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Fehr M, Lang N, Rubio L, Güsewell S, Templeton A, Aeppli S, Tsang R, Hodgson D, Moccia A, Bargetzi M, Caspar C, Brülisauer DMA, Ebnöther M, Fischer N, Prica A, Kukreti V, Ghilardi G, Krasniqi F, Mey UJ, Mingrone W, Novak U, Richter P, Kridel R, Rodin D, Rütti M, Schmidt A, Stenner F, Voegeli M, Zander T, Crump M, Hitz F, Kuruvilla J. PROGNOSTIC FACTORS IN ELDERLY PATIENTS WITH CLASSICAL HODGKIN LYMPHOMA ‐ A JOINT ANALYSIS OF TWO CLINICAL DATABASES. Hematol Oncol 2021. [DOI: 10.1002/hon.113_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M Fehr
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - N Lang
- Hôpitaux Universitaires Genève, Department of Oncology Genève Switzerland
| | - L Rubio
- Manchester Royal Infirmary, Haematology Manchester UK
| | - S Güsewell
- Cantonal Hospital St. Gallen, Clinical Trials Unit St. Gallen Switzerland
| | - A.J. Templeton
- Claraspital Basel, Oncology and Haematology Basel Switzerland
| | - S Aeppli
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - R Tsang
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - D Hodgson
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - A Moccia
- Oncology Institute of Southern Switzerland, Department of Medical Oncology Bellinzona Switzerland
| | - M Bargetzi
- Cantonal Hospital Aarau, Haematology Aarau Switzerland
| | - C Caspar
- Cantonal Hospital Baden, Oncology und Haematology Baden Switzerland
| | | | - M Ebnöther
- Claraspital Basel, Oncology and Haematology Basel Switzerland
| | - N Fischer
- Cantonal Hospital Winterthur, Medical Oncology and Haematology Winterthur Switzerland
| | - A Prica
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - V Kukreti
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - G Ghilardi
- Oncology Institute of Southern Switzerland, Haematology Bellinzona Switzerland
| | - F Krasniqi
- University Hospital Basel, Oncology Basel Switzerland
| | - U. J Mey
- Cantonal Hospital Grisons, Oncology and Haematology Chur Switzerland
| | - W Mingrone
- Cantonal Hospital Olten, Centre for Oncology Olten Switzerland
| | - U Novak
- University Hospital Bern, Medical Oncology Bern Switzerland
| | - P Richter
- Cantonal Hospital Grisons, Oncology and Haematology Chur Switzerland
| | - R Kridel
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - D Rodin
- Princess Margaret Cancer Centre, Radiation Oncology Toronto Switzerland
| | - M Rütti
- Hospital Wil, Medicine Wil Switzerland
| | - A Schmidt
- Stadtspital Triemli, Medical Oncology und Haematology Zürich Switzerland
| | | | - M Voegeli
- Cantonal Hospital Baselland, Oncology and Haematology Liestal Switzerland
| | - T Zander
- Cantonal Hospital Luzern, Medical Oncology Luzern Switzerland
| | - M Crump
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - F Hitz
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - J Kuruvilla
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
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Moccia AA, Aeppli S, Güsewell S, Bargetzi M, Caspar C, Brülisauer D, Ebnöther M, Fehr M, Fischer N, Ghilardi G, Krasniqi F, Lang N, Mey U, Mingrone W, Novak U, Pfleger C, Richter P, Rütti M, Schmidt A, Stenner F, Voegeli M, Zander T, Zucca E, Hitz F. Clinical characteristics and outcome of patients over 60 years with Hodgkin lymphoma treated in Switzerland. Hematol Oncol 2020; 39:196-204. [PMID: 33300135 DOI: 10.1002/hon.2830] [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] [Received: 11/21/2020] [Accepted: 12/06/2020] [Indexed: 11/09/2022]
Abstract
Hodgkin lymphoma (HL) in older patients appears to be a different disease compared with younger patients with historically lower survival rates. This is related to a variety of factors, including increased treatment-related toxicity, the presence of comorbidities, and biologic differences. In order to better assess the clinical characteristics, treatment strategies, and outcome of this particular population, we conducted a population-based, retrospective analysis including 269 patients with HL older than 60 years (median age 71 years, range 60-94), treated between 2000 and 2017 in 15 referral centers across Switzerland. Primary endpoints were overall survival (OS), progression-free survival (PFS), and cause-specific survival (CSS). The vast majority of patients were treated with curative intent, either with a combined modality approach (chemotherapy followed by radiation therapy) or with systemic therapy. At a median follow-up of 6.6 years (95% confidence interval [CI], 6.0-7.6), 5-year PFS was 52.2% (95% CI, 46.0-59.2), 5-year OS was 62.5% (95% CI, 56.4-69.2), and 5-year CSS was 85.1.8% (95% CI, 80.3-90.1) for the entire cohort. A significant difference in terms of CSS was observed for patients older than 71 years in comparison to patients aged 60-70 years (hazard ratio 2.6, 1.3-5.0, p = 0.005). Bleomycin-induced lung toxicity (BLT) was documented in 26 patients (17.7%) out of the 147 patients exposed to this compound and was more frequent in patients older than 71 years (15/60, 25%). Outcome of HL pts older than 71 years appeared to decrease substantially in comparison to the younger counterpart. Treatment-related toxicities appeared to be relevant, in particular, BLT. New, potentially less toxic strategies need to be investigated in prospective clinical trials in this particular frail population.
