1
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Cope S, Keeping ST, Goldgrub R, Ayers D, Jansen JP, Penrod JR, Korytowsky B, Juarez-Garcia A, Yuan Y. Indirect comparison of nivolumab ± ipilimumab (CheckMate 032) versus other treatments for recurrent small-cell lung cancer. J Comp Eff Res 2019; 8:733-751. [PMID: 31237143 DOI: 10.2217/cer-2018-0130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Aim: To estimate the comparative efficacy of nivolumab ± ipilimumab versus alternative treatments for small-cell lung cancer after at least one prior line of chemotherapy. Materials & m ethods: A systematic literature review identified six randomized controlled trials (RCTs) that could be connected in a network. The Kaplan-Meier survival curves from these RCTs were synthesized using network meta-analysis models. Aggregate-level matching was used to connect CheckMate 032 to the RCTs. Results: CheckMate 032 was connected to the network by Amrubicin Clinical Trial-1. Nivolumab ± ipilimumab had a more durable tumor response and more favorable long-term survival versus topotecan via intravenous and versus amrubicin. Conclusion: Compared with chemotherapies for recurrent small-cell lung cancer, nivolumab ± ipilimumab improves response duration, which may translate to long-term survival benefits.
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Affiliation(s)
- Shannon Cope
- Precision Xtract, Vancouver, BC, V6H 3Y4, Canada
| | | | | | - Dieter Ayers
- Precision Xtract, Vancouver, BC, V6H 3Y4, Canada
| | | | - John R Penrod
- Bristol-Myers Squibb, Princeton Pike, Lawrence Township, NJ 08648, USA
| | - Beata Korytowsky
- Bristol-Myers Squibb, Princeton Pike, Lawrence Township, NJ 08648, USA
| | | | - Yong Yuan
- Bristol-Myers Squibb, Princeton Pike, Lawrence Township, NJ 08648, USA
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2
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López-González A, Diz P, Gutierrez L, Almagro E, García Palomo A, Provencio M. The role of anthracyclines in small cell lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2014; 1:5. [PMID: 25332950 DOI: 10.3978/j.issn.2305-5839.2013.01.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/22/2013] [Indexed: 11/14/2022]
Abstract
Small cell lung cancer (SCLC) represents the 15% of the totally of lung cancer. The percentage of cases in women is arising due to the differences in smoking patterns; it occurs almost exclusively in smokers and appears to be most common in heavy smokers. The stage of disease at presentation is the most important prognostic factor in patients with SCLC; for patients with extended stage disease, the median survival is around 10 months, and the five-year survival rate is 1 to 2 percent. The standard regimen for patients with extensive disease is cisplatin based chemotherapy. Second line chemotherapy is generally less effective than the initial treatment but it can provide significant palliation for many patients. We make a review here of the different options of second line chemotherapy and the role of anthracyclines in it.
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Affiliation(s)
- Ana López-González
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Pilar Diz
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Lourdes Gutierrez
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Elena Almagro
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Andrés García Palomo
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Mariano Provencio
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
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3
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Surcel CI, van Oort IM, Sooriakumaran P, Briganti A, De Visschere PJL, Fütterer JJ, Ghadjar P, Isbarn H, Ost P, van den Bergh RCN, Yossepowitch O, Giannarini G, Ploussard G. Prognostic effect of neuroendocrine differentiation in prostate cancer: A critical review. Urol Oncol 2014; 33:265.e1-7. [PMID: 25238700 DOI: 10.1016/j.urolonc.2014.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/13/2014] [Accepted: 08/13/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND The multiple pathways that are involved in neuroendocrine differentiation (NED) in prostate cancer (PCa) are poorly elucidated. Evidence suggests that several environmental triggers induce NED leading to the adaptation of PCa to its close environment to maintain cell proliferation. Nevertheless, there is conflicting evidence regarding the prognostic role of NED in PCa. METHODS In this review, we aimed to summarize all available data about NED and to assess the prognostic role of NED in disease progression and therapy resistance, and its role in routine clinical practice. This review was based on articles found through a PubMed literature search between 1993 and 2013. The study outcome measure was the effect of NED on oncologic outcomes at each PCa stage. RESULTS In total, 59 articles reporting on the effect of NED on oncologic outcomes have been selected. In clinical practice, immunostaining for NED markers could have interesting predictive value for assessing the oncologic outcomes in patients receiving androgen-deprivation therapy. Thus, patients with high NED burden may be candidates for more aggressive treatment strategies targeting NED pathways. Conversely, strong evidence is lacking concerning its potential independent prognostic value in hormone-naïve PCa. CONCLUSIONS Current published data are not sufficient to recommend the use of NE markers in routine practice, particularly at early PCa stage.
