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Chiru ED, Grasic Kuhar C, Oseledchyk A, Schötzau A, Gonzalez MJ, Kurzeder C, Vetter M. Clinical application of the 21-gene oncotype recurrence score in an older cohort: A single center experience. Transl Oncol 2023; 36:101724. [PMID: 37480708 PMCID: PMC10375846 DOI: 10.1016/j.tranon.2023.101724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND In early luminal breast cancer, the Oncotype DX® Recurrence Score (RS) prognostic and predictive value with regards to chemotherapy (CHT) application benefit has been broadly validated. In older patients its value has not been deeply addressed. This study aimed to evaluate the benefits of RS testing and to look at differences in treatment allocation for these patients when compared with younger ones. METHODS We included data from consecutive patients with early luminal HER2-negative breast cancer, treated between 2010 and 2022 at the University Hospital Basel and Cantonal Hospital Baselland, Switzerland. The older cohort included 63 (19%) patients aged ≥70, and the younger cohort 263 (81%) patients aged <70. RESULTS Older breast cancer patients had more co-morbidities (N = 36, 57% vs. N = 92, 35%, p = 0.002) and a higher clinical risk status (N = 49, 78% vs. N = 155, 59%; p = 0.01) when compared to younger patients. Histopathologic characteristics were significantly different between the two cohorts. Although older patients had a higher clinical risk status (78% vs. 59%) (p = 0.01), most of them (74%) received no CHT. Specifically, adjuvant CHT was administered less frequently in older than in younger patients (13% vs. 22%; p = 0.01). Moreover, older patients were less likely to complete CHT (>4 cycles: 78% vs. 97%). CONCLUSION Breast cancer patients aged ≥70 have higher clinical risk status, more co-morbidities, higher clinical stage (driven by larger tumor size), and more often RS ≥26. However, they receive fewer adjuvant RT and CHT than those aged <70. RS maintains its independent prognostic value in older patients. However, assessing the predictive value of additional CHT benefit remains challenging due to significant differences in CHT administration. Although therapy decision-making in older patients with breast cancer still follows RS-based guidelines, clinical practice indicates an individualized treatment approach.
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Affiliation(s)
- E D Chiru
- Medical Oncology, Basel University Hospital, Basel, Switzerland; Center of Oncology and Hematology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - C Grasic Kuhar
- Medical Oncology Department, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Oseledchyk
- Medical Oncology, Basel University Hospital, Basel, Switzerland
| | - A Schötzau
- Department of Gynecologic Oncology, Basel University Hospital, Basel, Switzerland
| | - M J Gonzalez
- Adullam Hospital and care centers, Basel, Switzerland
| | - C Kurzeder
- Breast Center, Basel University Hospital, Basel, Switzerland; Department of Gynecologic Oncology, Basel University Hospital, Basel, Switzerland
| | - M Vetter
- Medical Oncology, Basel University Hospital, Basel, Switzerland; Center of Oncology and Hematology, Cantonal Hospital Baselland, Liestal, Switzerland; Breast Center, Basel University Hospital, Basel, Switzerland.
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Nussbaumer RL, Maggi N, Castrezana L, Zehnpfennig L, Schwab FD, Krol J, Oberhauser I, Weber WP, Kurzeder C, Haug MD, Kappos EA. The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery. Breast Cancer Res Treat 2023; 197:333-341. [PMID: 36403182 PMCID: PMC9823081 DOI: 10.1007/s10549-022-06811-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/09/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the study was to analyze the impact of neoadjuvant systemic treatment (NST) on postoperative complications and the beginning of adjuvant treatment. METHODS This study includes data from a prospectively maintained database including patients with breast cancer (BC) stage I-IV with or without NST undergoing breast cancer surgery between January 2010 and September 2021. RESULTS Out of 517 enrolled patients, 77 received NST, 440 had primary breast surgery. After NST patients underwent surgery after a meantime of 34 days (26.5-40 days). No statistical significance could be found comparing the complication grading according to the Clavien Dindo classification. The complications were most frequently rated as grade 3b. There were no complications with grade 4 or higher. When differentiating into short and long-term, the overall rate of short-term complications was 20.3% with no significant difference between the two groups (20.8% vs. 20.2%). Regarding long-term complications, there was more impairment of shoulder mobility (26.0% vs. 9.5%, p ≤ 0.001) and chronic pain (42.9% vs. 28.6%, p ≤ 0.016) for patients with NST. The beginning of the administration of the adjuvant treatment was comparable in both groups (46.3 days vs. 50.5 days). CONCLUSION In our cohort, complications between both groups were comparable according to Clavien Dindo. This study shows that NST has no negative impact on postoperative short-term complications and most importantly did not lead to a delay of the beginning of adjuvant treatment. Therefore, NST can be safely admitted, even when followed by extensive breast reconstruction surgery.