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Affiliation(s)
- A A Moccia
- Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - S Aeppli
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - S Güsewell
- Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - M Bargetzi
- Hematology, Kantonsspital Aarau, Aarau, Switzerland
| | - C Caspar
- Medical Oncology and Hematology, Kantonsspital Baden, Baden, Switzerland
| | - D Brülisauer
- Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - M Ebnöther
- Medical Oncology and Hematology, Claraspital, Basel, Switzerland
| | - M Fehr
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - N Fischer
- Medical Oncology and Hematology Clinic, Kantonsspital Winterthur, Winterthur, Switzerland
| | - G Ghilardi
- Hematology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F Krasniqi
- Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland
| | - N Lang
- Medical Oncology Clinic, University Hospital of Geneva, Genève, Switzerland
| | - U Mey
- Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - W Mingrone
- Medical Oncology Clinic, Kantonsspital Olten, Olten, Switzerland
| | - U Novak
- Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - C Pfleger
- Medical Oncology and Hematology, Claraspital, Basel, Switzerland
| | - P Richter
- Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - M Rütti
- Internal Medicine Clinic, Spital Wil, Wil, Switzerland
| | - A Schmidt
- Medical Oncology and Hematology Clinic, Stadtspital Triemli, Zürich, Switzerland
| | - F Stenner
- Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland
| | - M Voegeli
- Medical Oncology and Hematology Clinic, Kantonsspital Baselland, Liestal, Switzerland
| | - T Zander
- Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | - E Zucca
- Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F Hitz
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Joerger M, Metaxas Y, Schmitt A, Koeberle D, Zaman K, Betticher D, Mach N, Renner C, Mark M, Petrausch U, Caspar C, Britschgi C, Taverna C, Zenger F, Mingrone W, Schulz J, Kopp C, Hayoz S, Stathis A, von Moos R. LBA80 Outcome and prognostic factors of SARS CoV-2 infection in cancer patients: A cross-sectional study (SAKK 80/20 CaSA). Ann Oncol 2020. [PMCID: PMC7506361 DOI: 10.1016/j.annonc.2020.08.2321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ruhstaller T, Thuss-Patience P, Hayoz S, Schacher S, Knorrenschild JR, Schnider A, Plasswilm L, Budach W, Eisterer W, Hawle H, Mariette C, Hess V, Mingrone W, Montemurro M, Girschikofsky M, Schmidt SC, Bitzer M, Bedenne L, Brauchli P, Stahl M. Neoadjuvant chemotherapy followed by chemoradiation and surgery with and without cetuximab in patients with resectable esophageal cancer: a randomized, open-label, phase III trial (SAKK 75/08). Ann Oncol 2019; 29:1386-1393. [PMID: 29635438 DOI: 10.1093/annonc/mdy105] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background This open-label, phase III trial compared chemoradiation followed by surgery with or without neoadjuvant and adjuvant cetuximab in patients with resectable esophageal carcinoma. Patients and methods Patients were randomly assigned (1 : 1) to two cycles of chemotherapy (docetaxel 75 mg/m2, cisplatin 75 mg/m2) followed by chemoradiation (45 Gy, docetaxel 20 mg/m2 and cisplatin 25 mg/m2, weekly for 5 weeks) and surgery, with or without neoadjuvant cetuximab 250 mg/m2 weekly and adjuvant cetuximab 500 mg/m2 fortnightly for 3 months. The primary end point was progression-free survival (PFS). Results In total, 300 patients (median age, 61 years; 88% male; 63% adenocarcinoma; 85% cT3/4a, 90% cN+) were assigned to cetuximab (n = 149) or control (n = 151). The R0-resection rate was 95% for cetuximab versus 97% for control. Postoperative treatment-related mortality was 6% in both arms. Median PFS was 2.9 years [95% confidence interval (CI), 2.0 to not reached] with cetuximab and 2.0 years (95% CI, 1.5-2.8) with control [hazard ratio (HR), 0.79; 95% CI, 0.58-1.07; P = 0.13]. Median overall survival (OS) time was 5.1 years (95% CI, 3.7 to not reached) versus 3.0 years (95% CI, 2.2-4.2) for cetuximab and control, respectively (HR, 0.73; 95% CI, 0.52-1.01; P = 0.055). Time to loco-regional failure after R0-resection was significantly longer for cetuximab (HR 0.53; 95% CI, 0.31-0.90; P = 0.017); time to distant failure did not differ between arms (HR, 1.01; 95% CI, 0.64-1.59, P = 0.97). Cetuximab did not increase adverse events in neoadjuvant or postoperative settings. Conclusion Adding cetuximab to multimodal therapy significantly improved loco-regional control, and led to clinically relevant, but not-significant improvements in PFS and OS in resectable esophageal carcinoma. Clinical trial information NCT01107639.
