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König D, Schär S, Vuong D, Guckenberger M, Furrer K, Opitz I, Weder W, Rothschild SI, Ochsenbein A, Zippelius A, Addeo A, Mark M, Eboulet EI, Hayoz S, Thierstein S, Betticher DC, Ris HB, Stupp R, Curioni-Fontecedro A, Peters S, Pless M, Früh M. Long-term outcomes of operable stage III NSCLC in the pre-immunotherapy era: results from a pooled analysis of the SAKK 16/96, SAKK 16/00, SAKK 16/01, and SAKK 16/08 trials. ESMO Open 2022; 7:100455. [PMID: 35398718 PMCID: PMC9011017 DOI: 10.1016/j.esmoop.2022.100455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/20/2022] [Accepted: 02/28/2022] [Indexed: 12/25/2022] Open
Abstract
Background Chemoradiotherapy with durvalumab consolidation has yielded excellent results in stage III non-small-cell lung cancer (NSCLC). Therefore, it is essential to identify patients who might benefit from a surgical approach. Material and methods Data from 437 patients with operable stage III NSCLC enrolled in four consecutive Swiss Group for Clinical Cancer Research (SAKK) trials (16/96, 16/00, 16/01, 16/08) were pooled and outcomes were analyzed in 431 eligible patients. All patients were treated with three cycles of induction chemotherapy (cisplatin/docetaxel), followed in some patients by neoadjuvant radiotherapy (44 Gy, 22 fractions) (16/00, 16/01, 16/08) and cetuximab (16/08). Results With a median follow-up time of 9.3 years (range 8.5-10.3 years), 5- and 10-year overall survival (OS) rates were 37% and 25%, respectively. Overall, 342 patients (79%) underwent tumor resection, with a complete resection (R0) rate of 80%. Patients (n = 272, 63%) with R0 had significantly longer OS compared to patients who had surgery but incomplete resection (64.8 versus 19.2 months, P < 0.001). OS for patients who achieved pathological complete remission (pCR) (n = 66, 15%) was significantly better compared to resected patients without pCR (86.5 versus 37.0 months, P = 0.003). For patients with pCR, the 5- and 10-year event-free survival and OS rates were 45.7% [95% confidence interval (CI) 32.8% to 57.7%] and 28.1% (95% CI 15.2% to 42.6%), and 58.2% (95% CI 45.2% to 69.2%) and 45.0% (95% CI 31.5% to 57.6%), respectively. Conclusion We report favorable long-term outcomes in patients with operable stage III NSCLC treated with neoadjuvant chemotherapy with cisplatin and docetaxel ± neoadjuvant sequential radiotherapy from four prospective SAKK trials. Almost two-third of the patients underwent complete resection after neoadjuvant therapy. We confirm R0 resection and pCR as important predictors of outcome. Combined modality treatment in operable stage III NSCLC results in 5- and 10-year survival rates of 37% and 25%. Long-term survival for patients with incomplete resection is poor. Complete resection and pCR are important predictors for outcome.
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Affiliation(s)
- D König
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland.