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Affiliation(s)
- Cristian I Surcel
- Centre of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Inge M van Oort
- Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Prasanna Sooriakumaran
- Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Alberto Briganti
- Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Jurgen J Fütterer
- Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Hendrik Isbarn
- Department of Urology, Regio Clinic Wedel, Wedel, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Piet Ost
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium
| | | | - Ofer Yossepowitch
- Department of Urology, Rabin Medical Center-Beilinson, Petach-Tikva, Israel; Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - Gianluca Giannarini
- Department of Experimental and Clinical Medical Sciences, Urology Unit, University of Udine, Udine, Italy
| | - Guillaume Ploussard
- Department of Urology, CHU Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris 7 Diderot, Paris, France.
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4
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Jett JR, Schild SE, Kesler KA, Kalemkerian GP. Treatment of small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e400S-e419S. [PMID: 23649448 DOI: 10.1378/chest.12-2363] [Citation(s) in RCA: 224] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Small cell lung cancer (SCLC) is a lethal disease for which there have been only small advances in diagnosis and treatment in the past decade. Our goal was to revise the evidence-based guidelines on staging and best available treatment options. METHODS A comprehensive literature search covering 2004 to 2011 was conducted in MEDLINE, Embase, and five Cochrane databases using SCLC terms. This was cross-checked with the authors' own literature searches and knowledge of the literature. Results were limited to research in humans and articles written in English. RESULTS The staging classification should include both the old Veterans Administration staging classification of limited stage (LS) and extensive stage (ES), as well as the new seventh edition American Joint Committee on Cancer/International Union Against Cancer staging by TNM. The use of PET scanning is likely to improve the accuracy of staging. Surgery is indicated for carefully selected stage I SCLC. LS disease should be treated with concurrent chemoradiotherapy in patients with good performance status. Thoracic radiotherapy should be administered early in the course of treatment, preferably beginning with cycle 1 or 2 of chemotherapy. Chemotherapy should consist of four cycles of a platinum agent and etoposide. ES disease should be treated primarily with chemotherapy consisting of a platinum agent plus etoposide or irinotecan. Prophylactic cranial irradiation prolongs survival in those individuals with both LS and ES disease who achieve a complete or partial response to initial therapy. To date, no molecularly targeted therapy agent has demonstrated proven efficacy against SCLC. CONCLUSION Evidence-based guidelines are provided for the staging and treatment of SCLC. LS-SCLC is treated with curative intent with 20% to 25% 5-year survival. ES-SCLC is initially responsive to standard treatment, but almost always relapses, with virtually no patients surviving for 5 years. Targeted therapies have no proven efficacy against SCLC.
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Affiliation(s)
- James R Jett
- Division of Oncology, National Jewish Health, Denver, CO.