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Affiliation(s)
- T Ruhstaller
- Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
| | | | - S Hayoz
- SAKK Coordinating Center, Berne, Switzerland
| | - S Schacher
- Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | | | - A Schnider
- City Hospital Triemli, Zürich, Switzerland
| | - L Plasswilm
- Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; University of Berne, Berne, Switzerland
| | - W Budach
- University Hospital Düsseldorf, Düsseldorf, Germany
| | - W Eisterer
- Medical University of Innsbruck, Innsbruck, Austria
| | - H Hawle
- SAKK Coordinating Center, Berne, Switzerland
| | - C Mariette
- Hôpital Universitaire C. Huriez, Lille, France
| | - V Hess
- University Hospital of Basel, Basel, Switzerland
| | - W Mingrone
- Cantonal Hospital of Olten, Olten, Switzerland
| | - M Montemurro
- University Hospital of Lausanne, Lausanne, Switzerland
| | | | - S C Schmidt
- Charité - University Medicine, Berlin, Germany
| | - M Bitzer
- University Hospital of Tübingen, Tübingen, Germany
| | - L Bedenne
- Hospital Center Regional University of Dijon, Dijon, France
| | - P Brauchli
- SAKK Coordinating Center, Berne, Switzerland
| | - M Stahl
- Kliniken Essen-Mitte, Essen, Germany
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Mauti L, Klingbiel D, Schmid S, Bouchaab H, Bartnick T, Gautschi O, Rothschild S, Loeffler M, Froesch P, Petrausch U, Wolleb Schild S, Mingrone W, Pratsch Peter S, Savic Prince S, Pless M, von Moos R, Metaxas Y. Pembrolizumab as second or further line treatment in relapsed malignant pleural mesothelioma: A Swiss registry. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx389] [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: 11/13/2022] Open
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Blum D, Koeberle D, Omlin A, Walker J, Von Moos R, Mingrone W, deWolf-Linder S, Hayoz S, Kaasa S, Strasser F, Ribi K. Feasibility and acceptance of electronic monitoring of symptoms and syndromes using a handheld computer in patients with advanced cancer in daily oncology practice. Support Care Cancer 2014; 22:2425-34. [DOI: 10.1007/s00520-014-2201-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
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Hitz F, Martinelli G, Zucca E, von Moos R, Mingrone W, Simcock M, Peterson J, Cogliatti SB, Bertoni F, Zimmermann DR, Ghielmini M. A multicentre phase II trial of gemcitabine for the treatment of patients with newly diagnosed, relapsed or chemotherapy resistant mantle cell lymphoma: SAKK 36/03. Hematol Oncol 2009; 27:154-9. [PMID: 19274614 DOI: 10.1002/hon.891] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mantle cell lymphoma (MCL) has a poor prognosis with often short and incomplete remissions. We aimed to test the efficacy and tolerability of gemcitabine in treating MCL. Gemcitabine was given in doses of 1000 mg/m(2) as a 30 min infusion on days 1 and 8 of each 3 week cycle for a maximum of nine cycles. Eighteen patients with a median age of 70 years were recruited. MCL was newly diagnosed in half of patients and relapsed in the remainder. Fifteen patients had Ann Arbor stage IV. The best-recorded responses were 1 CR (complete remission), 4 PRs (partial responses), 8 SDs (stable diseases) and 4 PDs (diseases progression). The response rate (RR) (CR + PR) was 5 (28%; 95% confidence interval: 7.1, 48.5). The patient achieving a CR had stage IV disease. Most haematological adverse events occurred during the first chemotherapy cycle. Three patients developed non-haematological serious adverse events: dyspnea, glomerular microangiopathy with haemolytic uremic syndrome (HUS) and hyperglycaemia. The median time-to-progression and treatment response duration (TRD) was 8.0 (95% confidence interval: 5.5, 9.3) and 10.6 (95% confidence interval: 5.5, 10.9) months, respectively. We conclude that Gemcitabine is well tolerated, moderately active and can induce disease stabilization in patients with MCL.
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Affiliation(s)
- F Hitz
- Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland.