| | - S Schär
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - D Vuong
- Department of Radiation Oncology, University Hospital of Zurich, Zurich, Switzerland
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital of Zurich, Zurich, Switzerland
| | - K Furrer
- Department of Thoracic Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - I Opitz
- Department of Thoracic Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - W Weder
- Clinics for Thoracic Surgery, Bethanien, Zurich, Switzerland
| | - S I Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - A Ochsenbein
- Department of Medical Oncology, University Hospital of Bern (Inselspital), Bern, Switzerland
| | - A Zippelius
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - A Addeo
- Department of Oncology, University Hospital of Geneva, Geneva, Switzerland
| | - M Mark
- Department of Oncology, Cantonal Hospital of Graubünden, Chur, Switzerland
| | - E I Eboulet
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - S Hayoz
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - S Thierstein
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - D C Betticher
- Clinics of Medical Oncology, Cantonal Hospital of Fribourg (HFR), Fribourg, Switzerland
| | - H-B Ris
- Clinics for Thoracic Surgery, Hôpital du Valais, Sion, Switzerland
| | - R Stupp
- Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - A Curioni-Fontecedro
- Department of Medical Oncology, University Hospital of Zurich, Zurich, Switzerland
| | - S Peters
- Department of Medical Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - M Pless
- Department of Medical Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - M Früh
- Department of Medical Oncology/Hematology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
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Wirsching HG, Tabatabai G, Roelcke U, Hottinger AF, Jörger F, Schmid A, Plasswilm L, Schrimpf D, Mancao C, Capper D, Conen K, Hundsberger T, Caparrotti F, von Moos R, Riklin C, Felsberg J, Roth P, Jones DTW, Pfister S, Rushing EJ, Abrey L, Reifenberger G, Held L, von Deimling A, Ochsenbein A, Weller M. Bevacizumab plus hypofractionated radiotherapy versus radiotherapy alone in elderly patients with glioblastoma: the randomized, open-label, phase II ARTE trial. Ann Oncol 2019; 29:1423-1430. [PMID: 29648580 DOI: 10.1093/annonc/mdy120] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The addition of bevacizumab to temozolomide-based chemoradiotherapy (TMZ/RT → TMZ) did not prolong overall survival (OS) in patients with newly diagnosed glioblastoma in phase III trials. Elderly and frail patients are underrepresented in clinical trials, but early reports suggested preferential benefit in this population. Patients and methods ARTE was a 2 : 1 randomized, multi-center, open-label, non-comparative phase II trial of hypofractionated RT (40 Gy in 15 fractions) with bevacizumab (10 mg/kg×14 days) (arm A, N = 50) or without bevacizumab (arm B, N = 25) in patients with newly diagnosed glioblastoma aged ≥65 years. The primary objective was to obtain evidence for prolongation of median OS by the addition of bevacizumab to RT. Response was assessed by RANO criteria. Quality of life (QoL) was monitored by the EORTC QLQ-C30/BN20 modules. Exploratory studies included molecular subtyping by 450k whole methylome and gene expression analyses. Results Median PFS was longer in arm A than in arm B (7.6 and 4.8 months, P = 0.003), but OS was similar (12.1 and 12.2 months, P = 0.77). Clinical deterioration was delayed and more patients came off steroids in arm A. Prolonged PFS in arm A was confined to tumors with the receptor tyrosine kinase (RTK) I methylation subtype (HR 0.25, P = 0.014) and proneural gene expression (HR 0.29, P = 0.025). In a Cox model of OS controlling for established prognostic factors, associations with more favorable outcome were identified for age <70 years (HR 0.52, P = 0.018) and Karnofsky performance score 90%-100% (HR 0.51, P = 0.026). Including molecular subtypes into that model identified an association of the RTK II gene methylation subtype with inferior OS (HR 1.73, P = 0.076). Conclusion Efficacy outcomes and exploratory analyses of ARTE do not support the hypothesis that the addition of bevacizumab to RT generally prolongs survival in elderly glioblastoma patients. Molecular biomarkers may identify patients with preferential benefit from bevacizumab. Clinical trial registration number NCT01443676.
