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Quek RHH, Farid M, Wang E, Asavamongkolkul A, Leung A, Prayogo N, Punyaratabandhu T, Yeoh EM, Shantakumar S, Manson S, Ngan RK. Epidemiology, treatment (tx) patterns and outcomes in Asian soft tissue sarcoma (STS) patients: Results from the Soft Tissue Sarcoma in the Asia Pacific Region (STAR) study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Mohamad Farid
- National Cancer Centre, Division of Medical Oncology, Singapore, Singapore
| | - Edward Wang
- University of the Philippines, Philippine General Hospital, Department of Orthopaedics, Manila, Philippines
| | - Apichat Asavamongkolkul
- Faculty of Medicine, Siriraj Hospital, Mahidol University, Department of Orthopaedic Surgery, Bangkok, Thailand
| | - Alex Leung
- Queen Elizabeth Hospital, Department of Clinical Oncology, Hong Kong, Hong Kong
| | | | | | | | | | | | - Roger K.C. Ngan
- Queen Elizabeth Hospital, Department of Clinical Oncology, Hong Kong, Hong Kong
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Yap YS, Cornelio GH, Devi BCR, Khorprasert C, Kim SB, Kim TY, Lee SC, Park YH, Sohn JH, Sutandyo N, Wong DWY, Kobayashi M, Landis SH, Yeoh EM, Moon H, Ro J. Brain metastases in Asian HER2-positive breast cancer patients: anti-HER2 treatments and their impact on survival. Br J Cancer 2012; 107:1075-82. [PMID: 22918394 PMCID: PMC3461152 DOI: 10.1038/bjc.2012.346] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 07/10/2012] [Accepted: 07/13/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In Asia, large-scale studies on anti-HER2 treatment in HER2-positive breast cancer patients with brain metastases are limited. We studied the treatment patterns of these patients in Asia to evaluate the impact of anti-HER2 treatment on the time to occurrence of brain metastases (TTBM) and survival after brain metastasis (BM). METHODS A retrospective study of HER2-positive breast cancer patients diagnosed with BM between January 2006 and December 2008 in six Asian countries was conducted. Demographics, tumour characteristics, treatment details, and events dates were collected from medical records. RESULTS Data from 280 patients were analysed. Before BM, 63% received anti-HER2 treatment. These patients had significantly longer TTBM than those without anti-HER2 treatment (median 33 vs 19 months; P<0.002). After BM, 93% received radiotherapy, 57% received chemotherapy, and 41% received anti-HER2 treatment (trastuzumab and/or lapatinib). Use of both anti-HER2 agents, primarily sequentially, after BM demonstrated the longest survival after BM and was associated with a significant survival benefit over no anti-HER2 treatment (median 26 vs 6 months; hazard ratio 0.37; 95% CI 0.19-0.72). CONCLUSION Anti-HER2 treatment before BM was associated with longer TTBM. Anti-HER2 treatment after BM was associated with a survival benefit, especially when both trastuzumab and lapatinib were utilised.