| | - Steven E Schild
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ
| | - Kenneth A Kesler
- Division of Thoracic Surgery, Indiana University, Indianapolis, IN
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5
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Califano R, Abidin AZ, Peck R, Faivre-Finn C, Lorigan P. Management of small cell lung cancer: recent developments for optimal care. Drugs 2012; 72:471-90. [PMID: 22356287 DOI: 10.2165/11597640-000000000-00000] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Small cell lung cancer (SCLC) represents approximately 13% of all lung cancer diagnoses and the incidence has reduced over the last 20 years. Treatment of SCLC remains challenging because of its rapid growth, early dissemination and development of drug resistance during the course of the disease. Chemotherapy remains the cornerstone of treatment for limited (LD) and extensive disease (ED), with concurrent chemotherapy and radical thoracic radiotherapy representing the best treatment option for fit patients with LD. Platinum-based chemotherapy is the treatment of choice in fit patients with good organ function, and the radiosensitizing effect of cisplatin is critically important for concurrent chemoradiotherapy in LD. Anthracycline-containing regimens represent a viable alternative for patients where platinum-based chemotherapy is contraindicated. Patients who relapse or progress after first-line chemotherapy have a very poor prognosis. Second-line therapy may produce a modest clinical benefit. Maintenance chemotherapy has not been shown to convincingly improve outcomes for SCLC. A number of targeted agents have been investigated in LD and ED, mostly in unselected populations, with disappointing results. Prophylactic cranial irradiation has been shown to reduce the incidence of brain metastases and prolong survival for both LD and ED without negative impact on quality of life (QOL) and cognitive function. Ongoing trials will shed some light on the impact of thoracic radiotherapy on QOL, symptom control and survival in ED SCLC patients who benefitted from first-line chemotherapy.
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Affiliation(s)
- Raffaele Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
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6
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Owonikoko TK, Behera M, Chen Z, Bhimani C, Curran WJ, Khuri FR, Ramalingam SS. A systematic analysis of efficacy of second-line chemotherapy in sensitive and refractory small-cell lung cancer. J Thorac Oncol 2012; 7:866-72. [PMID: 22722788 PMCID: PMC3381878 DOI: 10.1097/jto.0b013e31824c7f4b] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Small-cell lung cancer (SCLC) patients unresponsive or relapsing within 90 days after frontline chemotherapy have poor prognosis and are treated with regimens different from the first-line regimen. Potential differences in the efficacy of second-line therapy for refractory and sensitive SCLC have not been well studied. METHODS Studies that enrolled sensitive and refractory (relapse < 90 days or > 90 days) SCLC patients for second-line therapy were identified using electronic databases (MEDLINE, EMBASE, and Cochrane library), and meeting abstracts databases. A systematic analysis was conducted using Comprehensive Meta Analysis (version 2.2.048) software to calculate the odds ratio of response and 95% confidence interval. Median overall survival time for sensitive and resistant SCLC patients was compared by two-sided Student's t test. We tested for significant heterogeneity by Cochran's chi-square test and I-square index. RESULTS Twenty-one studies published between 1984 and 2011 were eligible for this analysis with a total of 1692 patients enrolled; 912 with sensitive and 780 with refractory SCLC. The overall response rate was 17.9% with a higher response rate of 27.7% (range, 0%-77%) for sensitive SCLC versus 14.8% (range, 0%-70%) for refractory patients; p=0.0001. Pooled overall odds ratio of response was 2.235 (95% confidence interval: 1.518-3.291; p=0.001) favoring patients with sensitive disease. Median overall survival time was 6.7 months with a weighted survival of 7.7 and 5.4 months for sensitive and refractory SCLC, respectively (p = 0.0035). CONCLUSIONS Refractory SCLC patients derive modest clinical benefit from second-line chemotherapy. However, response and survival outcomes are superior with chemosensitive disease.
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Affiliation(s)
- Taofeek K Owonikoko
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA.