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Ruhstaller T, Widmer L, Schuller J, Roth A, Hess V, Mingrone W, von Moos R, Borner M, Pestalozzi B, BalmerMajno S, Köberle D, Terraciano L, Schnider A, Bodis S, Popescu R. Multicenter phase II trial of preoperative induction chemotherapy followed by chemoradiation with docetaxel and cisplatin for locally advanced esophageal carcinoma (SAKK 75/02). Ann Oncol 2009; 20:1522-1528. [DOI: 10.1093/annonc/mdp045] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [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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Taverna CJ, Bassi S, Hitz F, Mingrone W, Pabst T, Cevreska L, del Giglio A, Vorobiof DA, Simcock M, Ghielmini M. First results of long-term rituximab maintenance treatment in follicular lymphoma: Safety analysis of the randomized phase III trial SAKK 35/03. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
8534 Background: Rituximab maintenance has been shown to be effective in patients with follicular lymphoma. The optimal duration of maintenance remains unknown. Methods: We prospectively registered 270 patients with untreated, chemotherapy resistant or relapsed follicular lymphoma. All patients received rituximab induction consisting of 4 weekly doses (375 mg/m2). Responding patients (PR and CR) were randomized to a short maintenance consisting of four doses of rituximab (375 mg/m2) every two months (arm A) or prolonged maintenance consisting of rituximab every two months for a maximum of five years or until progression or unacceptable toxicity (arm B). Primary endpoint was event-free survival. Here we present the safety analysis. Results: From October 2004 to November 2007 165 patients were randomized, 82 in arm A and 83 in arm B. The median follow up is 22.7 months. A total of 442 hematological and non-hematological adverse events were observed, 27 of grade 3 and 6 of grade 4. Five subsequent cancers and 9 grade 3 and 4 infections were reported. Grade 3 and 4 neutropenia occurred in 5 patients, decreased levels of IgG were observed in 19 patients. Four grade 3 infections occurred after 2 years of maintenance. In arm B, maintenance was stopped due to unacceptable toxicity (fever) in 1 patient after 18 months and due to subsequent breast cancer in 1 patient after 20 months. One patient died 4 months after randomization because of ileus and consecutive peritonitis; considered to be unrelated to therapy. Twenty-nine patients are on maintenance for two or more years of which 6 patients are on for three or more years. In this analysis, median duration of the prolonged maintenance is 23.7 months. Conclusions: Rituximab maintenance beyond two years is feasible. We do not have evidence for increased toxicity after 2 years of maintenance. However, close follow up of patients under prolonged rituximab maintenance is necessary. The trial has been closed for accrual but there are still patients on treatment. [Table: see text]
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Affiliation(s)
- C. J. Taverna
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - S. Bassi
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - F. Hitz
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - W. Mingrone
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - T. Pabst
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - L. Cevreska
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - A. del Giglio
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - D. A. Vorobiof
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - M. Simcock
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
| | - M. Ghielmini
- Kantonsspital Munsterlingen, Munsterlingen, Switzerland; Istituto Europeo di Oncologia, Milan, Italy; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Aarau/Olten, Olten, Switzerland; Inselspital Bern, Bern, Switzerland; Department of Hematology, Skopje, Macedonia, The Former Yugoslav Republic of; Hematology and Oncology, ABC Fondation, Sao Paulo, Brazil; Sandton Oncology Center, Johannesburg, South Africa; Swiss Group for Clinical Cancer Research SAKK, Bern, Switzerland; Oncology
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Schuller JC, Balmer-Majno S, Mingrone W, Hess V, von Moos R, Borner M, Schnider A, Koeberle D, Popescu RA, Ruhstaller T. Preoperative induction chemotherapy with docetaxel-cisplatin followed by concurrent docetaxel-cisplatin and radiation therapy (RT) in patients with locally advanced esophageal cancer: Final results of the multicenter phase ll trial SAKK 75/02. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gerber D, Dietrich D, Koeberle D, Saletti P, Borner M, Caspar CB, Mingrone W, Beretta K, Herrmann R. Clinical benefit and quality of life in patients with advanced biliary tract cancer receiving gemcitabine plus capecitabine (GemCap): Results from a multicenter phase II trial (SAKK 44/02). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15531] [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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Borner M, Koeberle D, Von Moos R, Saletti P, Rauch D, Hess V, Trojan A, Helbling D, Pestalozzi B, Caspar C, Ruhstaller T, Roth A, Kappeler A, Dietrich D, Lanz D, Mingrone W. Adding cetuximab to capecitabine plus oxaliplatin (XELOX) in first-line treatment of metastatic colorectal cancer: a randomized phase II trial of the Swiss Group for Clinical Cancer Research SAKK. Ann Oncol 2008; 19:1288-1292. [PMID: 18349029 DOI: 10.1093/annonc/mdn058] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To determine the activity and tolerability of adding cetuximab to the oxaliplatin and capecitabine (XELOX) combination in first-line treatment of metastatic colorectal cancer (MCC). PATIENTS AND METHODS In a multicenter two-arm phase II trial, patients were randomized to receive oxaliplatin 130 mg/m(2) on day 1 and capecitabine 1000 mg/m(2) twice daily on days 1-14 every 3 weeks alone or in combination with standard dose cetuximab. Treatment was limited to a maximum of six cycles. RESULTS Seventy-four patients with good performance status entered the trial. Objective partial response rates after external review and radiological confirmation were 14% and 41% in the XELOX and in the XELOX + Cetuximab arm, respectively. Stable disease has been observed in 62% and 35% of the patients, with 76% disease control in both arms. Cetuximab led to skin rash in 65% of the patients. The median overall survival was 16.5 months for arm A and 20.5 months for arm B. The median time to progression was 5.8 months for arm A and 7.2 months for arm B. CONCLUSION Differences in response rates between the treatment arms indicate that cetuximab may improve outcome with XELOX. The correct place of the cetuximab, oxaliplatin and fluoropyrimidine combinations in first-line treatment of MCC has to be assessed in phase III trials.