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Affiliation(s)
- H-G Wirsching
- Brain Tumor Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - G Tabatabai
- Brain Tumor Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - U Roelcke
- Department of Neurology, Brain Tumor Center Aarau, Cantonal Hospital Aarau, Aarau, Switzerland
| | - A F Hottinger
- Department of Clinical Neurosciences, University Hospital Lausanne, Lausanne, Switzerland; Department of Medical Oncology, University Hospital Lausanne, Lausanne, Switzerland
| | - F Jörger
- Department of Clinical Trials Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - A Schmid
- Department of Medical Oncology, University Hospital Bern, Bern, Switzerland
| | - L Plasswilm
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - D Schrimpf
- Department of Neuropathology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Mancao
- Genentech, Oncology Biomarker Development, Basel, Switzerland
| | - D Capper
- Department of Neuropathology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Conen
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - T Hundsberger
- Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - F Caparrotti
- Department of Radiation Oncology, University Hospital Geneva, Geneva, Switzerland
| | - R von Moos
- Department of Medical Oncology, Cantonal Hospital Chur, Chur, Switzerland
| | - C Riklin
- Department of Medical Oncology, Cantonal Hospital Lucerne, Lucerne Switzerland
| | - J Felsberg
- Department of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - P Roth
- Brain Tumor Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - D T W Jones
- German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Pediatric Hematology and Oncology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - S Pfister
- German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Pediatric Hematology and Oncology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - E J Rushing
- Brain Tumor Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neuropathology, University Hospital Zurich, Zurich, Switzerland
| | - L Abrey
- F. Hoffmann-La Roche, Pharma Division, Product Development Oncology, Basel, Switzerland
| | - G Reifenberger
- Department of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Cancer Research Center, Essen/Düsseldorf, Germany
| | - L Held
- Biostatistics Department, University of Zurich, Zurich, Switzerland
| | - A von Deimling
- Department of Neuropathology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Ochsenbein
- Department of Medical Oncology, University Hospital Bern, Bern, Switzerland
| | - M Weller
- Brain Tumor Center Zurich, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
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Zens P, Bello C, Scherz A, Ochsenbein A, Von Gunten M, Schmid R, Neppl C, Berezowska S. P2.09-19 Effect of Neoadjuvant (Radio)chemotherapy on PD-L1 Expression in Resected Non-Small Cell Lung Cancers. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1668] [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: 10/25/2022]
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Kündig A, Fung C, Scherz A, Ochsenbein A, Herrmann E, Ermis E, Schmid R, Hewer E, Berezowska S. P1.04-05 PD-L1 Expression (SP263) in Lung Cancer and Paired Brain Metastases – A Single Center Study in 211 Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.908] [Citation(s) in RCA: 1] [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: 11/26/2022]
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Ehmann M, Wannesson L, Pless M, Früh M, Gautschi O, Curioni-Fontecedro A, Betticher D, Mark M, Ochsenbein A, Rothschild S. Afatinib for patients with advanced NSCLC pretreated with chemotherapy and an EGFR tyrosine kinase inhibitor: Retrospective analysis of the Swiss Afatinib Named Patient Program. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.030] [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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Pless M, Stupp R, Ris H, Stahel R, Weder W, Thierstein S, Xyrafas A, Früh M, Cathomas R, Zippelius A, Roth A, Ochsenbein A, Meier U, Mamot C, Rauch D, Gautschi O, Gerard M, Betticher D, Mirimanoff R, Peters S. Final Results of the Sakk 16/00 Trial: a Randomized Phase III Trial Comparing Neoadjuvant Chemoradiation to Chemotherapy Alone in Stage Iiia/N2 Non-Small Cell Lung Cancer (Nsclc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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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Knecht U, Slotboom J, Ochsenbein A, Beck J, Pica A, Wiest R. P16.19 * THE EFFECTS OF BEVACIZUMAB ON MR-IMAGING AND 1H-MR-SPECTROSCOPY (MRS) IN PATIENTS WITH HIGH GRADE GLIOMAS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.315] [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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Rothschild S, Gautschi O, Huegli B, Li Q, Stalder L, Zippelius A, Cathomas R, Peters S, Frueh M, Mach N, Ochsenbein A, Leibundgut EO. Prospective Evaluation of Circulating Vegf in Patients with Advanced Non-Small Cell Lung Cancer Treated with Bevacizumab, Pemetrexed and Cisplatin in the Trial Sakk19/09. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.29] [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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Stahel R, Riesterer O, Alexandros X, Opitz I, Beyeler M, Ochsenbein A, Früh M, Cathomas R, Nackaerts K, Peters S, Mamot C, Zippelius A, Mordasini C, Clemens K, Eckhardt K, Schmid R, Nagel W, Aebersold D, Gautschi O, Weder W. Neoadjuvant Chemotherapy and Extrapleural Pneumonectomy (Epp) of Malignant Pleural Mesothelioma (Mpm) with or Without Hemithoracic Radiotherapy: Final Results of the Randomized Multicenter Phase Ii Trial Sakk17/04. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.65] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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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10
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Joerger M, Baty F, Früh M, Droege C, Stahel RA, Betticher DC, von Moos R, Ochsenbein A, Pless M, Gautschi O, Rothschild S, Brauchli P, Klingbiel D, Zappa F, Brutsche M. Circulating microRNA profiling in patients with advanced non-squamous NSCLC receiving bevacizumab/erlotinib followed by platinum-based chemotherapy at progression (SAKK 19/05). Lung Cancer 2014; 85:306-13. [PMID: 24928469 DOI: 10.1016/j.lungcan.2014.04.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 12/08/2013] [Revised: 04/23/2014] [Accepted: 04/26/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Molecular subclassification of non small-cell lung cancer (NSCLC) is essential to improve clinical outcome. This study assessed the prognostic and predictive value of circulating micro-RNA (miRNA) in patients with non-squamous NSCLC enrolled in the phase II SAKK (Swiss Group for Clinical Cancer Research) trial 19/05, receiving uniform treatment with first-line bevacizumab and erlotinib followed by platinum-based chemotherapy at progression. MATERIALS AND METHODS Fifty patients with baseline and 24 h blood samples were included from SAKK 19/05. The primary study endpoint was to identify prognostic (overall survival, OS) miRNA's. Patient samples were analyzed with Agilent human miRNA 8x60K microarrays, each glass slide formatted with eight high-definition 60K arrays. Each array contained 40 probes targeting each of the 1347 miRNA. Data preprocessing included quantile normalization using robust multi-array average (RMA) algorithm. Prognostic and predictive miRNA expression profiles were identified by Spearman's rank correlation test (percentage tumor shrinkage) or log-rank testing (for time-to-event endpoints). RESULTS Data preprocessing kept 49 patients and 424 miRNA for further analysis. Ten miRNA's were significantly associated with OS, with hsa-miR-29a being the strongest prognostic marker (HR=6.44, 95%-CI 2.39-17.33). Patients with high has-miR-29a expression had a significantly lower survival at 10 months compared to patients with a low expression (54% versus 83%). Six out of the 10 miRNA's (hsa-miRN-29a, hsa-miR-542-5p, hsa-miR-502-3p, hsa-miR-376a, hsa-miR-500a, hsa-miR-424) were insensitive to perturbations according to jackknife cross-validation on their HR for OS. The respective principal component analysis (PCA) defined a meta-miRNA signature including the same 6 miRNA's, resulting in a HR of 0.66 (95%-CI 0.53-0.82). CONCLUSION Cell-free circulating miRNA-profiling successfully identified a highly prognostic 6-gene signature in patients with advanced non-squamous NSCLC. Circulating miRNA profiling should further be validated in external cohorts for the selection and monitoring of systemic treatment in patients with advanced NSCLC.
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Affiliation(s)
- M Joerger
- Department of Medical Oncology & Hematology, Cantonal Hospital, St. Gallen, Switzerland.
