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Meegdes M, Geurts S, Erdkamp F, Dercksen M, Vriens B, Aaldering K, Pepels M, Winkel L, Teeuwen N, De Boer M, Tjan-Heijnen V. 248P The implementation of CDK 4/6 inhibitors and its impact on treatment choices in HR+/HER2- advanced breast cancer patients: A study of the Dutch SONABRE registry. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.531] [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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Pouwels XGLV, Geurts SME, Ramaekers BLT, Erdkamp F, Vriens BEPJ, Aaldering KNA, van de Wouw AJ, Dercksen MW, Smilde TJ, Peters NAJB, Riel JMV, Pepels MJ, Heijnen-Mommers J, Joore MA, Tjan-Heijnen VCG, de Boer M. The relative effectiveness of eribulin for advanced breast cancer treatment: a study of the southeast Netherlands advanced breast cancer registry. Acta Oncol 2020; 59:82-89. [PMID: 31583931 DOI: 10.1080/0284186x.2019.1670356] [Citation(s) in RCA: 4] [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] [Indexed: 10/25/2022]
Abstract
Background: Eribulin provided significant overall survival (OS) benefit in heavily pretreated advanced breast cancer patients in the EMBRACE trial. We investigated the use of eribulin in daily clinical practice, the relative effectiveness of eribulin versus non-eribulin chemotherapy, and the safety of eribulin in real-world patients included in the SOutheast Netherlands Advanced BREast cancer (SONABRE) registry.Material and methods: Patients treated with eribulin and eligible patients for eribulin who received a different chemotherapy (i.e., non-eribulin group) in ten hospitals in 2013-2017 were included. A multivariate matching algorithm was applied to correct for differences in baseline characteristics between the groups, including the number of previous treatment lines. Progression-free survival (PFS) and OS of eribulin were compared with the matched non-eribulin group through Kaplan-Meier curves and multivariate Cox proportional hazard models. The occurrence of dose delay and reduction was described.Results: Forty-five patients received eribulin according to its registration criteria and 74 patients were eligible for eribulin but received non-eribulin chemotherapy. Matching increased the similarity in baseline characteristics between the eribulin and non-eribulin groups. Median PFS was 3.5 months (95% confidence interval (CI): 2.7-5.5) in the eribulin group and 3.2 months (95% CI: 2.0-4.8) in the matched non-eribulin group (adjusted hazard ratio (HR): 0.83, 95% CI: 0.49-1.38). Median OS was 5.9 months (95% CI: 4.6-11.0) and 5.2 months (95% CI: 4.6-9.5) in the eribulin and non-eribulin groups, respectively (adjusted HR: 0.66, 95% CI: 0.38-1.13). Dose delay or reduction occurred in 14 patients (31%) receiving eribulin.Conclusions: No difference in PFS and OS was observed between eribulin and non-eribulin treated patients. Eribulin had a manageable toxicity profile.
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Affiliation(s)
- X. G. L. V. Pouwels
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - S. M. E. Geurts
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - B. L. T. Ramaekers
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - F. Erdkamp
- Department of Internal Medicine, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
| | - B. E. P. J. Vriens
- Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - K. N. A. Aaldering
- Department of Internal Medicine, Laurentius Hospital, Roermond, The Netherlands
| | - A. J. van de Wouw
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
| | - M. W. Dercksen
- Department of Internal Medicine, Máxima Medical Centre, Veldhoven/Eindhoven, The Netherlands
| | - T. J. Smilde
- Department of Internal Medicine, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands
| | - N. A. J. B. Peters
- Department of Internal Medicine, Sint Jans Gasthuis, Weert, The Netherlands
| | - J. M. van Riel
- Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - M. J. Pepels
- Department of Internal Medicine, Elkerliek Hospital, Helmond, The Netherlands
| | - J. Heijnen-Mommers
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M. A. Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - V. C. G. Tjan-Heijnen
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M. de Boer
- School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
- Division Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Claessens A, Timman R, Busschbach J, Bouma J, Rademaker-Lakhai J, Erdkamp F, Tjan-Heijnen V, Bos M. Influence on quality of life of chemotherapy scheduling for patients with advanced HER2-negative breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz100.010] [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: 11/12/2022] Open
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Erdkamp F, Claessens A, Lopez-Yurda M, Bouma J, van Tinteren H, Rademaker-Lakhai J, Honkoop A, de Graaf H, Tjan-Heijnen V, Bos M. Intermittent versus continuous chemotherapy beyond first-line for patients with HER2-negative advanced breast cancer (BOOG 2010-02). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz100.009] [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: 11/12/2022] Open