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Affiliation(s)
- M Borner
- Institute of Medical Oncology, Inselspital, Bern, Switzerland.
| | - D Koeberle
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - R Von Moos
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - P Saletti
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Rauch
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - V Hess
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - A Trojan
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Helbling
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - B Pestalozzi
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - C Caspar
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - T Ruhstaller
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - A Roth
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - A Kappeler
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Dietrich
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Lanz
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - W Mingrone
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
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- Institute of Medical Oncology, Inselspital, Bern, Switzerland
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13
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Ruhstaller T, Widmer L, Balmer Majno S, Mingrone W, Hess V, von Moos R, Borner M, Schnider A, Koeberle D, Popescu R. Preoperative induction chemotherapy with docetaxel-cisplatin followed by concurrent docetaxel-cisplatin and radiation therapy in patients with locally advanced esophageal cancer: A prospective, multicenter phase ll trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4562] [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
4562 Background: The role of preoperative therapy in patients (pts) with locally advanced esophageal cancer remains unclear. Non-randomized and randomized studies were often performed in single and highly specialized centers. The purpose of this study was to investigate 1) the efficacy and toxicity of preoperative docetaxel-cisplatin together with radiation therapy (RT) 2) the feasibility of a complex preoperative strategy in a community-based multicenter setting. Methods: Eligibility criteria: resectable, locally advanced (uT3 or uN1, T4 if deemed resectable) squamous cell carcinoma (SCC) or adenocarcinoma (AC) of the thoracic esophagus or gastroesophageal junction (Siewert type l); staged by EUS, CT and PET scan; age 18–70y; PS <2; normal organ functions. Treatment: 2 cycles of docetaxel 75mg/m2 and cisplatin 75mg/m2 q3w, followed by weekly x5 docetaxel 20mg/m2 and cisplatin 25mg/m2 with concomitant 45 Gy RT in 25 fractions; surgery 3- 8 weeks after RT. A two stage-design was used with two primary endpoints: 1) efficacy (TRG : tumor regression grade ); 2) feasibility (successful completion of entire therapy and being alive 30 days after surgery). Results: 66 pts, 56 males, were included from 11 institutions; median age 61y (35–70y); AC 53%; SCC 46%; 53 pts (80%) completed the preoperative therapy, underwent resection and were alive 30 days after surgery; 10 pts (15%) had no resection (4 progressive disease, 4 medical reasons, 2 patient’s refusal). Of 56 (85%) pts who had surgery, 51 pts had RO-resection (91%), 5 pts (9%) died due to complications after surgery (3 after > 30 days). Conclusion: Our trimodality treatment shows encouraging antineoplastic activity with 57% histopathological responders (TRG1 and 2) and acceptable feasibility in a community-based multicenter setting. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- T. Ruhstaller
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - L. Widmer
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - S. Balmer Majno
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - W. Mingrone
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - V. Hess
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - R. von Moos
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - M. Borner
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - A. Schnider
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - D. Koeberle
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - R. Popescu
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
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14
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Weder W, Stahel RA, Bernhard J, Bodis S, Vogt P, Ballabeni P, Lardinois D, Betticher D, Schmid R, Stupp R, Ris HB, Jermann M, Mingrone W, Roth AD, Spiliopoulos A. Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma. Ann Oncol 2007; 18:1196-202. [PMID: 17429100 DOI: 10.1093/annonc/mdm093] [Citation(s) in RCA: 218] [Impact Index Per Article: 12.8] [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: 12/23/2022] Open
Abstract
BACKGROUND The aim of this multicenter trial was to prospectively evaluate neo-adjuvant chemotherapy followed by extrapleural pneumonectomy (EPP) and radiotherapy, including quality of life as outcome. PATIENTS AND METHODS Eligible patients had malignant pleural mesothelioma of all histological types, World Health Organization performance status of zero to two and clinical stage T1-T3, N0-2, M0 disease considered completely resectable. Neo-adjuvant chemotherapy consisted of three cycles of cisplatin and gemcitabine followed by EPP. Postoperative radiotherapy was considered for all patients. RESULTS In all, 58 of 61 patients completed three cycles of neo-adjuvant chemotherapy. Forty-five patients (74%) underwent EPP and in 37 patients (61%) the resection was complete. Postoperative radiotherapy was initiated in 36 patients. The median survival of all patients was 19.8 months [95% confidence interval (CI) 14.6-24.5]. For the 45 patients undergoing EPP, the median survival was 23 months (95% CI 16.6-32.9). Psychological distress showed minor variations over time with distress above the cut-off score indicating no morbidity with 82% (N = 36) at baseline and 76% (N = 26) at 3 months after surgery (P = 0.5). CONCLUSIONS The observed rate of operability is promising. A median survival of 23 months for patients undergoing EPP compares favourably with the survival reported from single center studies of upfront surgery. This approach was not associated with an increase in psychological distress.