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Affiliation(s)
- R. L. Nussbaumer
- grid.410567.1Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland ,grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland
| | - N. Maggi
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland
| | - L. Castrezana
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland
| | - L. Zehnpfennig
- grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - F. D. Schwab
- grid.410567.1Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland ,grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - J. Krol
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland
| | - I. Oberhauser
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland
| | - W. P. Weber
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - C. Kurzeder
- grid.410567.1Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland ,grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - M. D. Haug
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland ,grid.410567.1Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
| | - Elisabeth A. Kappos
- grid.410567.1Breast Center, University Hospital of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland ,grid.410567.1Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
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Chiru E, Grasic Kuhar C, Oseledchyk A, Kurzeder C, Vetter M. 21-Gene Oncotype DX® Recurrence-Score benefits and application in elderly breast cancer patients. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00291-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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You B, Tod M, Leary A, Ray-Coquard I, Lortholary A, Hardy-Bessard A, Perren T, Cook A, Pfisterer J, Bois A, Kurzeder C, Burges A, Peron J, Freyer G, Colomban O. Preponderant impact of the chemosensitivity assessed by the modeled CA-125 kinetic parameter KELIM on the success of the first line treatment: Pooled analysis of AGO-OVAR 7, AGO-OVAR 9 and ICON7 trials--a GINECO-GINEGEPS study. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Geissler F, Vetter M, Schoetzau A, Montavon C, Kurzeder C, Heinzelmann V, Schwab FD. Review of treatment strategies for HER2 positive breast cancer and their implementation in a major Swiss hospital. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Affiliation(s)
- F Geissler
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
| | - M Vetter
- Gynecological Cancer Center, University Hospital Basel
- Breast Cancer Center, University Hospital Basel
- Department of Medical Oncology, University Hospital Basel
| | - A Schoetzau
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
| | - C Montavon
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Gynecological Cancer Center, University Hospital Basel
| | - C Kurzeder
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Gynecological Cancer Center, University Hospital Basel
- Breast cancer Center, University Hospital Basel
| | - V Heinzelmann
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Gynecological Cancer Center, University Hospital Basel
| | - FD Schwab
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Breast cancer Center, University Hospital Basel
- Gynaecological Cancer Center, University Hospital Basel
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Weber W, Henke G, Ribi K, Hayoz S, Seiler S, Maddox C, Ruhstaller T, Zwahlen D, Muenst S, Ackerknecht M, Fitzal F, Matrai Z, Újhelyi M, Kurzeder C, Lelièvre L, Tausch C, Heil J, Knauer M. 126TiP Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101 - TAXIS): A multicenter randomized phase III trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Colomban O, Tod M, Leary A, Ray-Coquard I, Lortholary A, Hardy-Bessard AC, Pfisterer J, Du Bois A, Kurzeder C, Burges A, Peron J, Freyer G, You B. Early prediction of the platinum-resistant relapse risk using the CA125 modeled kinetic parameter KELIM: A pooled analysis of AGO-OVAR 7 & 9; ICON 7 (AGO/GINECO/ MRC CTU/GCIG trials). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mijuskovic B, Tremp M, Heimer M, Boll D, Aschwanden M, Zeindler J, Kurzeder C, Schaefer D, Haug M, Kappos E. Color Doppler ultrasound and computed tomographic angiography for perforator mapping in DIEP flap breast reconstruction revisited: A cohort study. J Plast Reconstr Aesthet Surg 2019; 72:1632-1639. [DOI: 10.1016/j.bjps.2019.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/02/2019] [Accepted: 06/09/2019] [Indexed: 11/25/2022]
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Montagna G, Ritter M, Jasmin Z, Dellas S, B. sabine, Weber W, Kurzeder C. Radioactive seed localisation for non-palbable breast cancer: our experience. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kommoss S, Heitz F, Winterhoff B, Wang C, Canzler U, Aliferis C, Belau A, Wang J, Hanker L, Kommoss F, du Bois A, Ma S, Sehouli J, Kimmig R, Tourani R, Kurzeder C, Mahner S, Park-Simon TW, Dowdy SC, Pfisterer J. Significant overall survival improvement in proliferative subtype ovarian cancer patients receiving bevacizumab. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Kommoss
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - F Heitz
- Kliniken Essen-Mitte (KEM), Gynäkologie und Gynäkologische Onkologie, Essen, Deutschland
| | - B Winterhoff
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, Vereinigte Staaten von Amerika
| | - C Wang
- Mayo Clinic, Rochester, Vereinigte Staaten von Amerika
| | - U Canzler
- Uni.-Klinikum Carl Gustav Carus, Dresden, Deutschland
| | - C Aliferis
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - A Belau
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Greifswald, Deutschland
| | - J Wang
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - L Hanker
- Universitätsklinikum Schleswig-Holstein Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Deutschland
| | - F Kommoss
- Institut für Pathologie im Medizin Campus Bodensee Friedrichshafen, Friedrichshafen, Deutschland
| | - A du Bois
- Kliniken Essen-Mitte (KEM), Gynäkologie und Gynäkologische Onkologie, Essen, Deutschland
| | - S Ma
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - J Sehouli
- Universitätsmedizin Berlin Charité, Campus Virchow Klinikum, Klinik für Frauenheilkunde, Berlin, Deutschland
| | - R Kimmig
- Universitätsklinikum Essen, Frauenklinik, Essen, Deutschland
| | - R Tourani
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - C Kurzeder
- Universitätsspital Basel, Frauenklinik, Basel, Schweiz
| | - S Mahner
- Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, München, Deutschland
| | - TW Park-Simon
- Medizinische Hochschule Hannover, Gynäkologische Onkologie, Hannover, Deutschland
| | - SC Dowdy
- Mayo Clinic, Rochester, Vereinigte Staaten von Amerika
| | - J Pfisterer
- Zentrum für Gynäkologische Onkologie Kiel, Kiel, Deutschland
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Dröge LA, Eckes L, Osman S, Pasternak J, Jordan J, Harter P, Mustea A, Muallem MZ, Wimberger P, Mahner S, Kurzeder C, Hasenburg A, Chekerov R, Denschlag D, Sehouli J. Management von Patientinnen mit gynäkologischem Sarkom – Eine Umfrage zur Behandlungspraxis der betreuenden GynäkologInnen im Rahmen der REGSA-Studie (Deutsches gynäkoonkologisches Sarkomregister) – MONITOR IX. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- LA Dröge
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - L Eckes
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - S Osman
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - J Pasternak
- Universitätsklinik Tübingen, Gynäkologie, Tübingen, Deutschland
| | - J Jordan
- NOGGO e.V., Gynäkologische Onkologie, Berlin, Deutschland
| | - P Harter
- Kliniken Essen Mitte, Gynäkologie und Gynäkoonkologie, Essen, Deutschland
| | - A Mustea