| | - F Baty
- Department of Pneumology, Cantonal Hospital, St. Gallen, Switzerland
| | - M Früh
- Department of Medical Oncology & Hematology, Cantonal Hospital, St. Gallen, Switzerland
| | - C Droege
- Department of Medical Oncology, University Hospital Basel, Switzerland
| | - R A Stahel
- Department of Medical Oncology, University Hospital Zurich, Switzerland
| | - D C Betticher
- Department of Medical Oncology, Cantonal Hospital, Fribourg, Switzerland
| | - R von Moos
- Department of Medical Oncology, Cantonal Hospital, Chur, Switzerland
| | - A Ochsenbein
- Department of Medical Oncology, University Hospital, Bern, Switzerland
| | - M Pless
- Department of Medical Oncology, Cantonal Hospital, Winterthur, Switzerland
| | - O Gautschi
- Department of Medical Oncology, Cantonal Hospital, Luzern, Switzerland
| | - S Rothschild
- Department of Medical Oncology, Cantonal Hospital, Luzern, Switzerland
| | - P Brauchli
- SAKK Coordinating Center, Bern, Switzerland
| | | | - F Zappa
- Oncology Department, Clinica Luganese, Lugano, Switzerland
| | - M Brutsche
- Department of Pneumology, Cantonal Hospital, St. Gallen, Switzerland
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Gross S, Lennerz V, Gallerani E, Sessa C, Mach N, Boehm S, Hess D, von Boehmer L, Knuth A, Ochsenbein A, Gnad-Vogt U, Zieschang J, Forssmann U, Woelfel T, Kaempgen E. First-in-human trial focusing on the immunologic effects of the survivin-derived multiepitope vaccine EMD640744. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2515] [Citation(s) in RCA: 2] [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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12
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Zappa F, Droege C, Betticher DC, von Moos R, Brutsche MH, Baty F, Bubendorf L, Ochsenbein A, Oppliger Leibundgut E, Gautschi O, Froesch P, Stahel RA, Rauch D, Schmid P, Mayer M, Crowe S, Brauchli P, Ribi K, Pless M. Bevacizumab (B) and erlotinib (E) as first-line therapy in metastatic nonsquamous non-small cell lung cancer (NSCLC) followed by platinum-based chemotherapy (CT) at disease progression (PD): A multicenter phase II trial, SAKK 19/05. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7561] [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: 11/20/2022] Open
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13
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von Moos R, Seifert B, Simcock M, Goldinger SM, Gillessen S, Ochsenbein A, Michielin O, Cathomas R, Schläppi M, Moch H, Schraml PH, Mjhic-Probst D, Mamot C, Schönewolf N, Dummer R. First-line temozolomide combined with bevacizumab in metastatic melanoma: a multicentre phase II trial (SAKK 50/07). Ann Oncol 2011; 23:531-6. [PMID: 21527587 DOI: 10.1093/annonc/mdr126] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Oral temozolomide has shown similar efficacy to dacarbazine in phase III trials with median progression-free survival (PFS) of 2.1 months. Bevacizumab has an inhibitory effect on the proliferation of melanoma and sprouting endothelial cells. We evaluated the addition of bevacizumab to temozolomide to improve efficacy in stage IV melanoma. PATIENTS AND METHODS Previously untreated metastatic melanoma patients with Eastern Cooperative Oncology Group performance status of two or more were treated with temozolomide 150 mg/m(2) days 1-7 orally and bevacizumab 10 mg/kg body weight i.v. day 1 every 2 weeks until disease progression or unacceptable toxicity. The primary end point was disease stabilisation rate [complete response (CR), partial response (PR) or stable disease (SD)] at week 12 (DSR12); secondary end points were best overall response, PFS, overall survival (OS) and adverse events. RESULTS Sixty-two patients (median age 59 years) enrolled at nine Swiss centres. DSR12 was 52% (PR: 10 patients and SD: 22 patients). Confirmed overall response rate was 16.1% (CR: 1 patient and PR: 9 patients). Median PFS and OS were 4.2 and 9.6 months. OS (12.0 versus 9.2 months; P = 0.014) was higher in BRAF V600E wild-type patients. CONCLUSIONS The primary end point was surpassed showing promising activity of this bevacizumab/temozolomide combination with a favourable toxicity profile. Response and OS were significantly higher in BRAF wild-type patients.
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Affiliation(s)
- R von Moos
- Department of Medicine Oncology, Kantonal Hospital Graubuenden, Chur, Switzerland.
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14
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Egger M, Ochsenbein A, Gerber AU. [A young man with sore throat and infection]. Schweiz Med Wochenschr 1997; 127:861-3. [PMID: 9289812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Postanginal septicemia (Lemierre's syndrome) is an infection with anaerobes that ensues from certain oropharyngeal infections: septic thrombophlebitis of the internal jugular vein leads to abscess formation in the lungs and possibly in other organs. Based upon a recently observed typical case the syndrome is presented and its possible importance for empirical therapy of tonsillopharyngitis and septicemias involving unknown organisms is briefly discussed.
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Affiliation(s)
- M Egger
- Medizinische Abteilungen, Regionalspital Burgdorf
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