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Affiliation(s)
- W Weder
- Department of Thoracic Surgery, University Hospital Zurich, Switzerland
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15
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Borner M, Mingrone W, Koeberle D, Von Moos R, Rauch D, Saletti P, Herrmann R, Dietrich D, Lanz D, Roth A. The impact of cetuximab on the capecitabine plus oxaliplatin (XELOX) combination in first-line treatment of metastatic colorectal cancer (MCC): A randomized phase II trial of the Swiss Group for Clinical Cancer Research (SAKK). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3551] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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
3551 Background: XELOX is a valuable alternative to continuous infusion FOLFOX type regimens in the treatment of MCC (Borner et al, JCO 2002, 1759). Cetuximab is an EGFR antibody, which has been shown to improve the efficacy of chemotherapy. A phase II study in first-line treatment of MCC has demonstrated a high response rate combining cetuximab with FOLFOX (Tabernero et al, Proc ASCO 2004, 3512). Methods: Multicenter, randomized two-arm phase II trial: OXA 130 mg/m2 day 1 and oral CAP 1000 mg/m2 bid days 1–14 every 21 days alone or in combination with cetuximab 250 mg/m2 weekly after a loading dose of 400 mg/m2. Treatment was limited to a maximum of 6 cycles. With 37 patients in each arm, the power was 90% to select the truly better arm if the true between-arm difference in response rate (RECIST) is at least 15%. The study was open for accrual until October 2005. Results: We present here the results of 74 patients included in the study. In 67 patients the first response data are available (investigators’ assessment after 3 cycles). The two arms are well balanced for relevant patient, disease and treatment characteristics. The study treatment was well tolerated with grade 3/4 toxicities in < 10% of the cycles in each arm. The frequency of side effects was balanced, but with more frequent skin toxicity in the cetuximab arm (6% versus 0% grade 3/4). Conclusions: Cetuximab seems to positively interact with XELOX in terms of efficacy but not toxicity. The cetuximab/XELOX combination appears to be a valuable option in first-line treatment of MCC especially if high response rates are a primary objective. This trial was supported in part by Merck KGaA and Sanofi-Aventis Switzerland. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- M. Borner
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - W. Mingrone
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - D. Koeberle
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - R. Von Moos
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - D. Rauch
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - P. Saletti
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - R. Herrmann
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - D. Dietrich
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - D. Lanz
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - A. Roth
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
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16
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Pfreundschuh MG, Ho A, Wolf M, Cavallin-Stahl E, Pettengell R, Vasova I, Belch A, Walewski J, Zinzani PL, Mingrone W, Loeffler M. Treatment results of CHOP-21, CHOEP-21, MACOP-B and PMitCEBO with and without rituximab in young good-prognosis patients with aggressive lymphomas: Rituximab as an “equalizer” in the MInT (MABTHERA International Trial Group) study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6529] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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)
- M. G. Pfreundschuh
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - A. Ho
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - M. Wolf
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - E. Cavallin-Stahl
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - R. Pettengell
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - I. Vasova
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - A. Belch
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - J. Walewski
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - P.-L. Zinzani
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - W. Mingrone
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
| | - M. Loeffler
- Univklin des Saarlandes, Homburg, Germany; Med. Poliklinik, Universität Heidelberg, Germany; Peter MacCallum Cancer Ctr, East Melbourne, Australia; Univ Hosp, Lund, Sweden; St George Hosp, London, United Kingdom; Masaryk Univ Hosp, Brno-Bohunice, Czech Republic; Cross Cancer Institute, Edmonton, AB, Canada; M. Sklodowska-Curie Memorial Institute, Warsaw, Poland; Inst di Ematologia, Bologna, Italy; Kantonsspital, Aarau, Switzerland; IMISE, Leipzig, Germany
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Stahel RA, Weder W, Ballabeni P, Betticher D, Schmid R, Stupp R, Ris HB, Roth A, Mingrone W, Bodis S. Neoadjuvant chemotherapy followed by extrapleural pneumonectomy for malignant pleural mesothelioma (MPM): A multicenter phase II trial of the SAKK. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. A. Stahel