- Universitätsmedizin Greifswald, Gynäkologie, Greifswald, Deutschland
| | - MZ Muallem
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - P Wimberger
- Uni.-Klinikum Carl Gustav Carus, Gynäkologie und Onkologie, Dresden, Deutschland
| | - S Mahner
- Universität München, Gynäkologie und Geburtshilfe, München, Deutschland
| | - C Kurzeder
- Universitätsspital Basel, Gynäkologie, Basel, Schweiz
| | - A Hasenburg
- Universität Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - R Chekerov
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - D Denschlag
- Hochtaunus-Kliniken, Gynäkologie und Geburtshilfe, Bad Homburg, Deutschland
| | - J Sehouli
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
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Sehouli J, Chekerov R, Reinthaller A, Richter R, Gonzalez-Martin A, Harter P, Woopen H, Petru E, Hanker L, Keil E, Wimberger P, Klare P, Kurzeder C, Hilpert F, Belau A, Zeimet A, Bover-Barcelo I, Canzler U, Mahner S, Meier W. Topotecan plus carboplatin versus standard therapy with paclitaxel plus carboplatin (PC) or gemcitabine plus carboplatin (GC) or pegylated liposomal doxorubicin plus carboplatin (PLDC): a randomized phase III trial of the NOGGO-AGO-Study Group-AGO Austria and GEICO-ENGOT-GCIG intergroup study (HECTOR). Ann Oncol 2016; 27:2236-2241. [DOI: 10.1093/annonc/mdw418] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/20/2016] [Accepted: 08/23/2016] [Indexed: 11/13/2022] Open
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Kahl A, Ataseven B, Harter P, Heitz FH, Kurzeder C, Schneider S, Prader S, Traut A, du Bois A. Die prognostische Wertigkeit altersadjustierten Charlson Komorbiditätsindex bei Frauen mit primärem epithelialem Ovarialkarzinom auf die peri-/postoperative Morbidität und Mortalität. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ataseven B, Kahl A, Harter P, Heitz F, Kurzeder C, Schneider S, Prader S, Traut A, du Bois A. Der prognostische Stellenwert des altersadjustierten Charlson Komorbiditätsindex auf das Gesamtüberleben bei 1038 Frauen mit primärem epithelialem Ovarialkarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ataseven B, Harter P, Heitz F, Heikaus S, Grimm C, Traut A, Kurzeder C, Prader S, du Bois A. The revised 2014 FIGO staging system for epithelial ovarian cancer: is a subclassification of FIGO stage IV justified? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ataseven B, du Bois A, Harter P, Prader S, Grimm C, Kurzeder C, Schneider S, Heikaus S, Traut A, Heitz F. Impact of abdominal wall metastases on prognosis in FIGO IV epithelial ovarian cancer. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kurzeder C, Harter P, Prader S, Heitz F, Ataseven B, Schneider S, Traut A, du Bois A. Roboterassistierte radikale Hysterektomie nach neoadjuvanter Chemotherapie bei lokal fortgeschrittenem Zervixkarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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You B, Colomban O, Tod M, Ray-Coquard I, Lortholary A, Hardy-Bessard A, Du Bois A, Huober J, Meier W, Kurzeder C, Pfisterer J. The predictive value of the CA-125 modeled kinetic parameter KELIM is validated in 3 independent datasets (AGO-OVAR 7 & 9; ICON 7 AGO/GINECO/GCIG trials). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cecere S, Arenare L, Signoriello S, Bologna A, Vergote I, Kurzeder C, Scambia G, Lorusso D, Murgia V, Lombardi D, Sacco C, Breda E, Pisano C, Salutari V, Raspagliesi F, Bryce J, Daniele G, Piccirillo M, Gallo C, Perrone F, Pignata S. Quality of life (QOL) analysis of the MITO8 phase 3 trial, a collaboration of MITO, Mango, AGO Study Group, BGOG, ENGOT, and GCIG. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw338.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, Marth C, Nout R, Querleu D, Mirza MR, Sessa C, Altundag O, Amant F, van Leeuwenhoek A, Banerjee S, Bosse T, Casado A, de Agustín L, Cibula D, Colombo N, Creutzberg C, del Campo JM, Emons G, Goffin F, González-Martín A, Greggi S, Haie-Meder C, Katsaros D, Kesic V, Kurzeder C, Lax S, Lécuru F, Ledermann J, Levy T, Lorusso D, Mäenpää J, Marth C, Matias-Guiu X, Morice P, Nijman H, Nout R, Powell M, Querleu D, Mirza M, Reed N, Rodolakis A, Salvesen H, Sehouli J, Sessa C, Taylor A, Westermann A, Zeimet A. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2015; 27:16-41. [PMID: 26634381 DOI: 10.1093/annonc/mdv484] [Citation(s) in RCA: 685] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/05/2015] [Indexed: 12/27/2022] Open
Abstract
The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.
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Affiliation(s)
- N Colombo
- Division of Medical Gynecologic Oncology, European Institute of Oncology and University of Milan-Bicocca, Milan, Italy
| | - C Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - F Amant
- Department of Gynecological Oncology, University Hospital Leuven, Leuven, Belgium Center for Gynecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek, Amsterdam
| | - T Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - A González-Martín
- Department of Medical Oncology, GEICO Cancer Center, Madrid Department of Medical Oncology, MD Anderson Cancer Center, Madrid, Spain
| | - J Ledermann
- Department of Oncology and Cancer Trials, UCL Cancer Institute, London, UK
| | - C Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - R Nout
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - D Querleu
- Department of Surgery, Institut Bergonié, Bordeaux, France Department of Gynecology and Obstetrics, McGill University Health Centre, Montreal, Canada
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Sessa
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
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Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P, Hauptmann S, Sehouli J. Statement by the Kommission Ovar of the AGO: The New FIGO and WHO Classifications of Ovarian, Fallopian Tube and Primary Peritoneal Cancer. Geburtshilfe Frauenheilkd 2015; 75:1021-1027. [PMID: 26556905 DOI: 10.1055/s-0035-1558079] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
More than 25 years after the last revision, in 2012 the FIGO Oncology Committee began revising the FIGO classification for staging ovarian, Fallopian tube and primary peritoneal cancers. The new classification has become effective with its publication at the beginning of 2014. Following recent findings on the pathogenesis of ovarian, Fallopian tube and primary peritoneal cancer and reflecting standard clinical practice, the three entities have now been classified uniformly. The histological subtype is included (high-grade serous - HGSC; low-grade serous - LGSC; mucinous - MC; clear cell - CCC; endometrioid - EC). Stages III and IV have been fundamentally changed: stage IIIA now refers to a localized tumor limited to the pelvis with (only) retroperitoneal lymph node metastasis (formerly classified as IIIC). Stage IV has been divided into IVA and IVB, with IVA defined as malignant pleural effusion and IVB as parenchymatous or extra-abdominal metastasis including inguinal and mediastinal lymph node metastasis as well as umbilical metastasis. A new WHO classification was published almost concurrently. The classification of serous tumors addresses the issue of the tubal carcinogenesis of serous ovarian cancer, even if no tubal precursor lesions are found for up to 30 % of serous high-grade cancers. The number of subgroups was reduced and subgroups now include only high-grade serous, low-grade serous, mucinous, seromucinous, endometrioid, clear cell and Brenner tumors. The category "transitional cell carcinomas" has been dropped and the classification "seromucinous tumors" has been newly added. More attention has been focused on the role of borderline tumors as a stage in the progression from benign to invasive lesions.