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Fuchs CS, Shitara K, Di Bartolomeo M, Lonardi S, Al-Batran SE, Van Cutsem E, Ilson DH, Alsina M, Chau I, Lacy J, Ducreux M, Mendez GA, Alavez AM, Takahari D, Mansoor W, Enzinger PC, Gorbounova V, Wainberg ZA, Hegewisch-Becker S, Ferry D, Lin J, Carlesi R, Das M, Shah MA, Karaseva NA, Kowalyszyn RD, Hernandez CA, Csoszi T, De Vita F, Pfeiffer P, Sugimoto N, Kocsis J, Csilla A, Bodoky G, Garnica Jaliffe G, Protsenko S, Madi A, Wojcik E, Brenner B, Folprecht G, Sarosiek T, Peltola KJ, Bono P, Ayala H, Aprile G, Gerardo CG, Huitzil Melendez FD, Falcone A, Di Costanzo F, Tehfe M, Mineur L, García Alfonso P, Obermannova R, Senellart H, Petty R, Samuel L, Acs PI, Hussein MA, Nechaeva MN, Erdkamp F, Won E, Bendell JC, Gallego Plazas J, Lorenzen S, Melichar B, Escudero MA, Pezet D, Phelip JM, Kaen DL, Reeves JAJ, Longo Muñoz F, Madhusudan S, Barone C, Fein LE, Gomez Villanueva A, Hebbar M, Prausova J, Visa Turmo L, Vidal Barrull J, Yilmaz MKN, Beny A, Van Laarhoven H, DiCarlo BA, Esaki T, Fujitani K, Geboes K, Geva R, Kadowaki S, Leong S, Machida N, Raj MS, Ramirez Godinez FJ, Ruzsa A, Ford H, Lawler WE, Maisey NR, Petera J, Shacham-Shmueli E, Sinapi I, Yamaguchi K, Hara H, Beck JT, Błasińska-Morawiec M, Villalobos Valencia R, Alcindor T, Bajaj M, Berry S, Gomez CM, Dammrich D, Patel R, Taieb J, Ten Tije A, Burkes RL, Cabanillas F, Firdaus I, Chua CC, Hironaka S, Hofheinz RD, Lim HJ, Nordsmark M, Piko B, Verma U, Wadsley J, Yukisawa S, Gutiérrez Delgado F, Denlinger CS, Kallio R, Pikiel J, Wojcik-Tomaszewska J, Brezden-Masley C, Jang RWJ, Pribylova J, Sakai D, Bartoli MA, Cats A, Grootscholten M, Dichmann RA, Hool H, Shaib W, Tsuji A, Van den Eynde M, Velez-Cortez H, Asmis TR. Ramucirumab with cisplatin and fluoropyrimidine as first-line therapy in patients with metastatic gastric or junctional adenocarcinoma (RAINFALL): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2019; 20:420-435. [PMID: 30718072 DOI: 10.1016/s1470-2045(18)30791-5] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/03/2018] [Accepted: 10/16/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND VEGF and VEGF receptor 2 (VEGFR-2)-mediated signalling and angiogenesis can contribute to the pathogenesis and progression of gastric cancer. We aimed to assess whether the addition of ramucirumab, a VEGFR-2 antagonist monoclonal antibody, to first-line chemotherapy improves outcomes in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma. METHODS For this double-blind, randomised, placebo-controlled, phase 3 trial done at 126 centres in 20 countries, we recruited patients aged 18 years or older with metastatic, HER2-negative gastric or gastro-oesophageal junction adenocarcinoma, an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and adequate organ function. Eligible patients were randomly assigned (1:1) with an interactive web response system to receive cisplatin (80 mg/m2, on the first day) plus capecitabine (1000 mg/m2, twice daily for 14 days), every 21 days, and either ramucirumab (8 mg/kg) or placebo on days 1 and 8, every 21 days. 5-Fluorouracil (800 mg/m2 intravenous infusion on days 1-5) was permitted in patients unable to take capecitabine. The primary endpoint was investigator-assessed progression-free survival, analysed by intention to treat in the first 508 patients. We did a sensitivity analysis of the primary endpoint, including a central review of CT scans. Overall survival was a key secondary endpoint. This study is registered with ClinicalTrials.gov, number NCT02314117. FINDINGS Between Jan 28, 2015, and Sept 16, 2016, 645 patients were randomly assigned to receive ramucirumab plus fluoropyrimidine and cisplatin (n=326) or placebo plus fluoropyrimidine and cisplatin (n=319). Investigator-assessed progression-free survival was significantly longer in the ramucirumab group than the placebo group (hazard ratio [HR] 0·753, 95% CI 0·607-0·935, p=0·0106; median progression-free survival 5·7 months [5·5-6·5] vs 5·4 months [4·5-5·7]). A sensitivity analysis based on central independent review of the radiological images did not corroborate the investigator-assessed difference in progression-free survival (HR 0·961, 95% CI 0·768-1·203, p=0·74). There was no difference in overall survival between groups (0·962, 0·801-1·156, p=0·6757; median overall survival 11·2 months [9·9-11·9] in the ramucirumab group vs 10·7 months [9·5-11·9] in the placebo group). The most common grade 3-4 adverse events were neutropenia (85 [26%] of 323 patients in the ramucirumab group vs 85 [27%] of 315 in the placebo group), anaemia (39 [12%] vs 44 [14%]), and hypertension (32 [10%] vs 5 [2%]). The incidence of any-grade serious adverse events was 160 (50%) of 323 patients in the ramucirumab group and 149 (47%) of 315 patients in the placebo group. The most common serious adverse events were vomiting (14 [4%] in the ramucirumab group vs 21 [7%] in the placebo group) and diarrhoea (11 [3%] vs 19 [6%]). There were seven deaths in each group, either during study treatment or within 30 days of discontinuing study treatment, which were the result of treatment-related adverse events. In the ramucirumab group, these adverse events were acute kidney injury, cardiac arrest, gastric haemorrhage, peritonitis, pneumothorax, septic shock, and sudden death (n=1 of each). In the placebo group, these adverse events were cerebrovascular accident (n=1), multiple organ dysfunction syndrome (n=2), pulmonary embolism (n=2), sepsis (n=1), and small intestine perforation (n=1). INTERPRETATION Although the primary analysis for progression-free survival was statistically significant, this outcome was not confirmed in a sensitivity analysis of progression-free survival by central independent review, and did not improve overall survival. Therefore, the addition of ramucirumab to cisplatin plus fluoropyrimidine chemotherapy is not recommended as first-line treatment for this patient population. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Charles S Fuchs
- Yale Cancer Center, Smilow Cancer Hospital, New Haven, CT, USA.
| | - Kohei Shitara
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | - Salah-Eddin Al-Batran
- Institute of Clinical Cancer Research at Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt, Germany
| | - Eric Van Cutsem
- University Hospitals Gasthuisberg, Leuven and KULeuven, Belgium
| | - David H Ilson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria Alsina
- Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Ian Chau
- Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Jill Lacy
- Yale Cancer Center, Smilow Cancer Hospital, New Haven, CT, USA
| | - Michel Ducreux
- Gustave Roussy Cancer Centre, Grand Paris, Villejuif, France; Université Paris-Saclay, France
| | | | | | | | | | | | | | - Zev A Wainberg
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - David Ferry
- Eli Lilly and Company, New York City, NY, USA
| | - Ji Lin
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Mayukh Das
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Manish A Shah
- Weill Cornell Medical College, NY, USA; New York Presbyterian Hospital, New York, NY, USA
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van Rooijen K, Kurk S, van der Kruijssen D, Elias S, May A, Cats A, Creemers GJ, Erdkamp F, Loosveld O, Rodenburg C, Tanis P, Vink G, de Wilt J, Punt C, Koopman M. Influence of primary tumour sidedness on survival after upfront primary tumour resection (PTR) in synchronous metastatic colon cancer (mCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.076] [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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Claessens A, Bos M, de Groot S, van Leeuwen-Stok E, Lopez-Yurda M, Honkoop A, de Graaf H, van Druten E, van Warmerdam L, van der Sangen M, Tjan-Heijnen V, Erdkamp F. Efficacy of two times four versus continuous eight cycles of paclitaxel/bevacizumab as first-line chemotherapy in metastatic breast cancer: The Stop&Go study of the Dutch Breast Cancer Research Group (BOOG). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.009] [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: 11/12/2022] Open
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Kurk S, Peeters P, Stellato R, Dorresteijn B, Jourdan M, Creemers GJ, Erdkamp F, de Jongh F, Kint P, Poppema B, Radema S, Simkens L, Tanis B, Tjin-A-Ton M, Van der Velden A, Punt C, Koopman M, May A. Impact of sarcopenia on dose limiting toxicities in metastatic colorectal cancer patients (mCRC pts) receiving palliative systemic treatment. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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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Sonke G, Hart L, Campone M, Erdkamp F, Janni W, Verma S, Villanueva C, Jakobsen E, Alba E, Wist E, Favret A, Bachelot T, Hegg R, Wheatley-Price P, Souami F, Sutradhar S, Miller M, Germa C, Burris H. Efficacy and safety of ribociclib (LEE011) + letrozole in elderly patients with hormone receptor-positive (HR+), HER2-negative (HER2−) advanced breast cancer (ABC) in MONALEESA-2. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30091-6] [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: 10/20/2022]
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May AM, Boer JH, Velthuis M, Steins Bisschop CN, Los M, Erdkamp F, ten Bokkel Huinink D, Bloemendal HJ, Rodenhuis C, de Roos MAJ, Verhaar M, van der Wall E, Peeters PHM. Abstract P1-10-09: Are patients with breast cancer undergoing adjuvant treatment able to follow an exercise program with a moderate to high intensity? Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-10-09] [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: We recently showed in a randomized trial, the Physical Activity during Cancer Treatment (PACT) study, that an 18-week exercise program reduced complaints of fatigue and improved physical fitness in newly diagnosed breast cancer patients undergoing adjuvant treatment. The beneficial effects were probably underestimated due to high levels of physical activity in the control group that received usual care only. Another possibility for dilution of the effect might be limited participation of the intervention group in the supervised exercise program or low compliance, i.e., an adjustment of the prescribed exercise protocol. We set out to study participation and compliance and to find determinants of reduced compliance.