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - W. Weder
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - P. Ballabeni
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - D. Betticher
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - R. Schmid
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - R. Stupp
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - H.-B. Ris
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - A. Roth
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - W. Mingrone
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
| | - S. Bodis
- Swiss Group for Clinical Cancer Research (SAKK), and Swiss Institute for Applied Cancer Research, Switzerland
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18
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Martinelli G, Ferrucci PF, Mingrone W, Cocorocchio E, Conconi A, Peccatori FA, De Luzio K, Santoro P, Mazzetta C, Zucca E, Cavalli F. ACOD, a modified CHOP regimen for elderly patients with aggressive non-Hodgkin's lymphoma. Leuk Lymphoma 2003; 44:801-6. [PMID: 12802917 DOI: 10.1080/1042819031000067981] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 10/27/2022]
Abstract
The aim of this study is to verify the feasibility and the clinical activity of a new CHOP-like schedule (ACOD) with a fractionated days 1 and 8 administration in elderly patients. This regimen was chosen in the attempt to allow a sufficient dose intensity (DI) of each drug with better compliance. Fifty-two patients, (74 years, median age), with diffuse large B cell non-Hodgkin's lymphoma were retrospectively evaluated. Patients received ADM 25 mg/sqm, CTX 500 mg/sqm, VCR 1.2 mg/sqm (max 2 mg intravenously) days 1 and 8 and PDN 50 mg orally, days 1-8. Results showed that 54% of patients reached a complete remission, 21% a partial remission with an overall response rate of 75%. Two-thirds of the patients received at least 70% of the planned dose of cyclophosphamide and doxorubicin and 50% of vincristine and prednisone. The median duration of follow up was 12.6 months (range 0.7-61.4). The estimated median OS was 15.2 months (95%CI = [11.6, not estimable]); the estimated median PFS was 5.7 months (95%CI = [5.12, not estimable]). After 2 years, the proportion of patients alive was 47% (95%CI = 34-64%) and the proportion of patients free from progression was 39% (95%CI = 27-57%). Grade 3-4 leukopenia was observed in 61% of patients with 11% of febrile neutropenia. In conclusion, the ACOD chemotherapy regimen seems safe and feasible in elderly patients. This schedule allowed a sufficient DI of chemotherapic agents with clinical results very similar to those recorded with the standard CHOP regimen in young adults.
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Affiliation(s)
- G Martinelli
- Division of Hematoncology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
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19
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Bargetzi MJ, Passweg J, Baertschi E, Schoenenberger A, Gwerder C, Tichelli A, Burger J, Mingrone W, Herrmann R, Gratwohl A, Wernli M. Mobilization of peripheral blood progenitor cells with vinorelbine and granulocyte colony-stimulating factor in multiple myeloma patients is reliable and cost effective. Bone Marrow Transplant 2003; 31:99-103. [PMID: 12621490 DOI: 10.1038/sj.bmt.1703787] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [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: 02/07/2023]
Abstract
Cyclophosphamide with granulocyte colony stimulating factor (G-CSF) is commonly used to mobilize stem cells in multiple myeloma. Timing of collection is variable and incidence and severity of side effects is substantial. To optimize timing of collection, to reduce side effects and to limit costs of the procedure, we evaluated vinorelbine, a drug shown to have activity in multiple myeloma, in combination with G-CSF as mobilizing regimen. A total of 19 consecutive patients with advanced stage multiple myeloma received one dose of vinorelbine 35 mg/m(2) intravenously on day 1 in an outpatient setting and G-CSF 10 microg/kg/day from day 4 divided in two daily doses. Median CD34+ cell blood counts measured on day 8 of mobilization were 142 x 10(6)/l (range 57-467). One 15-l apheresis on day 8 resulted in sufficient stem cells (median 11.1 x 10(6) CD34+ cells/kg, range 6.2-36.0 prior and median 7.5 x 10(6) CD34+ cells/kg, range 4.0-20.2 post-positive CD34+ cell selection) for transplantation. Hematopoietic recovery was swift with ANC >0.5 x 10(9)/l on day 11 median (range 10-15) and platelets >20 x 10(9)/l on day 12 median (range 10-15) after reinfusion of the stem cells on day 0. No episodes of febrile neutropenia were observed during mobilization. In our institutions cost reduction for the procedure was about 1700 euros compared to the mobilization with cyclophosphamide and G-CSF. Vinorelbine and G-CSF allow precise timing and harvesting of sufficient stem cells, and might be an alternative to cyclophosphamide in the mobilization of stem cells for autologous transplantation in multiple myeloma.