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Affiliation(s)
| | - C Fotopoulou
- Gynäkologie, Universitätsmedizin Charité, Berlin
| | - P Harter
- Gynäkologie und Gyn. Onkologie, Kliniken Essen-Mitte, Essen
| | - C Kurzeder
- Gynäkologie und Gyn. Onkologie, Kliniken Essen-Mitte, Essen
| | - A Mustea
- Gynäkologie und Geburtshilfe, Universitätsmedizin Greifswald, Greifswald
| | - P Wimberger
- Gynäkologie und Geburtshilfe, Technische Universität Dresden, Dresden
| | - S Hauptmann
- MVZ für Gynäkologie, Zytologie und Histologie Homburg (Saar), Homburg
| | - J Sehouli
- Gynäkologie, Universitätsmedizin Charité, Berlin
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Schwameis R, Grimm C, Stefanidou N, Heitz F, Polterauer S, Kurzeder C, Harter P, Reinthaller A, Kölbl H, du Bois A. Neoadjuvante Chemotherapie mit Carboplatin/Paclitaxel versus Paclitaxel/Ifosfamid/Cisplatin in der Therapie des Zervixkarzinoms (FIGO 1b2 – 2b) – retrospektive multizentrische Analyse. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1548622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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23
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Kurzeder C, Schmalfeldt B, Grischke EM, Rau J, Meier W, Lück HJ, Hasenburg A, Belau A, Mahner S, Marmé F, Hilpert F, Gropp-Meier M, Zorr A, Vergote I, Hils R, Canzler U, Rein D, de Gregorio N, Jackisch C, Gerber B, du Bois A. Die AGO-OVAR 2.20/PENELOPE Studie – Therapie des platinresistenten Ovarialkarzinoms mit Pertuzumab (P) und Chemotherapie (CT) nach Biomarker-unterstützter Präselektion von Patienten. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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24
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El-Khalfaoui K, Heitz F, Cesur Ö, Kurzeder C, Harter P, du Bois A. Differenziert die neue FIGO-Klassifikation für das Ovarialkarzinom besser die unterschiedlichen Prognosegruppen? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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25
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Kurzeder C, Persson J, du Bois A, Kannisto P, Bossmar T, Borgfeldt C, Heitz F, El Khalfaoui K, Traut A, Harter P. Robot assisted gynaecologic procedures in morbidly obese patients. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hilpert F, Kurzeder C, Schmalfeldt B, Neuser P, de Gregorio N, Pfisterer J, Park-Simon TW, Mahner S, Schröder W, Lück HJ, Heubner M, Hanker L, Thiel F, Emons G. Temsirolimus in women with platinum-resistant ovarian cancer or advanced/recurrent endometrial cancer: a multicenter phase II trial of the AGO Study Group (AGO-GYN 8). Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Grimm C, Stefanidou N, Heitz F, Schwameis R, Polterauer S, Kurzeder C, Harter P, Reinthaller A, Kölbl H, du Bois A. Neoadjuvante Chemotherapie mit Carboplatin/Paclitaxel versus Paclitaxel/Ifosfamid/Cisplatin in der Therapie des Zervixkarzinoms (FIGO 1b2-2b) – retrospektive multizentrische Analyse. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Heitz F, du Bois A, Harter P, Kurzeder C, Lubbe D, Vergote I, Plante M, Pfisterer J. 606 Impact of Beta-blocker Medication in Patients with Platinum Sensitive Recurrent Ovarian Cancer – a Combined Analysis of 2 Prospective Multicenter Trials by the AGO Study Group, NCIC-CTG and EORTC-CTG. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72403-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kurzeder C, Scholl S, Kamal M, Banu E, Kenter G, Mustea A, Ngo C, Popovic M. 575 RAIDs: Rational Molecular Assessments and Innovative Drug Selection, an EU Funded Project. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lee CK, Simes RJ, Brown C, Gebski V, Pfisterer J, Swart AM, Berton-Rigaud D, Plante M, Skeie-Jensen T, Vergote I, Schauer C, Pisano C, Parma G, Baumann K, Ledermann JA, Pujade-Lauraine E, Bentley J, Kristensen G, Belau A, Nankivell M, Canzler U, Lord SJ, Kurzeder C, Friedlander M. A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer. Ann Oncol 2012; 24:937-43. [PMID: 23104722 DOI: 10.1093/annonc/mds538] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with platinum-sensitive recurrent ovarian cancer have variable prognosis and survival. We extend previous work on prediction of progression-free survival by developing a nomogram to predict overall survival (OS) in these patients treated with platinum-based chemotherapy. PATIENTS AND METHODS The nomogram was developed using data from the CAELYX in Platinum-Sensitive Ovarian Patients (CALYPSO) trial. Multivariate proportional hazards models were generated based on pre-treatment characteristics to develop a nomogram that classifies patient prognosis based on OS outcome. We also developed two simpler models with fewer variables and conducted model validations in independent datasets from AGO-OVAR Study 2.5 and ICON 4. We compare the performance of the nomogram with the simpler models by examining the differences in the C-statistics and net reclassification index (NRI). RESULTS The nomogram included six significant predictors: interval from last platinum chemotherapy, performance status, size of the largest tumour, CA-125, haemoglobin and the number of organ sites of metastasis (C-statistic 0.67; 95% confidence interval 0.65-0.69). Among the CALPYSO patients, the median OS for good, intermediate and poor prognosis groups was 56.2, 31.0 and 20.8 months, respectively. When CA-125 was not included in the model, the C-statistics were 0.65 (CALYPSO) and 0.64 (AGO-OVAR 2.5). A simpler model (interval from last platinum chemotherapy, performance status and CA-125) produced a significant decrease of the C-statistic (0.63) and NRI (26.4%, P < 0.0001). CONCLUSIONS This nomogram with six pre-treatment characteristics improves OS prediction in patients with platinum-sensitive ovarian cancer and is superior to models with fewer prognostic factors or platinum chemotherapy free interval alone. With independent validation, this nomogram could potentially be useful for improved stratification of patients in clinical trials and also for counselling patients.