METHODS: 102 patients in the PACT study were randomized into the intervention group that received a supervised exercise program 2 times a week for 18 weeks (36 sessions in total). Each session had a duration of 60 minutes and included a pre-specified period of aerobic interval exercises of specific intensities as well as muscle strength exercises. Sessions were supervised by physiotherapists, intensity was based on individual fitness characteristics and results were kept in a log.
We computed attendance (percentage of total sessions attended) and compliance (adherence to the prescribed duration and intensity of the aerobic part and to the muscle strength part of each attended session). We computed for each woman the percentage of sessions the women complied with the protocol, and report median percentages for compliance with the aerobic exercises, duration and intensity, and with the muscle strength exercises separately. Determinants of low compliance that were included in linear regression models were: age, behavioral, physical and psychosocial factors.
RESULTS: For 92 patients exercise logs were available. Patients were, on average, 50.2±7.8 years of age, all patients received chemotherapy and 70% received radiotherapy. Participation was high: patients participated in 83% (interquartile range 69-91%) of the sessions offered. Overall, also compliance was high: in 88% (63-97%) and 84% (65-94%) of all attended sessions patients were able to complete the aerobic (duration) and muscle strength program, respectively, as prescribed in the protocol. Compliance to the high-intensity part of the aerobic program was lower: in 50% (22-82%) of the sessions the intensity of the aerobic exercises was adjusted. Especially patients who received radiotherapy in addition to chemotherapy and patients who were more physically fatigued at baseline had a lower compliance to the high-intensity part of the aerobic exercises (β=-5.3 (confidence interval -9.4;-1.2) and β=-0.6 (-1.0;-0.1), respectively).
CONLUSIONS: Participation in and compliance to an 18-week aerobic and muscle strength exercise program was high. Thus, patients are well capable to exercise during adjuvant treatment for breast cancer. This study shows that preferably high intensity aerobic exercises were adjusted in a significant number of participants rather than the duration or the strength exercises. This has to be taken into account when developing training programs, especially in those patients who receive both, radiotherapy and chemotherapy.
Citation Format: May AM, Boer JH, Velthuis M, Steins Bisschop CN, Los M, Erdkamp F, ten Bokkel Huinink D, Bloemendal HJ, Rodenhuis C, de Roos MAJ, Verhaar M, van der Wall E, Peeters PHM. Are patients with breast cancer undergoing adjuvant treatment able to follow an exercise program with a moderate to high intensity?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-09.
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Affiliation(s)
- AM May
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - JH Boer
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - M Velthuis
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - CN Steins Bisschop
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - M Los
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - F Erdkamp
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - D ten Bokkel Huinink
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - HJ Bloemendal
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - C Rodenhuis
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - MAJ de Roos
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - M Verhaar
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - E van der Wall
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
| | - PHM Peeters
- University Medical Center Utrecht, Utrecht, Netherlands; Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands; St. Antonius Hospital, Nieuwegein, Netherlands; Orbis Medisch Centrum, Sittard, Netherlands; Diakonessenhuis, Utrecht, Netherlands; Meander Medical Center, Amersfoort, Netherlands; Hospital Rivierenland, Tiel, Netherlands; Hofpoort Hospital, Woerden, Netherlands
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van Oijen B, Erdkamp F, Schouten H, van der Kuy P. The first study published? Ann Oncol 2015; 26:1803. [DOI: 10.1093/annonc/mdv243] [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: 11/15/2022] Open
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Lorusso V, Śmiałowska-Janiszewska A, Krzemieniecki K, Novoa SA, Mefti F, Janssen J, Steger G, Bird B, Turazza M, Yosef H, Albuisson E, Barnadas A, Batist G, De Mouzon J, Erdkamp F, Leonard R, Namer M, Maumus-Robert S, Aapro M. Use of Liposomal Doxorubicin for Metastatic Breast Cancer Management Across Europe: Results of Eos (European Observatory & Survey). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.45] [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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Tjan-Heijnen VC, Smorenburg CH, de Graaf H, Erdkamp F, Honkoop A, Wals J, van Gastel S, van der SM, Seynaeve C, Nortier JW, Borm G. PD04-02: Recovery of Ovarian Function in Breast Cancer Patients with Chemotherapy-Induced Amenorrhea Receiving Anastrozole in the Dutch DATA Study. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-pd04-02] [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
Background: In early stage hormone receptor positive breast cancer, aromatase inhibitors (AIs) are established as adjuvant therapy for postmenopausal women. In daily practice AIs are also offered to patients with chemotherapy-induced amenorrhea (CIA). The impact of AIs on estrogen (E2) levels in these patients has not extensively been studied, although this could be very relevant for the efficacy and safety of the adjuvant hormonal treatment. The Dutch phase III DATA study is assessing the impact on disease-free survival of 3 vs. 6 years of anastrozole after 2–3 years of tamoxifen (N=1900 patients in total), and has included both postmenopausal patients and patients with CIA. The current analysis reports on the hormonal data in the CIA group.
