that's reassuring.So I would sit down and read thisvery carefully if I'm treating patients with a new regimen,

  • 04:39

    SPEAKER 1 [continued]: with brentuximab.And then I would read the discussion section.And then, because brentuximab is an approveddrug for other conditions in addition to Hodgkin's lymphoma,there's going to be what's calledthe prescribing information.So I would probably pull up the prescribing informationfor brentuximab.

  • 04:60

    SPEAKER 1 [continued]: And information from this trial will be in the updated label.It's called a label.And so all of this information will also be in that.So I probably would check that out also.Again, it's supported by Millennium Pharmaceuticals.And that is the manufacturer of brentuximab.But it's a peer reviewed study in a very high impact journal

  • 05:21

    SPEAKER 1 [continued]: and very important findings.So definitely, it's a high quality studythat we can be confident in the results.

Video Info

Series Name: How to Read and Interpret a Scientific Paper

Episode: 1

Publisher: SciMedly, LLC

Publication Year: 2021

Video Type:Documentary

Methods: Data analysis skills, Ratio scales, Ratio variables, Methodology, Epidemiology, Participatory epidemiology, Participatory research, Participatory action research

Keywords: data analysis; medical research; peer review; research reports; Scientific research

Segment Info

Segment Num.: 1

Persons Discussed:

Events Discussed:

Keywords:

Abstract

Introduction on how to read a scientific paper, using a study on brentuximab as a treatment for Hodgkin's lymphoma as an example, including study design, patient demographics, and adverse events.

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Introduction

Introduction on how to read a scientific paper, using a study on brentuximab as a treatment for Hodgkin's lymphoma as an example, including study design, patient demographics, and adverse events.

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