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Affiliation(s)
- C K Lee
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
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Schwentner L, Van Ewijk R, Kurzeder C, Hoffmann I, König J, Kreienberg R, Blettner M, Wöckel A. Participation in adjuvant clinical breast cancer trials: does study participation improve survival compared to guideline adherent adjuvant treatment? A retrospective multi-centre cohort study of 9,433 patients. Eur J Cancer 2012; 49:553-63. [PMID: 22959469 DOI: 10.1016/j.ejca.2012.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 08/11/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Adjuvant clinical trials (CTs) usually compare a standard treatment regime versus an innovative new substance or regimen. Participation in CT however, is available for only few patients and exclusion criteria are usually very strict. Therefore we used an unselected patient cohort to investigate the following questions: MATERIAL AND METHODS This German retrospective multi-centre cohort study included 9433 patients with primary breast cancer recruited from 1992 to 2008. RESULTS One thousand two hundred and fifty-five (13.3%) patients participated in adjuvant clinical trials (PA) and 8178 (86.7%) did not (NPA). RFS was higher among participants (PA) than among non-participants (NPA) [p=0.006], but differences in overall survival (OAS) were not significant [p=0.15]. When stratified for guideline adherence, the outcome was not different for guideline conform NPA [RFS: p=0.88] [OAS: p=0.37] compared to PA. Survival parameters however, were significantly poorer in non-guideline conform PA [RFS: p<0.001] [OAS: p<0.001] and non-guideline conform NPA [RFS: p<0.001] [OAS: p<0.001] as compared to guideline adherent PA. DISCUSSION There is a strong association between guideline adherence in adjuvant treatment in BC and survival. PA in clinical trials tended to higher survival rates, but only if guideline-adherent treatment was applied. Patients who do not have access to clinical trials may profit substantially from guideline-adherent adjuvant treatment.
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Affiliation(s)
- L Schwentner
- Department of Gynaecology and Obstetrics, University Ulm, Prittwitzstraße 43, 89075 Ulm, Germany.
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Baumann KH, du Bois A, Meier W, Rau J, Wimberger P, Sehouli J, Kurzeder C, Hilpert F, Hasenburg A, Canzler U, Hanker LC, Hillemanns P, Richter B, Wollschlaeger K, Dewitz T, Bauerschlag D, Wagner U. A phase II trial (AGO 2.11) in platinum-resistant ovarian cancer: a randomized multicenter trial with sunitinib (SU11248) to evaluate dosage, schedule, tolerability, toxicity and effectiveness of a multitargeted receptor tyrosine kinase inhibitor monotherapy. Ann Oncol 2012; 23:2265-2271. [PMID: 22377563 DOI: 10.1093/annonc/mds003] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Recurrent platinum-resistant ovarian cancer usually has a poor outcome with conventional chemotherapeutic therapy and new treatment modalities are warranted. This phase II study was conducted to evaluate sunitinib, an oral antiangiogenic multitargeted tyrosin kinase inhibitor, in this setting. MATERIAL AND METHODS The primary end point of this randomized phase II trial was the objective response rate according to RECIST criteria and/or Gynecologic Cancer InterGroup CA125 response criteria to sunitinib in patients with recurrent platinum-resistant ovarian cancer who were pretreated with up to three chemotherapies. A selection design was employed to compare two schedules of sunitinib (arm 1: 50 mg sunitinib daily orally for 28 days followed by 14 days off drug; and arm 2: 37.5 mg sunitinib administered daily continuously). RESULTS Of 73 patients enrolled, 36 patients were randomly allocated to the noncontinuous treatment arm (arm 1) and 37 patients were randomly allocated to the continuous treatment arm (arm 2). The mean age was 58.8 and 58.5 years, respectively. We observed six responders (complete response + partial response) in arm 1 (16.7%) and 2 responders in arm 2 (5.4%). The median progression-free survival (arm 1: 4.8 [2.9-8.1] months; arm 2: 2.9 [2.9-5.1] months) and the median overall survival (arm 1: 13.6 [7.0-23.2] months; arm 2: 13.7 [8.4-25.6] months) revealed no significant difference. Adverse events included fatigue as well as cardiovascular, gastrointestinal and abdominal symptoms, hematologic and hepatic laboratory abnormalities. Pattern and frequency of adverse events revealed no substantial differences between both treatment groups. CONCLUSIONS Sunitinib treatment is feasible and moderately active in relapsed platinum-resistant ovarian cancer. The noncontinuous treatment schedule should be chosen for further studies in ovarian cancer.
