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Carteni G, Manegold C, Martin Garcia G, Siena S, Zielinski C, Amadori D, Liu Y, Visseren-Grul C, Blatter J, Stahel R. 6571 POSTER Open-label study of pemetrexed (P) alone or in combination with a platinum in patients (pts) with peritoneal mesothelioma (PM): results from the international expanded access program (EAP). EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71399-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Santoro A, O'Brien M, Stahel R, Nackaerts K, Baas P, Paz-Ares L, Sundstrom S, Visseren-Grul C, Blatter J, Manegold C. Pemetrexed plus cisplatin (P+Cis) or pemetrexed plus carboplatin (P+Cb) for chemonaive patients (pts) with malignant pleural mesothelioma (MPM): Results of the International Expanded Access Program (EAP). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7562 Background: In a phase III study of P+Cis versus Cis, MPM pts demonstrated a significant survival benefit (12.1 mo vs 9.3 mo median survival; 50.3% vs 38.0% 1-yr survival) and clinical benefit in favor of P+Cis (Vogelzang 2003). Other studies similarly demonstrated efficacy associated with P+Cb. Before and during review by regulatory agencies, EAP provided access to P alone or P plus a platinum (Cis or Cb) for 3311 MPM pts in 13 countries. Safety and efficacy data for chemonaïve pts receiving P+platinum are summarized in this abstract. Methods: Eligible pts had histologic or cytologic diagnosis of MPM not amenable to curative treatment with surgery. P 500 mg/m2 was given in combination with either Cis 75 mg/m2 or Cb AUC 5 once every 21 days with standard pre- medication consisting of vitamin B12, folic acid, and dexamethasone. Investigator-determined response (RR) and survival data (with censoring) were recorded at the end of study participation. Myelosuppression data were also collected. Results: 1,704 chemonaïve pts received =1 dose of P+Cis (843 pts) or P+Cb (861 pts) and were evaluable for safety. For the P+Cis group, the median age was 62 yrs (range, 24–78) and 85.3% of pts were male. For the P+Cb group, the median age was 66 yrs (range, 35–89) and 80.5% of pts were male. More than 90% of pts in both groups had performance status (PS) data; 86.8% of P+Cis pts and 85.8% of P+Cb pts had Karnofsky PS =80. Among the study participants, 745 P+Cis pts and 752 P+Cb pts were evaluated for efficacy. See the table for efficacy and safety data. Conclusions: This large study confirmed the activity of P+Cis and P+Cb, demonstrating clinically similar one-year survival for the treatment of chemonaive pts with MPM. No significant financial relationships to disclose. [Table: see text]
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Pless M, Stupp R, Kann R, Zouhair A, Mayer M, Thierstein S, Stahel R, Betticher D, Balmer Majno S, Ris HB. Preoperative chemoradiotherapy in non-small cell lung cancer (NSCLC) patients with operable stage IIIB disease. A phase II trial of the Swiss Group for Clinical Cancer Research (SAKK). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18021 Background and Methods: Outcome of patients (pts) with locally advanced NSCLC treated with radio- or chemoradiotherapy is poor. This two-stage phase II trial (planned sample size 46) aimed at evaluating feasibility and outcome of a tri-modality concept of neoadjuvant chemotherapy (CT), radiotherapy (RT) followed by definitive surgery in operable, stage IIIB NSCLC pts. Treatment consisted of 3 cycles of cisplatin (100 mg/m2) and docetaxel (85 mg/m2) followed by accelerated, concomitant boost RT (44 Gy/22 fx) and surgery. Primary endpoint is event-free survival at 1 year. Operable pts up to age 75 and a performance status of 0–1 with stage IIIB NSCLC (pleural effusion excluded) were eligible. Results: Forty-five eligible pts (46 accrued) with a median age was 60 years (range 28–70) were treated between September 2001 and May 2006. Tumor location was right-sided in 28 pts and left-sided in 17 pts. Histology was squamous cell 42%, large cell 11%, adeno-13% and undifferentiated carcinoma 33%. N3-disease was present in 29%, T4 stage in 78%. CT (45 pts) and RT (34 pts) were delivered as prescribed in >80% of cycles. The median time from enrollment to surgery was 3.7 months (2.8 - 5.2). The objective response rate after CT was 53% (95% c.i. 38–68%), after additional RT 67% (51–80%). Surgery (pneumonectomy in 17) was performed in 31 pts (69%), with an R0 resection in 24 pts. Median duration of hospitalization was 12 days (8–134). Two pts died in the perioperative phase due to ARDS and a cerebro-vascular event, respectively. Mature results of the primary endpoint and overall survival will be available at the ASCO meeting. Conclusions: Combined multimodality treatment strategy is feasible in a subgroup of patients, with acceptable toxicity. About two thirds of patients responded to the induction therapy, and were able to undergo subsequent surgery. No significant financial relationships to disclose.