Patients and methods: We identified patients from the DATA study < 55 years of age at randomization who had received adjuvant chemotherapy and developed CIA, and excluded patients with ovariectomy or use of LHRH agonist. Patients were considered as having CIA if they were in amenorrhea since 3 months before start of chemotherapy up to 6 months after start of chemotherapy, and did not resume menses during tamoxifen therapy. Patients were eligible if postmenopausal E2 levels were confirmed within the last three months before randomization. Plasma FSH and E2 levels were serially determined at 6-month intervals.
Results: A total of 285 patients with CIA were identified in the DATA study. Median age was 50.8 years (range 35.9 - 54.9). Results on E2 and FSH levels are presented in the Table. During treatment with anastrazole, FSH levels tended to increase over time and E2 levels didn't decline. Of note, FSH increased in nearly all patients with significantly elevated (premenopausal) E2 levels, in contrast to the pattern seen in spontaneous recovery of ovarian function. During follow-up, 4 patients had vaginal bleeding, 2 of them having postmenopausal E2 levels. In 8 (2.8%) patients E2 levels became ≥ 200 pmol/l (considered premenopausal) after 12–30 months use of AI. Using a more strict cutoff value of E2 (≥ 100 pmol/l), 62 (21.8%) patients had elevated levels of E2 during AI treatment. With 70 pmol/l as cutoff value, 117 (41.0%) patients had at some point during treatment an increased E2 level. Updated and detailed analyses will be presented at the meeting.
Conclusion: In this first series of a large number of CIA patients with available data on E2 and FSH levels during anastrozole therapy, we observed high E2 levels in a substantial number of patients. The combination of increased E2 and FSH levels may indicate continuous stimulation of remaining ovarian follicles. The efficacy of AIs in women with CIA without strict E2 monitoring and adequate treatment modification in the presence of increasing E2 can be questioned. Further data hereon are warranted.
Supported by: AstraZeneca NL and the Dutch Breast Cancer Trialists’ Group (BOOG).
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD04-02.
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Affiliation(s)
- VC Tjan-Heijnen
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - CH Smorenburg
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - H de Graaf
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - F Erdkamp
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - A Honkoop
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - J Wals
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - S van Gastel
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - Sangen M van der
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - C Seynaeve
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - JW Nortier
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
| | - G Borm
- 1Maastricht University Medical Centre, Netherlands; Medical Centre Alkmaar, Netherlands; Medical Centre Leeuwarden, Netherlands; Orbis Medical Centre, Netherlands; Isala Clinics, Netherlands; Atrium Medical Centre, Netherlands; Comprehensive Cancer Centre Netherlands Nijmegen, Netherlands; Catharina-Hospital, Netherlands; Erasmus University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Radboud University Nijmegen Medical Centre, Netherlands
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Krzemieniecki K, Antolín Novoa S, Gozy M, Schumacher C, Steger GG, Carteni' G, Bird BR, Albuisson E, Barnadas A, Batist G, De Mouzon J, Erdkamp F, Leonard RCF, Lueck H, Namer M, Venturini M, Ronga P, Maumus-Robert S, Aapro MS. Therapeutic management of metastatic breast cancer across Europe: European observatory and survey (EOS). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11556] [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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15
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Aapro M, Bernard-Marty C, Brain E, Batist G, Erdkamp F, Krzemieniecki K, Leonard R, Lluch A, Monfardini S, Ryberg M, Soubeyran P, Wedding U. Anthracycline cardiotoxicity in the elderly cancer patient: a SIOG expert position paper. Ann Oncol 2011; 22:257-67. [DOI: 10.1093/annonc/mdq609] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [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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de Jongh E, van Brummelen D, van Warmerdam L, Fontaine C, Dopchie C, Vos A, Janssens J, Erdkamp F. Abstract P6-11-08: A Comparison of Chemotherapeutic Treatment Practice in Metastatic Breast Cancer (MBC) in Belgium (BE) and The Netherlands (NL). Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p6-11-08] [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: Current treatment recommendations provide limited guidance for chemotherapy (CT) of MBC, while physicians have many options to choose from. We undertook a retrospective survey to describe and compare actual CT approaches to MBC in clinical practice in two neighboring European countries, BE and NL.