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MESH Headings
- Angiogenesis Inhibitors/administration & dosage
- Angiogenesis Inhibitors/adverse effects
- Disease-Free Survival
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Drug Resistance, Neoplasm
- Female
- Humans
- Indoles/administration & dosage
- Indoles/adverse effects
- Kaplan-Meier Estimate
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasms, Cystic, Mucinous, and Serous/drug therapy
- Neoplasms, Cystic, Mucinous, and Serous/mortality
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/mortality
- Platinum Compounds/pharmacology
- Proportional Hazards Models
- Pyrroles/administration & dosage
- Pyrroles/adverse effects
- Receptor Protein-Tyrosine Kinases/antagonists & inhibitors
- Sunitinib
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Affiliation(s)
- K H Baumann
- Department of Gynaecology, University of Marburg, Marburg.
| | - A du Bois
- Department of Gynaecology and Gynaecological Oncology, HSK Wiesbaden and Kliniken Essen Mitte, Essen
| | - W Meier
- Department of Gynaecology and Obstetrics, Evangelic Hospital, Duesseldorf
| | - J Rau
- Coordinating Centre for Clinical Trials, University of Marburg, Marburg
| | - P Wimberger
- Department of Gynaecology and Obstetrics, University of Duisburg-Essen, Essen
| | - J Sehouli
- Department of Gynaecology, Charité, Berlin
| | - C Kurzeder
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm
| | - F Hilpert
- Department of Gynaecology and Obstetrics, University of Kiel, Kiel
| | - A Hasenburg
- Department of Gynaecology and Obstetrics, University of Freiburg, Freiburg
| | - U Canzler
- Department of Gynaecology and Obstetrics, University of Dresden, Dresden
| | - L C Hanker
- Department of Gynaecology and Obstetrics, University of Frankfurt am Main, Frankfurt am Main
| | - P Hillemanns
- Department of Gynaecology and Obstetrics, Medical School Hannover, Hannover
| | - B Richter
- Department of Gynaecology and Obstetrics, Elbland Hospital, Radebeul
| | - K Wollschlaeger
- Department of Gynaecology and Obstetrics, University of Magdeburg, Magdeburg
| | - T Dewitz
- Department of Gynaecology and Obstetrics, Hospital of Gifhorn, Gifhorn
| | - D Bauerschlag
- Department of Gynaecology and Obstetrics, University Medical Center Aachen RWTH, Aachen, Germany
| | - U Wagner
- Department of Gynaecology, University of Marburg, Marburg
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Schwentner L, Van Ewijk R, Kurzeder C, Hoffmann I, König J, Kreienberg R, Blettner M, Wöckel A. Verbessert die Teilnahme in adiuvanten Studien das Überleben im Vergleich zur leitliniengerechten Behandlung beim Mammakarzinom? Eine retrospektive multizentrische Kohortenstudie mit 9452 Patientinnen. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1318590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Untch M, von Minckwitz G, Konecny G, Conrad U, Fett W, Kurzeder C, Lück HJ, Stickeler E, Urbaczyk H, Liedtke B, Beckmann M, Salat C, Harbeck N, Müller V, Schmidt M, Hasmüller S, Lenhard M, Nekljudova V, Lebeau A, Loibl S, Fasching P. PREPARE trial: a randomized phase III trial comparing preoperative, dose-dense, dose-intensified chemotherapy with epirubicin, paclitaxel, and CMF versus a standard-dosed epirubicin–cyclophosphamide followed by paclitaxel with or without darbepoetin alfa in primary breast cancer—outcome on prognosis. Ann Oncol 2011; 22:1999-2006. [DOI: 10.1093/annonc/mdq713] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Untch M, Fasching P, Konecny G, von Koch F, Conrad U, Fett W, Kurzeder C, Lück HJ, Stickeler E, Urbaczyk H, Liedtke B, Salat C, Harbeck N, Müller V, Schmidt M, Hasmüller S, Lenhard M, Schuster T, Nekljudova V, Lebeau A, Loibl S, von Minckwitz G. PREPARE trial: a randomized phase III trial comparing preoperative, dose-dense, dose-intensified chemotherapy with epirubicin, paclitaxel and CMF versus a standard-dosed epirubicin/cyclophosphamide followed by paclitaxel ± darbepoetin alfa in primary breast cancer—results at the time of surgery. Ann Oncol 2011; 22:1988-1998. [DOI: 10.1093/annonc/mdq709] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wöckel A, Wolters R, Schwentner L, Kurzeder C, Wischnewsky M, Kreienberg R. Leitlinienkonformität bei der Therapie des primären Mammakarzinoms – Relevanter Nutzen für die Patientin? Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1286435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Baumann K, Pfisterer J, Wimberger P, Burchardi N, Kurzeder C, du Bois A, Loibl S, Sehouli J, Huober J, Schmalfeldt B, Vergote I, Lück HJ, Wagner U. Intraperitoneal treatment with the trifunctional bispecific antibody Catumaxomab in patients with platinum-resistant epithelial ovarian cancer: a phase IIa study of the AGO Study Group. Gynecol Oncol 2011; 123:27-32. [PMID: 21733566 DOI: 10.1016/j.ygyno.2011.06.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 06/06/2011] [Accepted: 06/07/2011] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to select the best catumaxomab regimen for further investigation in ovarian cancer based on confirmed tumour response. METHODS Randomised open-label phase IIa study in women with platinum-resistant or -refractory epithelial ovarian cancer. Catumaxomab (6-hour intraperitoneal infusion on days 0, 3, 7 and 10) was administered at a low (10, 10, 10 and 10 μg) or high dose (10, 20, 50 and 100 μg). Responders were patients with either a complete (CR) or partial (PR) response. RESULTS Forty-five patients were randomised to receive either low dose (23) or high dose (22). There were no responders in the low-dose versus one patient (5%) in the high-dose group with a PR. In the low-dose group, two patients (9%) had stable disease compared with five patients (23%) in the high-dose group. Catumaxomab was well tolerated and there was no difference between the dose groups in the incidence of treatment-induced adverse events, the most common of which were gastrointestinal and injection-site reactions. CONCLUSION Catumaxomab had modest activity in platinum-resistant ovarian cancer. The high-dose regimen was associated with a slightly better therapeutic index than the low dose regimen.
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Affiliation(s)
- K Baumann
- University of Marburg, Department of Gynaecology, Marburg, Germany.