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Opitz I, Sigrist B, Hillinger S, Lardinois D, Stahel R, Weder W, Hopkins-Donaldson S. Taurolidine and povidone-iodine induce different types of cell death in malignant pleural mesothelioma. Lung Cancer 2007; 56:327-36. [PMID: 17383050 DOI: 10.1016/j.lungcan.2007.01.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 11/08/2006] [Accepted: 01/24/2007] [Indexed: 10/23/2022]
Abstract
Taurolidine and povidone-iodine (PVP-I) are used in every day clinical practice, taurolidine as a broad spectrum antibiotic, and PVP-I as an antiseptic. The type of cell death induced in malignant pleural mesothelioma (MPM) cell lines by these agents was compared, and their ability to sensitize to chemotherapy assessed. Both taurolidine and PVP-I inhibited MPM cell growth after 7.5min incubation, but taurolidine was more effective at later time points and was more specific towards tumour cells than PVP-I. Taurolidine induced death by caspase-dependent and independent mechanisms, whereas in contrast, PVP-I induced a necrotic phenotype that was not caspase-dependent. Interestingly, both taurolidine and PVP-I induced the production of reactive oxygen intermediates and decreased mitochondrial membrane permeability, and cell death was inhibited by the oxygen scavenger N-acetyl cysteine. Taurolidine but not PVP-I treatment resulted in p53 activation in 2/3 MPM cell lines and a decrease in the protein levels of survivin, Bcl-2 and Mcl-1. Survivin also decreased in response to PVP-I whereas Bcl-xL remained unaffected by both treatments. Targeting of Bcl-xL with siRNA sensitized MPM cells to taurolidine and taurolidine treatment sensitized MPM cells to cisplatin-induced apoptosis. In conclusion, taurolidine and PVP-I are both cytotoxic to human MPM cells at early and late time points and induce reactive oxygen intermediate production. Taurolidine induces apoptosis and necrosis, activates p53 and sensitizes cells to cisplatin, whereas PVP-I inhibits cell growth via necrosis. Both agents are promising candidates for use in local treatment within multimodality concepts for MPM.
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Pavlidis N, Vermorken JB, Stahel R, Bernier J, Cervantes A, Audisio R, Pentheroudakis G, Costa A. Oncology for medical students: a European School of Oncology contribution to undergraduate cancer education. Cancer Treat Rev 2007; 33:419-26. [PMID: 17433552 DOI: 10.1016/j.ctrv.2007.02.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Accepted: 02/15/2007] [Indexed: 11/26/2022]
Abstract
Worldwide undergraduate cancer medicine is taught in a non-unanimous manner. There are frequent overlaps, omissions and discrepancies in the curricula of different medical schools concerning oncology teaching. Various attempts for possible changes and improvements have been made. Several extra-curriculum teaching programmes have been developed in academic European settings in collaboration with other scientific bodies. In this paper, we are analyzing the educational results from 115 medical students--mostly Europeans--who participated in three Oncology Summer Courses (2004, 2005, 2006) organized by European School of Oncology in collaboration with the University of Ioannina.