Methods: 20 BE and 18 NL hospitals collected data for 490 and 434 patients (pts), respectively, diagnosed with MBC in 2003-2009 and treated with ≥1 CT regimen. Demographic, disease and treatment data of the last 25 consecutively treated pts per hospital were included in each survey. The NL survey required age ≥70 yrs at MBC diagnosis, the BE survey had no upper age limit. We compared patient characteristics and treatment policies between both cohorts (BE vs. NL, for all comparisons). Results: BE patients were older at MBC diagnosis (median 60 vs. 56 yrs) and had M1 tumor status at primary diagnosis more frequently (26 vs. 20%). Average year of MBC diagnosis was 2005 for both countries. There were no striking differences in ER/PR positivity (61/50 vs. 64/47%), HER2/neu overexpression (27 vs. 31%), triple negative status (12 vs. 15%), or cardiac co-morbidity. Prior hormonal (22 vs. 12%), hormonal + adjuvant CT (32 vs. 26%), and total adjuvant CT (58 vs. 51%) had been given more frequently in the BE cohort. In pts receiving adjuvant CT, anthracyclines had been used more frequently in the NL cohort (61 vs. 78%). Pts in the BE and NL cohort received up to 10 and 6 lines of CT, respectively. 79 vs. 73% and 55 vs. 43% of pts received 2 and 3 lines of CT, respectively. BE pts received far more monotherapy in first line (46 vs. 25%), but not in second (66 vs. 65%) and third line (65 vs. 63%). Drugs used most frequently for monotherapy in lines 1-3 were the same in BE and NL: docetaxel (40 vs. 38%) and capecitabine (13 vs. 26%) in line 1; docetaxel (27 vs. 38%) and capecitabine (23 vs. 16%) in line 2; capecitabine (30 vs. 30%) and vinorelbine (16 vs. 19%) in line 3. The most frequently used CT combinations were very different: FEC (40%)vs. FAC (24%) in first line, FEC (7%) vs. CMF (14%) in second line, and non-pegylated liposomal doxorubicin/cyclophosphamide (6%) vs. CMF (15%) in third line.
Many different CT regimens for MBC were used throughout all lines (e.g. > 20 regimens in first line) in both countries. Overall, 81 vs. 71% of pts received a taxane and/or an anthracycline in first line, 57 vs. 60% in second line, and 43 vs. 29% in third line. 33 vs. 36% were re-challenged with an anthracycline after having received anthracycline-based (neo) adjuvant CT.
Physician-assessed response (52 vs. 53%) and stable disease rates (22 vs. 26%) to first-line CT were similar.
Conclusions: Daily treatment practice of MBC differs considerably between BE and NL, in particular with respect to monotherapy vs. combination CT in first line, specific combination regimens used in lines 1-3, and the number of subsequent lines employed. More adjuvant treatment appeared to have been given to Belgian pts. Despite these differences, reported response rates were remarkably similar. Although a wide variety of CT regimens are used in MBC in BE and NL, anthracyclines and taxanes are the cornerstones in both countries.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-11-08.