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Kurzeder C, Zhao L, Eisenhauer EA, Vergote IB, Du Bois A, Tai D, Wang Y, Gill JF, Hirte HW, Richter B, Hanker LC, Bentley J, Wagner UAG, Plante M, Kimmig R, Pfisterer J. The impact of dose intensity on the efficacy of gemcitabine plus carboplatin (GC) therapy for recurrent platinum-sensitive ovarian cancer (PSOC): A retrospective analysis of AGO-OVAR 2.5. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Harter P, Canzler U, Lueck H, Reuss A, Meier W, Fehm TN, Staehle A, Burges A, Kurzeder C, Sehouli J, Baumann KH, Hanker LC, Wimberger P, Schroeder W, Gropp M, Mahner S, Du Bois A. Pegylated liposomal doxorubicin and carboplatin in malignant mixed epithelial mesenchymal and mesenchymal gynecologic tumors: A phase II trial of the AGO study group. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wöckel A, Kurzeder C, Kreienberg R. Onkologie. BRENDA („Quality of breast cancer care under evidence based guidelines“) - Ein Studiennetzwerk der Versorgungsforschung. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1250083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Kurzeder C, Woeckel A, Kuehn T, Schlicht E, Blettner M, Felberbaum RE, Wischnewsky M, Kreienberg R. Evaluation of hormone receptor and benefit from adjuvant chemotherapy in breast cancer patients with intermediate- and high-risk disease. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Meier W, Lichtenegger W, Marth C, Gonzalez-Martin AJ, Harter P, Tome O, Wimberger P, Kurzeder C, Oskay-Özcelik G, Sehouli J. Topotecan plus carboplatin versus standard therapy with paclitaxel plus carboplatin (PC) or gemcitabin plus carboplatin (GC) or carboplatin plus pegylated doxorubicin (PLDC): A planed 200-pt interim safety analysis of the NOGGO-AGO-Germany-AGO Austria and GEICO-GCIG Intergroup Study (HECTOR). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hancke K, Denkinger MD, König J, Kurzeder C, Wöckel A, Herr D, Blettner M, Kreienberg R. Standard treatment of female patients with breast cancer decreases substantially for women aged 70 years and older: a German clinical cohort study. Ann Oncol 2010; 21:748-753. [PMID: 19825884 DOI: 10.1093/annonc/mdp364] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Hancke
- Department of Obstetrics and Gynecology, University of Ulm Medical School, Ulm.
| | - M D Denkinger
- Geriatric Department, Bethesda Geriatric Clinic, University of Ulm, Ulm
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany
| | - C Kurzeder
- Department of Obstetrics and Gynecology, University of Ulm Medical School, Ulm
| | - A Wöckel
- Department of Obstetrics and Gynecology, University of Ulm Medical School, Ulm
| | - D Herr
- Department of Obstetrics and Gynecology, University of Ulm Medical School, Ulm
| | - M Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany
| | - R Kreienberg
- Department of Obstetrics and Gynecology, University of Ulm Medical School, Ulm
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Blumstein C, Schmuecking M, Gebhard S, Perner S, Kurzeder C, Reske S, Aebersold D, Blumstein N. 67 poster: 18F-FDG PET/CT as a Selection Tool for Image Guided Radiotherapy (IGRT) in Patients with Recurrent or Residual Ovarian Cancer. Radiother Oncol 2010. [DOI: 10.1016/s0167-8140(15)34486-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kurzeder C, Wolters R, Wischnewsky M, Woeckel A, Atassi Z, Wiegel T, Kreienberg R. Guideline Compliant Irradiation Following Breast Conserving Surgery or Mastectomy Improves Recurrence Free Survival. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-4106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Two pivotal studies by Veronesi and Fisher have established the concept of breast conserving surgery for small breast cancers stage T1 or with size less than 4 cm respectively. The aim of this retrospective study was to validate the current practice of BCS in an unselected cohort of patients within the network of 16 regional breast cancer centres in germany and to quantify the detrimental effect of guideline non-compliant locoregional therapy on recurrence free survival.Methods: 4507 patients who received primary therapy between 1992 and 2005 were recorded. Data on surgery, axillary dissection and postoperative irradiation were used to categorize patients according to adherence to guidelines. The effect of guideline compliant locoregional therapy on recurrence free survival was calculated.Results: Out of 3579 patients (79.4%) who were treated by BCS 3036 (84.8%) received postoperative irradiation as mandated by the guideline. A total of 928 (20.6%) patients underwent mastectomy, out of these a fraction of 344 patients received postoperative irradiation as required by the guideline. No significant difference in recurrence free survival was found between patients who underwent BCS plus postoperative irradiation and those patients who underwent mastectomy (T1: HR=1.08 (95%-CI: 0.70-1.67), p=0.281; T2: HR=1.21 (95%-CI: 0.61 - 2.39), p=0.577). Guideline compliant locoregional therapy resulted in a significant improvement in RFS as shown for patients receiving guideline compliant BCS plus irradiation or guideline compliant mastectomy without irradiation versus patients with any type of non-compliant locoregional therapy (HR=3.53, 95%-CI: 2.97-4.18, p<0.001).Conclusion: Our findings support current clinical practice of BCS in small tumors as initially indicated and also in tumors of stage T2. Violations of guidelines for locoregional therapy were clearly associated with a poorer prognosis.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4106.