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Weiss GJ, Rosell R, Fossella F, Perry M, Stahel R, Barata F, Nguyen B, Paul S, McAndrews P, Hanna N, Kelly K, Bunn PA. The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer. Ann Oncol 2007; 18:453-60. [PMID: 17322539 DOI: 10.1093/annonc/mdl454] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Using data from a large phase III study of previously treated advanced non-small-cell lung cancer (NSCLC) that showed similar efficacy for pemetrexed and docetaxel, this retrospective analysis evaluates the impact of first-line chemotherapy on the outcome of second-line chemotherapy. PATIENTS AND METHODS In all, 571 patients with advanced NSCLC were randomly assigned to receive pemetrexed 500 mg/m(2) or docetaxel 75 mg/m(2) on day 1 of a 21-day cycle. Comparisons were made based on type of first-line therapy [gemcitabine + platinum (GP), taxane + platinum (TP), or other therapies (OT)], response to initial therapy, time since initial therapy, and clinical characteristics. The two second-line treatment groups were pooled for this analysis due to similar efficacy and were assumed to have no interaction with the first-line therapies. RESULTS Baseline characteristics were generally balanced. By multivariate analysis, gender, stage at diagnosis, performance status (PS), and best response to first-line therapy significantly influenced overall survival (OS). Additional factors by univariate analysis, histology, and time elapsed from first- to second-line therapy significantly influenced OS. CONCLUSIONS Future trials in the second-line setting should stratify patients by gender, stage at diagnosis, PS, and best response to first-line therapy.
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Junker K, Lindner M, Schütte W, Stahel R. Diagnostik und Therapie des Pleuramesothelioms*. Oncol Res Treat 2007. [DOI: 10.1159/000102867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Stahel R, Weder W. 173 Integrating chemotherapy into multi-modality treatment. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70249-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hopkins-Donaldson S, Marti T, Belyanskaya L, Simões-Wüst A, Sigrist B, Kurtz S, Zangemeister-Wittke U, Stahel R. 97 Cisplatin-induced apoptosis in malignant pleural mesothelioma cells involves p53 but not p14ARF. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70173-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Betticher DC, Hsu Schmitz SF, Tötsch M, Hansen E, Joss C, von Briel C, Schmid RA, Pless M, Habicht J, Roth AD, Spiliopoulos A, Stahel R, Weder W, Stupp R, Egli F, Furrer M, Honegger H, Wernli M, Cerny T, Ris HB. Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study. Br J Cancer 2006; 94:1099-106. [PMID: 16622435 PMCID: PMC2361244 DOI: 10.1038/sj.bjc.6603075] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim was to investigate the efficacy of neoadjuvant docetaxel-cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m-2 (day 1) plus cisplatin 40 or 50 mg m-2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel-cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.
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Lardinois D, Jung FJ, Opitz I, Rentsch K, Latkoczy C, Vuong V, Varga Z, Rousson V, Günther D, Bodis S, Stahel R, Weder W. Intrapleural topical application of cisplatin with the surgical carrier Vivostat increases the local drug concentration in an immune-competent rat model with malignant pleuromesothelioma. J Thorac Cardiovasc Surg 2006; 131:697-703. [PMID: 16515926 DOI: 10.1016/j.jtcvs.2005.08.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Revised: 08/05/2005] [Accepted: 08/17/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We sought to investigate whether intrapleural topical application of cisplatin with a surgical carrier has a prolonged local tissue level in comparison with cisplatin solution while reducing systemic toxicity. METHODS Forty immune-competent Fischer rats were inoculated with 10(6) mesothelioma cells. Ten days later, left pneumonectomy with tumor debulking was performed. Twenty animals underwent local application of cisplatin solution (100 mg/m2), whereas the same quantity of cisplatin was topically applied as a gel with the Vivostat (Vivolution) system in 20 other animals. In each group 5 subgroups of 4 animals were defined according to the harvesting time of blood and tissue samples (2, 4, 24, and 72 hours and 1 week) after local therapy. Platinum concentrations in serum and tissue and systemic toxicity were analyzed. RESULTS Platinum concentrations in tissue were significantly higher in the gel group (group 1) than in the solution group (group 2) at 1, 3, and 7 days after therapy (1510, 1224, and 1069 pg/mg for group 1 vs 598, 382, and 287 pg/mg for group 2; P = .007, P = .005, and P = .0002, respectively). Laboratory findings showed renal insufficiency in the animals of the solution group at 1 week, with values of 98 mmol/L versus 7.7 mmol/L for urea and 410 mumol/L versus 43 mumol/L for creatinine (P = .02 and P = .01, respectively), which was confirmed by means of pathologic analysis. CONCLUSIONS Intrapleural administration of cisplatin with the carrier Vivostat significantly provides sustained higher platinum concentrations up to 1 week in tissue in comparison with application of cisplatin solution without conferring systemic toxicity in this model.