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Affiliation(s)
- E de Jongh
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - D van Brummelen
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - L van Warmerdam
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - C Fontaine
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - C Dopchie
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - A Vos
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - J Janssens
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
| | - F. Erdkamp
- Zaans Medisch Centrum, Zaandam, Netherlands; Universitair Ziekenhuis Brussel, Belgium; Catharina Ziekenhuis, Eindhoven, Netherlands; Clinique Notre Dame, Tournai, Belgium; Ziekenhuis Bernhoven, Oss, Netherlands; Salvatorziekenhuis, Hasselt, Belgium; Orbis Medisch Centrum, Sittard, Netherlands
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Coombes RC, Bliss JM, Espie M, Erdkamp F, Wals JJ, Tres A, Coleman RE, Reise J, Cooper D, Hupperets P. DEVA: Randomized trial of sequential epirubicin and docetaxel versus epirubicin alone in node-positive postmenopausal early breast cancer (EBC) patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.536] [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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18
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Krzemieniecki K, Erdkamp F, Lindman H, Maenpaa J, Puertas J, Schwenkglenks M, Sevelda P, Smakal M, Varthalitis I, Verma S. 3036 G-CSF use and neutropenic events in patients with breast and lung tumours: data from routine clinical practice (IMPACT Solid study). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70635-4] [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: 10/20/2022] Open
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Reyners A, Smit WM, Schaapveld MS, Hoekman K, Erdkamp F, Lalisang R, Graaf H, Wymenga MA, Polee M, Willemse PH. Adding the specific COX-2 inhibitor celecoxib to docetaxel plus carboplatin in first line for stage IC-IV epithelial ovarian cancer: A randomized phase II study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5545] [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: 11/20/2022] Open
Abstract
5545 Background: Inhibition of COX-2 reduces the growth rate of tumors in vitro and COX-2 is over-expressed in ovarian cancer, so a COX-2 inhibitor might be beneficial. Methods: After debulking surgery patients (pts) with advanced epithelial ovarian cancer (FIGO IC-IV) received docetaxel 75 mg/m2 and carboplatin AUC=5 (CT) for 6–9 cycles q 3-wks and were randomized to celecoxib 400 mg BID (COX) for max three years or to control (CTR), stratified for residual tumor present in 58% vs 54%. Response rates and progression-free survival were based on CA-125 levels according to Rustin. Primary endpoints were biochemical CR (bCR)and safety, secondary progression free- (PFS) and overall survival (OS). Results: 183 of 201 pts enrolled were analyzed and baseline characteristics were well balanced between COX (n = 91) and control (CTR) arms (n = 93). Safety: Docetaxel and carboplatin was given full dose in 89% vs 84% pts and creatinine clearance remained stable vs baseline in both arms (96% vs 97% at Cycle 6). Toxicity grade 3–4 (COX vs CTR) was neutropenia in 26 vs 32, febrile neutropenia 12 vs 12, N/V 6 vs 5, allergy 7 vs 0 pts. Neurosensory grade 2–3 was less in COX (4 vs 13 pts, p< 0.05). Efficacy: Median duration of COX treatment was 6 months and 60% completed the combination with six or more cycles of CT. At a median follow-up of 20 months, CA-125 normalized (bCR) in COX 55/74 (74%) and CTR 49/74 (66%) pts with elevated baseline levels (n.s.). Median PFS was 17.4 vs 14.5 months (n.s.) and median survival 34.2 vs 34.7 months (n.s.). Conclusions: Celecoxib added to docetaxel/carboplatin in epithelial ovarian cancer had no effect on creatinine clearance, CA-125 response, PFS or OS. Celecoxib during CT was associated with allergic skin reactions but less neurotoxicity. No significant financial relationships to disclose.
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Affiliation(s)
- A. Reyners
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - W. M. Smit
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - M. S. Schaapveld
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - K. Hoekman
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - F. Erdkamp
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - R. Lalisang
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - H. Graaf
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - M. A. Wymenga
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - M. Polee
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
| | - P. H. Willemse
- Medisch Spectrum Twente, Enschede, Netherlands; IKNO, Groningen, Netherlands; VUMC, Amsterdam, Netherlands; Maaslandziekenhuis, Sittard, Netherlands; AMC, Maastricht, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; Medisch Centrum, Leeuwarden, Netherlands; University Medical Center Groningen, Groningen, Netherlands
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Koopman M, Antonini N, Douma J, Wals J, Honkoop A, Erdkamp F, de Jong R, Rodenburg C, Mol L, Punt C. 3015 ORAL Sequential vs. combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (ACC). A Dutch Colorectal Cancer Group (DCCG) phase III study. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70943-6] [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: 10/22/2022] Open
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Tol J, Koopman M, Rodenburg C, Cats A, Creemers G, de Swart C, Erdkamp F, Mol L, Antonini N, Punt C. 3000 ORAL Randomised phase III study of capecitabine, oxaliplatin and bevacizumab (CAPOX-B) with or without cetuximab in advanced colorectal cancer (ACC), the CAIRO2 study of the Dutch Colorectal Cancer Group (DCCG). An interim safety analysis. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70928-x] [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: 11/15/2022] Open
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Chan S, Davidson N, Juozaityte E, Erdkamp F, Pluzanska A, Azarnia N, Lee LW. Phase III trial of liposomal doxorubicin and cyclophosphamide compared with epirubicin and cyclophosphamide as first-line therapy for metastatic breast cancer. Ann Oncol 2005; 15:1527-34. [PMID: 15367414 DOI: 10.1093/annonc/mdh393] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [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: 11/12/2022] Open
Abstract
OBJECTIVE To ascertain the efficacy and tolerability of non-pegylated liposomal doxorubicin (Myocet) and epirubicin combined with cyclophosphamide in the first-line treatment of patients with metastatic breast cancer. METHODS One hundred and sixty anthracycline-naïve metastatic breast cancer patients were randomised to receive Myocet (M; 75 mg/m(2)) or epirubicin (E; 75 mg/m(2)) in combination with cyclophosphamide (C; 600 mg/m(2)), every 3 weeks for up to eight cycles. OUTCOME MEASURES Response (overall response = complete + partial response rates), time to disease progression, overall survival and cardiac function (left ventricular ejection fraction). RESULTS Overall response rates were 46% and 39% for MC and EC treatment, respectively (P=0.42). MC was superior to EC with respect to median time to treatment failure (5.7 versus 4.4 months; P=0.01) and median time to disease progression (7.7 versus 5.6 months; P=0.02). Median survival times were 18.3 and 16.0 months for MC and EC, respectively (P=0.504). Unsurprisingly, given an equimolar comparison, neutropenia and stomatitis/mucositis were significantly more common in patients who received MC. However, there was less injection site toxicity with MC. Both treatments showed a low incidence of cardiotoxicity. CONCLUSION Myocet appears to be an acceptable alternative to epirubicin as a first-line treatment for patients with metastatic breast cancer because it combines the dose-effect reliability of doxorubicin with the level of safety provided by epirubicin.