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Affiliation(s)
| | | | | | - A. Woeckel
- 1 University of Ulm Medical School, Germany
| | - Z. Atassi
- 1 University of Ulm Medical School, Germany
| | - T. Wiegel
- 3 University of Ulm Medical School, Germany
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Atassi Z, Wischnewsky M, Wöckel A, Kurzeder C, Wolters R, Novopashenny I, Kreienberg R. Influence of Treatment Conforming to Guidelines on Recurrence Free Survival (RFS) and Overall Survival (OS) in Triple Negative Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-2101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: The triple negative(TN) breast cancer subtype (ER neg, PR neg, HER 2 neg) represents about 10 to 15% 0f all breast cancer types. It characterizes an aggressive phenotype with significantly worsened RFS, OS as well as specific clinical and pathological properties. The aim of this study was: 1.To assess the efficacy of guideline conforming conventional chemotherapy, local recurrence rate, distant recurrence rate, as well as overall survival. 2.To ask for subgroups that show the greatest benefit from conventional chemotherapy and 3. to ask for impact of guidelines violation on RFS and OA.Patients and methods: 3658 breast cancer Patients that were first diagnosed between the years 2000 and 2005 were analyzed in a multicentric retrospective study. A total of 371 (10,1%) were triple negative. Results: Median age was 62 years(26-101) TN: 60years.(28-97). 13,8% of all included patients are triple negative. 90,3% of all TN patients are at intermediate/high risk according to Nottingham risk classification. 76,5 have G3 tumors. The 5 year DFS is 74,8% (95%CI 68,8% - 80,8%) and for none TN 86,5%(95%CI 84,6% - 88,4%) (logrankp<0,0001). The 5 year OS is 75,8%(95%CI:69,9%- 81,8%) and for none TN 86%(95%CI:84,1%-87,9%). (logrank p < 0,0001). The essential parameters for RFS and OS were guidelines conforming surgery and radiation therapy, when chemotherapy conforming to guidelines was provided. The 5 year RFS for TN patients undergoing a 100% guideline according adjuvant therapy is 86.1%(95%CI:78.9%-93.4%), with 1-2 violations 76.0% (95%CI:69.0%-83.1%) and with ≥3 violations 50.6%(95%CI:20.1%-81.1%) (logrank p<0.0001). In total a 66,8% of all TN patients were not treated according to guidelines (ranking of violations: Chemotherapy, radiation therapy, surgery). 18% had 2 or more violations. Summary: The Results show a significant improvement of outcomes in TN breast cancer patients when treatment is conducted in accordance to guidelines. There are subgroups of TN breast cancer patients that profit from therapy according to guidelines. The leading guideline violation was noted for radiation therapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2101.
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Sehouli J, Oskay-Özcelik G, Stengel D, Harter P, Kurzeder C, Belau A, Markmann S, Lorenz R, Mueller L, Lichtenegger W. 8002 What is the best schedule of Topotecan? – weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer – a randomized, multicenter trial of the North-Eastern German Society of Gynaecological Oncology (TOWER). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71524-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Wöckel A, Wolters R, Novasphenny I, Varga D, Atassi Z, Kurzeder C, Wischnewsky M, Kreienberg R. Vorteile einer leitlinienkonformen Therapie beim Mammakarzinom. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1239042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kurzeder C, König J, Wöckel A, Atassi Z, Wischnewski M, Blettner M, Kreienberg R. Kann eine Studienteilnahme das Überleben von Brustkrebspatienten verbessern? Ergebnisse der multizentrischen BRENDA Studie zur Versorgungsqualität in Deutschland. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1238982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Herrstedt J, Huober J, Priou F, Müller H, Baekelandt M, Kurzeder C, Pfisterer J, Stähle A, Ray-Coquard I, du Bois A. A randomized, phase III study (AGO-OVAR-9, GINECO-TCG, NSGO-OC-0102): Gemcitabine-paclitaxel-carboplatin (TCG) versus paclitaxel-carboplatin (TC) as first-line treatment of ovarian cancer (OC): Survival of FIGO stage I-IIA patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.18_suppl.lba5510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA5510 Background: One option to increase the efficacy of TC in pts with first diagnosis of ovarian cancer is to add a not cross-resistant drug. Methods: We conducted a randomized, prospective, stratified, phase III study comparing therapy with TC to TC plus gemcitabine. From 7/02 to 4/04, pts with a histological verified first diagnosis of epithelial OC, FIGO IC-IV were randomized to either TC (paclitaxel [T] 175 mg/m2 3h iv d1 + carboplatin [C] AUC 5 iv d1) or TCG (TC + gemcitabine [G] 800 mg/m2 iv d1+8) for at least 6 cycles every 21 days starting within 6 weeks post-operatively. The randomization was balanced within three strata: 1) FIGO I-IIA, 2) FIGO IIB-IIIC with residual tumor ≤ 10mm, 3) FIGO IIB-IIIC with residual tumor > 10 mm or FIGO IV. Primary endpoint is overall survival. Results: We enrolled 1,742 pts and administered 5,268 cycles TC and 5,129 cycles TCG. All baseline characteristics of the patients in both arms were well balanced. Most pts received 6+ cycles (87.2% TC, 86.2% TCG). Previous interim analyses has shown that TCG was tolerable but induced more hematological toxicity and final analysis has shown that addition of gemcitabine did not improve overall survival in patients with FIGO stage IIB-IV disease. Approximately 11% of the patients (n = 175) had FIGO stage I-IIA disease (stratum I). Most patients received 6+ cycles (93.3% TC, 86.9% TCG). With a median follow-up of 53.8 (range 0 –75) months, and using the log rank test and Cox regression analysis, no relevant differences in progression free survival (first quartile about 57 months and median ≥ 75 months in both groups, HR = 0.90 [95% CI: 0.47–1.72], p = 0.7500) and a negative trend in overall survival (first quartile ≥ 75 months in both groups, HR = 2.19 [95% CI: 0.75–6.41], p = 0.1419) were seen. Conclusions: Addition of G to TC did not improve efficacy in patients with stage I-IIA ovarian cancer. This was also the case for stratum II-III patients (previously reported). The addition of G to TC in patients with first diagnosis of ovarian cancer cannot be recommended. [Table: see text]
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Affiliation(s)
- J. Herrstedt
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - J. Huober
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - F. Priou
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - H. Müller
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - M. Baekelandt
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - C. Kurzeder
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - J. Pfisterer
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - A. Stähle
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - I. Ray-Coquard
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
| | - A. du Bois
- Odense University Hospital, Odense, Denmark; University of Tuebingen, Tuebingen, Germany; Centre Hospitalier, La Roche sur Yon, France; Philipps University, Marburg, Germany; The Norwegian Radium Hospital, Oslo, Norway; University Hospital Ulm, Ulm, Germany; Ubbo-Emmius-Klinik gGmbH, Aurich, Germany; St. Vincentius-Krankenhäuser, Karlsruhe, Germany; Centre Léon Bérard, Lyon, France; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden, Germany
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