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7
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Outcomes of small-cell lung cancer patients treated with second-line chemotherapy: A multi-institutional retrospective analysis. Lung Cancer 2011; 72:378-83. [DOI: 10.1016/j.lungcan.2010.09.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 09/09/2010] [Accepted: 09/14/2010] [Indexed: 11/20/2022]
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8
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Loriot Y, Massard C, Gross-Goupil M, Di Palma M, Escudier B, Bossi A, Fizazi K. Combining carboplatin and etoposide in docetaxel-pretreated patients with castration-resistant prostate cancer: a prospective study evaluating also neuroendocrine features. Ann Oncol 2009; 20:703-8. [DOI: 10.1093/annonc/mdn694] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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9
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Samson DJ, Seidenfeld J, Simon GR, Turrisi AT, Bonnell C, Ziegler KM, Aronson N. Evidence for management of small cell lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132:314S-323S. [PMID: 17873177 DOI: 10.1378/chest.07-1384] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
PURPOSES This systematic review addressed the following key questions on managing small cell lung cancer (SCLC): the sequence, timing, and dosing characteristics of primary thoracic radiotherapy (TRTx) for limited-stage disease; primary TRTx for extensive-stage disease; effect of prophylactic cranial irradiation (PCI); positron emission tomography (PET) for staging; treatment of mixed histology tumors; surgery; and second-line and subsequent-line treatment for relapsed/progressive disease. METHODS The review methods were defined prospectively in a written protocol. We primarily sought randomized controlled trials that compared the interventions of interest. RESULTS Robust evidence was lacking for all questions except PCI, for which a patient-level metaanalysis showed that PCI improves survival of SCLC patients who achieved complete response after primary therapy from 15.3 to 20.7% (p = 0.01). The case for concurrent over sequential radiation delivery rests largely on a single multicenter trial. Support for early concurrent therapy comes from one multicenter trial, but two other multicenter trials found no advantage. Metaanalysis did not find significant reductions in 2-year and 3-year mortality rates for early TRTx. Favorable results from a single-center trial on TRTx for extensive stage disease need replication in a multicenter setting. Relevant comparative studies were nonexistent for management of mixed histology disease and surgery for early limited SCLC. PET may be more sensitive in detecting extracranial disease than conventional staging modalities, but studies were of poor quality. CONCLUSIONS PCI improves survival among those with a complete remission to primary therapy. A research agenda is needed to optimize the effectiveness of TRTx and its components.
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Affiliation(s)
- David J Samson
- Technology Evaluation Center, Blue Cross Blue Shield Association, 1310 G St, NW, Washington, DC 20005, USA.
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10
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Cheng S, Evans WK, Stys-Norman D, Shepherd FA. Chemotherapy for Relapsed Small Cell Lung Cancer: A Systematic Review and Practice Guideline. J Thorac Oncol 2007; 2:348-54. [PMID: 17409809 DOI: 10.1097/01.jto.0000263720.15062.51] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE This clinical practice guideline, based on a systematic review, evaluates chemotherapy options for patients with relapsed small cell lung cancer (SCLC). METHODS Relevant randomized trials and meta-analyses were identified through a systematic search of the literature. External feedback was obtained from practitioners in Ontario, and the guideline was approved by the provincial lung cancer disease site group. RESULTS Six randomized trials met the eligibility criteria and were included for review. One randomized phase III trial of oral topotecan versus no treatment in patients receiving best supportive care found topotecan to have a significant benefit in terms of 6-month survival and quality of life. A randomized phase III trial compared outcomes of carboplatin in patients receiving a combination of etoposide and cisplatin (EP) and found no significant improvement associated with carboplatin, although it was associated with significantly higher grade 3/4 thrombocytopenia. Two randomized trials directly compared chemotherapy regimens (intravenous [i.v.] topotecan versus cyclophosphamide, doxorubicin, and vincristine (CAV); and bis-chloro-ethylnitrosourea, thiotepa, vincristine, and cyclophosphamide (BTOC) versus EP), but these trials found no significant differences in terms of disease response or survival. I.v. topotecan was associated with significantly higher toxicities (grade 4 thrombocytopenia and grade 3/4 anemia) and greater improvement in patient-reported symptoms compared with CAV. Two randomized trials of topotecan-treated patients comparing route of administration (i.v. versus oral) found no significant differences in terms of disease response, survival, or quality of life, although oral administration was associated with increased grade 3 or 4 diarrhea in both trials. CONCLUSION Evidence on the clinical benefit of second-line therapy in SCLC is limited. Topotecan is the most studied agent in this population; it has a response and survival benefit in comparison with placebo, but it also has greater toxicity in comparison with CAV. To date, significant differences in terms of response and survival are not evident in studied chemotherapy options.
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Affiliation(s)
- Susanna Cheng
- Toronto-Sunnybrook Regional Cancer Centre, Toronto, Canada.