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Affiliation(s)
- Y S Yap
- Department of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore
| | - G H Cornelio
- Saint Peregrine Oncology Unit, San Juan de Dios Hospital, 2772 Roxas Boulevard, Pasay City 1300, Philippines
| | - B C R Devi
- Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Kuching 93586, Malaysia
| | - C Khorprasert
- Division of Radiation Oncology, Faculty of Medicine, Chulalongkorn University, Rama 4 Road, Bangkok 10330, Thailand
| | - S B Kim
- Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea
| | - T Y Kim
- Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea
| | - S C Lee
- Department of Haematology-Oncology, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore
| | - Y H Park
- Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea
| | - J H Sohn
- Severance Hospital, Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - N Sutandyo
- Dharmais Hospital National Cancer Center, Jl. Let. Jend. S. Parman Kav. 84-86, Slipi, Jakarta Barat 11420, Indonesia
| | - D W Y Wong
- Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - M Kobayashi
- GlaxoSmithKline, 5 Moore Drive 17.2136K.2A, Research Triangle Park, NC 27709, USA
| | - S H Landis
- European Medical Affairs, GlaxoSmithKline, 1-3 Iron Bridge Road, Uxbridge, Middlesex UB11 1BT, UK
| | - E M Yeoh
- Oncology R&D, GlaxoSmithKline Pte Ltd, 150 Beach Road, Gateway West, Singapore 189720, Singapore
| | - H Moon
- GlaxoSmithKline (China) R&D Co. Ltd, 917 Halei Road, Zhangjiang Hi-Tech Park, Pudong, Shanghai 201203, China
| | - J Ro
- National Cancer Center, 111 Jeongbalsanro, Ilsan-gu, Goyang-si, Gyeonggi-do 410-769, Korea
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Yeo W, Chen PJ, Furuse J, Han KH, Hsu C, Lim HY, Moon H, Qin S, Yeoh EM, Ye SL. Eastern Asian expert panel opinion: designing clinical trials of molecular targeted therapy for hepatocellular carcinoma. BMC Cancer 2010; 10:620. [PMID: 21062497 PMCID: PMC2989333 DOI: 10.1186/1471-2407-10-620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 11/10/2010] [Indexed: 12/17/2022] Open
Abstract
The largest burden of hepatocellular carcinoma (HCC) lies in Asia, secondary to hepatitis B virus (HBV) infection. Improved survival with sorafenib has fostered new research but many challenges remain in designing clinical trials. The disease, its management, and populations affected by it are heterogeneous worldwide and within Asia. An expert conference of Eastern Asian oncologists and hepatologists was convened to foster consensus in clinical trial design. The panel identified key areas that need to be addressed to facilitate clinical trials in Asia. Stratification by viral etiology is desirable within Asia and by region in global trials. Antiviral therapy should also be considered as a stratification factor and incorporated into HCC management in trials. The panel agreed that histological diagnosis is not required for trial entry and that Barcelona-Clinic Liver Cancer (BCLC) staging is acceptable for trials as long as portal hypertension can be better defined with standardized methodology. Consensus in treatment must be sought to allow multi-national trials and it must be recognized that first-line sorafenib is not largely feasible in Asia. Finally, Asian nations must be urged to participate in clinical trials, many of which are ongoing, to advance new treatment options in this challenging disease.
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Affiliation(s)
- Winnie Yeo
- Prince of Wales Hospital, Shatin, Hong Kong.
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Chen PJ, Furuse J, Han KH, Hsu C, Lim HY, Moon H, Qin S, Ye SL, Yeoh EM, Yeo W. Issues and controversies of hepatocellular carcinoma-targeted therapy clinical trials in Asia: experts' opinion. Liver Int 2010; 30:1427-38. [PMID: 20557456 DOI: 10.1111/j.1478-3231.2010.02292.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Asia has a disproportionate share of the world's burden of hepatocellular carcinoma (HCC). However, the highly regarded clinical practice guidelines and recommendations for the design and conduct of clinical trials for HCC largely reflect Western practice. In order to design mutually beneficial international clinical trials of promising targeted therapies, it is imperative to understand how the aetiology, staging and treatment of HCC differ between Asian and Western countries. Our group, comprising experts in oncology and hepatology from countries that constitute the Eastern Asian region, convened to compare and contrast our current practices, evaluate potential compliance with the clinical trial recommendations, and offer suggestions for modifications that would enhance international collaboration. Here, we describe the results of our discussions, including recommendations for appropriate patient stratification based on potentially important differences in HCC aetiology, identification of practices that may confound interpretation of clinical trial outcomes (traditional Chinese medicine; antivirals that target hepatitis B virus; heterogeneous embolization procedures), suggestions for utilizing a common staging system in study protocols, recognition that sorafenib usage is limited by financial constraints and potentially increased toxicity in Asian patients, and expansion of patient populations that should be eligible for initial clinical trials with new agents.
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Affiliation(s)
- Pei-Jer Chen
- National Taiwan University Hospital, Taipei, Taiwan.
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