Wednesday 28 February 2024
Salisbury Foundation Trust

FOI_6767

Internal Reference Number: FOI_6767

Date Request Received: 06/09/2022 00:00:00

Date Request Replied To: 05/10/2022 00:00:00

This response was sent via: By Email

Request Summary: Metastatic Cholangiocarcinoma (CCA) and Acute myeloid leukaemia (AML)

Request Category: Private Individuals

 
Question Number 1:
How many patients in the last 12 months has the trust treated for metastatic Cholangiocarcinoma (CCA) or Acute myeloid leukaemia (AML)?

a. For each of AML and CCA, how many have IDH-1 mutation?

b. How many CCA are intrahepatic vs extrahepatic?

i) How many of each of these present at 2nd line? How many of these at 2nd line have IDH-1 mutation?

c. For AML, how many patients were not fit for intensive chemotherapy? How many of these AML patients have IDH-1 mutation?
 
Answer To Question 1:
How many patients in the last 12 months has the trust treated for metastatic Cholangiocarcinoma (CCA) or Acute myeloid leukaemia (AML)?
AML – 6
CCA - 0

a. For each of AML and CCA, how many have IDH-1 mutation?
AML - <5
CCA - IDH 1 mutation is not routinely tested.– 0

b. How many CCA are intrahepatic vs extrahepatic? Intrahepatic <5, Extrahepatic <5

i. How many of each of these present at 2nd line? How many of these at 2nd line have IDH-1 mutation? The first part of this question is unclear, if this is asking how many patients we treat with 2nd line chemotherapy, this is <5. None on 2nd line have IDH-1 mutation (either negative or not tested)

a. For AML, how many patients were not fit for intensive chemotherapy? How many of these AML patients have IDH-1 mutation? 5/6 were not fit for intensive treatment. <5 had IDH1 mutation.
 
Question Number 2:
How many patients have been treated with pemigatinib (CCA), venetoclax plus azacitadine dual therapy or azacitadine monotherapy (AML )?

a. What is the average treatment duration for CCA patients treated with pemigatinib and AML patients treated with azacitadine dual therapy and azacitadine monotherapy?

i) What is the preferred azacitadine product?
 
Answer To Question 2:
Q. Zero for pemigatinib but 9 for azacitidine for AML

a. 9 months

i) The contract brand is used.


 
Question Number 3:
What is the real-world dosing for venetoclax (in combination with a CYP3A4)?

a. What is the antifungal of choice for patients treated with venetoclax?

b. What is the antifungal average treatment duration when used in combination with venetoclax ?

c) what proportion of patients are treated with an antifungal in combination with venetoclax?

i) In what proportion of patients is the antifungal treatment stopped?

ii) In what proportion of these pts is the venetoclax dosage altered following cessation of the antifungal?

 
Answer To Question 3:
Q. What is the real-world dosing for venetoclax (in combination with a CYP3A4)? 100mg in combination with Posaconazole.

a. Posaconazole

b. 7.4 months.

c) 100%

i) 20 %

ii) none


 
Question Number 4:
Do you routinely test CCA and AML patients for IDH-1 mutation?

a. If so when does the testing take place. E.g. at diagnosis or following 1st line progression?

i) Is this done using NGS panel?

ii) Is this done using PCR testing?

b. What is the average turnaround time for these tests?
 
Answer To Question 4:
Q4 Do you routinely test CCA and AML patients for IDH-1 mutation? No routine testing for CCA or AML patients.

a. If so when does the testing take place. E.g. at diagnosis or following 1st line progression? At diagnosis.

i) Is this done using NGS panel? Yes

ii) Is this done using PCR testing? No

b. What is the average turnaround time for these tests? 7-28 days.
 
Question Number 5:
Who is responsible for the routine management of patients with CCA and AML?

a. Clinical oncologist / medical oncologist / specialist nurse etc?
 
Answer To Question 5:
Medical Oncologist for metastatic disease
AML - Haematologists
 
Question Number 6:
How many admissions have occurred in the last 12 months for patients with CCA and AML?

a. What is their average length of stay?

b. How many of these patients were readmissions or readmitted during this time? If readmitted, can you state the main reason?
 
Answer To Question 6:
We are unable to answer this question as the data is not easily available and would take in excess of 18 hours to collate.
 
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