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Affiliation(s)
- S Chan
- City Hospital, Nottingham, UK.
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Lalisang R, Erdkamp F, Wils J, Vreeswijk J, Wals J, Stoot J, Groot Y, Smeets J, van Geuns H. 168 A phase II study of docetaxel, epirubicin, and cispiatin with G-CSF (ienograstim) support in patients with advanced ovarian cancer. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90201-1] [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] Open
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Chan S, Davidson N, Juozaityte E, Erdkamp F, Hooftman L, Azarnia N. Phase III study of liposome-encapsulated doxorubicin (TLC D-99) and cyclophosphamide (CPA) vs. epirubicin (EPI) and CPA in first-line treatment of metastatic breast cancer (MBC). Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81679-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wils J, van Geuns H, Stoot J, Bergmans M, Boschma F, Bron H, Degen J, Erdkamp F, van Erp J, Haest J, Iding R, Lalisang F, de Pree N, de Rooy C, Snijders M, Schepers J, Vreeswijk J, Wals J, Werter M, Wetzels L, Smeets J, Schouten L. Cyclophosphamide, epirubicin and cisplatin (CEP) versus epirubicin plus cisplatin (EP) in stage Ic-IV ovarian cancer: a randomized phase III trial of the Gynecologic Oncology Group of the Comprehensive Cancer Center Limburg. Anticancer Drugs 1999; 10:257-61. [PMID: 10327029 DOI: 10.1097/00001813-199903000-00001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/26/2022]
Abstract
Cisplatin is the most important drug in the treatment of advanced ovarian cancer. The role of anthracyclines is controversial. We compared a combination of epirubicin plus cisplatin (EP) with a regimen of cyclophosphamide, epirubicin and cisplatin (CEP). Patients with stage Ic-IV ovarian cancer were randomized to receive either epirubicin 100 mg/m2 plus cisplatin 75 mg/m2 q 4 weeks or cyclophosphamide 500 mg/m2 plus epirubicin 75 mg/m2 plus cisplatin 50 mg/m2 q 4 weeks, which we considered the reference treatment based on our previous experience. Patients were initially debulked, followed by six cycles of chemotherapy, or in case primary debulking was insufficient or considered inappropriate, secondary debulking was attempted in selected cases after sufficient chemotherapy-induced regression. Optimal debulking was defined as residual lesions < or = 2 cm. A total of 210 patients (191 eligible) were randomized. Results did not show significant differences in all major endpoints (pathologically documented complete response and survival). The median survival for all patients was 34 months, for patients with stage III 26 months, for patients with stage IV 20 months and it has not been reached for patients with stage Ic-II. As no significant differences between an equitoxic regimen of EP and CEP were detected, it might be more useful to look again at the anthracyclines as part of combination chemotherapy instead of the alkylating agents.
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Affiliation(s)
- J Wils
- Laurentius Hospital, Roermond, The Netherlands.
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Erdkamp F, Houben M, Ackerman E, Breed W, van Spreeuwel J. Pancreatitis induced by mesalamine. Neth J Med 1992; 41:71-3. [PMID: 1407243] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Sulphasalazine is an active agent in the treatment of chronic inflammatory bowel disease, but there are a number of well-known side effects, including pancreatitis. The newer 5-ASA agents are thought to be equally effective but less toxic. Here we describe a patient who developed a pancreatitis due to mesalamine; this was confirmed at rechallenge.
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Affiliation(s)
- F Erdkamp
- Department of Internal Medicine, Catharina Hospital, Eindhoven, Netherlands
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