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Ghielmini M, Rufibach K, Salles G, Leoncini-Franscini L, Léger-Falandry C, Cogliatti S, Fey M, Martinelli G, Stahel R, Lohri A, Ketterer N, Wernli M, Cerny T, Schmitz SFH. Single agent rituximab in patients with follicular or mantle cell lymphoma: clinical and biological factors that are predictive of response and event-free survival as well as the effect of rituximab on the immune system: a study of the Swiss Group for Clinical Cancer Research (SAKK). Ann Oncol 2005; 16:1675-82. [PMID: 16030029 DOI: 10.1093/annonc/mdi320] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Predictive factors of rituximab efficacy and its effect on the immune system are still not defined. PATIENTS AND METHODS Three hundred and six patients with follicular or mantle cell lymphoma received four weekly doses of rituximab (induction) and no further treatment (arm A) or four more doses at 2-month intervals (arm B). RESULTS Response rate to induction was 44%. Independent predictive factors for response were disease bulk <5 cm, follicular histology, normal hemoglobin and low lymphocyte count. Factors associated with event-free survival (EFS) were having responded to induction, having received not more than one line of therapy, Ann Arbor stage I-III, high lymphocyte count, disease bulk <5 cm, Fc-gamma receptor genotype VV and receiving prolonged treatment. B cells were suppressed by treatment but recovered after a median of 12 months in arm A and 18 months in arm B. The median IgM level after 1 year was normal in arm A but was decreased to 73% of baseline in arm B. We observed 24 serious adverse events, equally distributed between arms. Ten patients receiving induction only and six patients receiving prolonged treatment developed a second tumor. CONCLUSIONS We defined the characteristics predicting response and EFS to rituximab. Prolonged treatment results in longer EFS at the cost of a longer reduction in B cell and IgM levels, but without additional clinical toxicity.
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Bunn P, Rosell R, Fossella F, Perry M, Stahel R, Barata F, Nguyen B, Paul S, Hanna N. PD-068 An exploratory analysis of a phase III study in patients with advanced non-small cell lung cancer (NSCLC): The impact of first-line gemcitabine and platinum therapy on the outcome of second-line therapy with pemetrexed or docetaxel. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80401-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Steinert HC, Santos Dellea MM, Burger C, Stahel R. Therapy response evaluation in malignant pleural mesothelioma with integrated PET–CT imaging. Lung Cancer 2005; 49 Suppl 1:S33-5. [PMID: 15950798 DOI: 10.1016/j.lungcan.2005.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gautschi O, Huegli B, Ziegler A, Bigosch C, Ratschiller D, Bowers N, Stahel R, Heighway J, Betticher D. P-484 CCND1/Cyclin D1 A870G gene polymorphism is associated with non-small cell lung cancer (NSCLC) risk, and affects prognosis and response to chemotherapy. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80977-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Weder W, Stahel R, Vogt P, Bernhard J, Ris H, Stupp R, Schmid R, Betticher D, Ballabeni P, Bodis S. P-436 Neoadjuvant chemotherapy followed by pleuropneumonectomy and radiotherapy for pleural mesothelioma: A multicenter phase II trial of the SAKK. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80929-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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D’Addario G, Rauch D, Stupp R, Stahel R, Pless M, Mach N, Rufibach K, Petersen J, Betticher DC. Multicenter phase II trial of gefitinib first-line therapy followed by chemotherapy in advanced non-small cell lung cancer (NSCLC): Preliminary results. A study of the Swiss Group for Clinical Cancer Research (SAKK). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Le Chevalier T, Scagliotti G, Natale R, Danson S, Rosell R, Stahel R, Thomas P, Rudd RM, Vansteenkiste J, Thatcher N, Manegold C, Pujol JL, van Zandwijk N, Gridelli C, van Meerbeeck JP, Crino L, Brown A, Fitzgerald P, Aristides M, Schiller JH. Efficacy of gemcitabine plus platinum chemotherapy compared with other platinum containing regimens in advanced non-small-cell lung cancer: a meta-analysis of survival outcomes. Lung Cancer 2005; 47:69-80. [PMID: 15603856 DOI: 10.1016/j.lungcan.2004.10.014] [Citation(s) in RCA: 231] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2004] [Revised: 10/26/2004] [Accepted: 10/27/2004] [Indexed: 11/21/2022]
Abstract
PURPOSE Gemcitabine-platinum combination activity has been clearly established in a number of phase II studies. It has also been compared against other combinations in many phase III trials. It is generally believed that all such regimens have an equivalent impact on survival. This meta-analysis aims to quantify the treatment effect of gemcitabine plus a platinum agent in the treatment of advanced NSCLC and compare the combination to other regimens used globally. DESIGN Data from a total of 4556 patients from 13 randomized trials investigating gemcitabine in combination with a platinum agent versus any other platinum-containing regimen were included in a meta-analysis of time-to-event outcomes. RESULTS A significant reduction in overall mortality in favor of gemcitabine-platinum regimens was observed, hazard ratio (HR) 0.90 (95% CI: 0.84-0.96) with an absolute benefit at 1 year of 3.9%. Median survival was 9.0 months for the gemcitabine-platinum regimens and 8.2 months for the comparator regimens. Sub-group analysis of the first- and second-generation platinum-based comparator regimens also indicated a significant benefit for gemcitabine-platinum regimens, HR 0.84 (CI: 0.71-0.9985). Analysis of third-generation agent plus platinum regimens showed a non-significant trend favoring gemcitabine-platinum regimens, HR 0.93 (CI: 0.86-1.01). There was a significant decrease in the risk of disease progression in favor of gemcitabine-platinum regimens, HR 0.88 (CI: 0.82-0.93). An absolute benefit of 4.2% at 1 year was estimated. Median progression-free survival was 5.1 months for gemcitabine-platinum regimens compared with 4.4 months for the comparator regimens. Sub-group analysis indicated a statistically significant progression-free survival benefit for patients assigned to gemcitabine-platinum treatment compared to first- and second-generation platinum regimens, HR 0.85 (CI: 0.77-0.94), and third-generation agent plus platinum regimens, HR 0.89 (CI: 0.82-0.96).