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11
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Abstract
Lung cancer was relatively uncommon at the turn of the 20th century, and has increased in prevalence at alarming rates, particularly because of the augmented trend in smoking, so that it is now the most common cause of cancer death in the world. As almost a quarter of these cancers are of small cell in origin, it seems only appropriate that small cell lung cancer receives ample attention, rather than seemingly to have been overlooked over the last 10-15 years. Despite its generally late presentation and high risk of dissemination, it is exceptionally sensitive to chemo-radiotherapy. This review looks at the diverse options of treatment that have been used over the last few years and tries to highlight the best available. As more than 50% of patients diagnosed with lung cancer are over 70 years of age and various studies have shown that older people respond just as well as their younger counterparts, with similar results in response rates, toxicity and outcomes, it is imperative that the older generation are not disregarded in terms of age being a contraindication to therapy.
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Affiliation(s)
- Samantha Cooper
- Department of Thoracic Medicine, University College Hospital, London, UK
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12
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Eselgrim M, Grunert H, Kühne T, Zoubek A, Kevric M, Bürger H, Jürgens H, Mayer-Steinacker R, Gosheger G, Bielack SS. Dose intensity of chemotherapy for osteosarcoma and outcome in the Cooperative Osteosarcoma Study Group (COSS) trials. Pediatr Blood Cancer 2006; 47:42-50. [PMID: 16206218 DOI: 10.1002/pbc.20608] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The prognostic relevance of dose intensity in the treatment of osteosarcoma is still under discussion. The aim of this study was to investigate whether higher dose intensities of chemotherapy correlated with better outcomes. PROCEDURE This study contains 917 consecutive Cooperative Osteosarcoma Study Group (COSS) patients <40 years with primary, high-grade central, nonmetastatic osteosarcoma of the extremities, who were in complete remission at least until day 200 after the start of chemotherapy. All COSS-protocols were based on a uniform treatment concept of aggressive polychemotherapy and definitive surgery. Chemotherapy dose intensity in the first 200 days of treatment (DI200) and possible correlations to overall and event-free survival were investigated. The study focused on methotrexate, doxorubicin, cisplatin, and ifosfamide, which are considered to be the most active drugs against osteosarcoma. Multivariate analyses including well-known prognostic factors were added to complete this investigation. RESULTS Until day 200, patients received 80.7 +/- 26.1 g/m2 methotrexate (MTX); 242 +/- 69 mg/m2 doxorubicin (DOX); 324 +/- 133 mg/m2 cisplatin (DDP); and 13.9 +/- 9.8 g/m2 ifosfamide (IFO) (mean +/- SD). Median follow-up from day 200 was 6.6 (0.02-22.1) years. There was no correlation between a higher DI200 of any one drug and better outcomes in uni- or multi-variate analyses. Total treatment intensity did not show such correlations either. CONCLUSIONS In an overall setting of intensive multidrug treatment of osteosarcoma, we could not prove that higher dose intensities correlate with better outcomes.
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Affiliation(s)
- Merle Eselgrim
- Universitätskinderklinikum Münster, Klinik und Poliklinik für Kinder- und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Münster, Germany
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Griesinger F, Overbeck T, Niederle N. Zweitlinientherapie des kleinzelligen Lungenkarzinoms (SCLC). ONKOLOGE 2005. [DOI: 10.1007/s00761-005-0886-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Davies AM, Evans WK, Mackay JA, Shepherd FA. Treatment of recurrent small cell lung cancer. Hematol Oncol Clin North Am 2004; 18:387-416. [PMID: 15094178 DOI: 10.1016/j.hoc.2003.12.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Angela M Davies
- University of California at Davis Cancer Center, 4501 X Street, Suite 3016, Sacramento, CA 95817, USA
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15
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Abstract
Extensive-stage small-cell lung cancer (ES-SCLC) continues to be a difficult management issue. While response rates to therapy are relatively high, durable responses are rare, and long-term survival rates are dismal. Although many attempts have been made to develop new therapies, cisplatin-based combination chemotherapy remains the mainstay in the management of these patients. In this review we highlight recent developments in the treatment and management of this malignancy, and discuss future prospects in treatment.
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Affiliation(s)
- Alexander Spira
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, 21231-1000, USA.
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