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Hansen HH, Bajorin DF, Muss HB, Purkalne G, Schrijvers D, Stahel R. Recommendations for a Global Core Curriculum in Medical Oncology. Ann Oncol 2005; 15:1603-12. [PMID: 15520060 DOI: 10.1093/annonc/mdh447] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hansen H, Bajorin D, Muss H, Purkalne G, Schrijvers D, Stahel R. Recommendations for a Global Core Curriculum in Medical Oncology Ann Oncol 2004; 15: 1603–1612. Ann Oncol 2005. [DOI: 10.1093/annonc/mdi099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gridelli C, Manegold C, Mali P, Reck M, Portalone L, Castelnau O, Stahel R, Betticher D, Pless M, Pons JT, Aubert D, Burillon JP, Parlier Y, De Marinis F. Oral vinorelbine given as monotherapy to advanced, elderly NSCLC patients: a multicentre phase II trial. Eur J Cancer 2004; 40:2424-31. [PMID: 15519515 DOI: 10.1016/j.ejca.2004.07.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Accepted: 07/15/2004] [Indexed: 10/26/2022]
Abstract
Vinorelbine intravenously (i.v.) demonstrated its efficacy and tolerability in advanced non-small cell lung cancer (NSCLC) patients, including elderly subjects. Since vinorelbine is now available as an oral formulation this phase II open study was designed to evaluate its activity and tolerability in advanced, elderly NSCLC patients. A total of 56 chemonaive patients were recruited from April 2001 through to March 2002. The dosage schedule, already tested in younger NSCLC patients, was 60 mg/m(2)once a week for three weeks (first cycle), followed by 80 mg/m(2) once a week until disease progression or development of unacceptable toxicity. A limited sampling scheme was used for performing pharmacokinetic analysis on 52 of 56 patients enrolled in the study. Treatment was well tolerated with grade 3/4 neutropenia in 11/17 patients (20/30%) and febrile neutropenia in 1 (2%). Six partial responses (11%) and 25 stable disease responses were recorded, with a disease control rate of 55%. Median overall survival was 8.2 months (95% Confidence Interval (CI) [6.2-11.3]). The clinical benefit response rate was 31% on 32 evaluable patients. Pharmacokinetic profiles appeared quite similar to the historical profiles recorded following i.v. administration. Oral vinorelbine appears to be a reasonable alternative to i.v. vinorelbine, both in terms of activity and tolerability, in advanced, elderly NSCLC patients.
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Lardinois D, Steinert HC, Tutic M, Görres G, Stahel R, Weder W. Incidence of non-metastatic extrathoracic lesions detected by whole-body FDG PET-CT imaging in patients with non-small-cell lung cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Stahel R, Rossi A, Petruzelka L, Kosimidis P, de Braud F, Bernardo MM, Souquet PJ, Parra HS, Gridelli C. Lessons from the ("Iressa" Expanded Access Programme: gefitinib in special non-small-cell lung cancer patient populations. Br J Cancer 2004; 89 Suppl 2:S19-23. [PMID: 14661049 PMCID: PMC2750243 DOI: 10.1038/sj.bjc.6601479] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Some subgroups of patients with advanced/metastatic non-small-cell lung cancer (NSCLC) are frequently considered ineligible for the aggressive, platinum-based combination chemotherapy that is the recommended treatment. Elderly patients may have a poorer tolerance of chemotherapy due to impaired organ function and frequent comorbidities; patients with poor performance status (PS; ⩾2 due to NSCLC and/or coexisting illnesses) are often considered unfit for chemotherapy; other patients may be unable or unwilling to endure the toxicity or inconvenience of chemotherapy. These patient groups may benefit from novel, relatively nontoxic treatment modalities. Gefitinib (‘Iressa’, ZD1839) 250 mg day−1 is well tolerated and has proven antitumour and symptom improvement activity in patients with previously treated NSCLC. Phase II trials (IDEAL 1 and 2) of gefitinib in advanced/metastatic NSCLC included 70 out of 425 (16.5%) patients with PS ⩾2, and their response rate, clinical benefit rate and rates of adverse events were similar to those of the overall trial population. In addition, many patients with advanced/metastatic NSCLC with poor PS or advanced age have received gefitinib 250 mg day−1 in an Expanded Access Programme (EAP). Observations from the EAP support those of IDEAL 1 and 2, and indicate that gefitinib 250 mg day−1 warrants further investigation in these patient groups.
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Stahel R. 736 Molecular concepts. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90764-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Gatzemeier U, De Marinis F, Manegold C, Mali P, Portalone L, Castelnau O, Stahel R, Betticher D, Pons J, Gridelli C. 815 Elderly patients (pts) with unresectable localised or metastatic non-small-cell-lung-cancer (NSCLC): results of a phase II study with oral navelbineâ (nvb) given as a weekly monotherapy and first line treatment. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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