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Affiliation(s)
- M J Bargetzi
- Center of Oncology/Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau, Switzerland
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20
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Bertolini F, Mingrone W, Alietti A, Ferrucci PF, Cocorocchio E, Peccatori F, Cinieri S, Mancuso P, Corsini C, Burlini A, Zucca E, Martinelli G, Cineri S. Thalidomide in multiple myeloma, myelodysplastic syndromes and histiocytosis. Analysis of clinical results and of surrogate angiogenesis markers. Ann Oncol 2001; 12:987-90. [PMID: 11521807 DOI: 10.1023/a:1011141009812] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [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
BACKGROUND Thalidomide, as a single agent, has been recently found to induce a clinical response in one third of refractory or relapsed myeloma patients. Although it has been reported that thalidomide significantly inhibits angiogenesis. it is still unclear whether its clinical effect is mediated, at least in part, by its anti-angiogenic properties. PATIENTS AND METHODS We evaluated thalidomide as a single agent in myeloma, myelodysplastic syndromes (MDS) and histiocytosis, i.e. hematological diseases characterized by increased angiogenesis, and measured prospectively a number of surrogate angiogenesis markers. RESULTS Clinical responses were observed in 7 of 17 myeloma and 2 of 5 MDS patients. The histiocytosis patient had a partial response. At the time of the best clinical response, plasma levels of angiogenic growth factors, vascular endothelial growth factor (VEGF) and basic-fibroblast growth factor (b-FGF), were significantly decreased, and flow cytometry indicated a decrease of activated endothelial cells in the bone marrow of responding MDS patients. CONCLUSIONS These observations confirm thalidomide efficacy in myeloma, suggest a possible use in MDS and histiocytosis and may contribute to the prediction of clinical response and to understanding the mechanism of thalidomide's action.
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Affiliation(s)
- F Bertolini
- Division of Hematology-Oncology, European Institute of Oncology, Milan, Italy.
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21
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Abstract
Prognosis of DLCL patients is variable and associated with well-defined risk factors. In the past decade several pretreatment variables have been incorporated into prognostic models to predict the death risk of individual patients. The International Prognostic Index (IPI), developed in an international consensus study, has been one of the most widely accepted of these models. In our study we applied some of the major prognostic models proposed for DLCLs in a cohort of 111 patients uniformly treated with a CHOP-like regimen in order to compare their sensitivity and specificity. We also evaluated the possibility of improving the IPI with the inclusion, from among the variables analysed, of serum beta-2 microglobulin level (beta-2M). The sensitivity, reflecting the ability to predict all failures in the cohort of patients as a whole, has improved from 45 to 73 per cent when the beta-2M-IPI model is compared with IPI, without a significant loss of specificity. Based on these results, the beta-2M-IPI may be useful for identifying the subset of patients with very poor prognoses. Therefore, the use of the serum beta-2M value in addition to the IPI may help in selection of the patients with DLCL at higher risk for treatment failure, and identification of those who may require specifically tailored therapeutic approaches.
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Affiliation(s)
- A Conconi
- Istituto Oncologico della Svizzera Italiana, Divisione di Oncologia Medica, Ospedale San Giovanni, Bellinzona, Switzerland
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Bertoni F, Gisi M, Roggero E, Conconi A, Mingrone W, Cavalli F, Zucca E. Molecular detection of circulating neoplastic cells in patients with clinically localised gastric and non-gastric mucosa-associated lymphoid tissue lymphoma. Dig Liver Dis 2000; 32:188-91. [PMID: 10975766 DOI: 10.1016/s1590-8658(00)80818-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Unlike other low-grade lymphomas, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type usually presents with localised disease. AIM To detect peripheral blood lymphoma involvement to establish the incidence of occult lymphoma dissemination. PATIENTS AND METHODS In a series of 18 cases, peripheral blood was analysed by polymerase chain reaction, with primers directed to the third-complementarity determining region of the immunoglobulin heavy chain gene. RESULTS AND CONCLUSION The presence of circulating neoplastic cells was detected in 21% of clinically localised cases. Moreover lymphoma cells were detected in 2 out of 6 morphologically normal bone marrow specimens. The present data show that, combining morphological and molecular methods, occult dissemination can be found in a large proportion of cases thus stressing the need for careful staging procedures. However, it has still to be clarified whether the presence of polymerase chain reaction-detectable circulating lymphoma cells can influence the outcome of mucosa-associated lymphoid tissue lymphoma patients submitted to antibiotic treatment (for gastric localisation) or local therapy (surgery or radiation, for non-gastric tumours).
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Affiliation(s)
- F Bertoni
- Istituto Oncologico della Svizzera Italiana, Divisione di Oncologia Medica, Ospedale San Giovanni Bellinzona, Switzerland
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Abstract
We analyzed topography and strength of 20 channel event-related potential maps to sentence endings differing in correctness, verbal vs. nonverbal surface form, priming, and repetition count. Seventeen healthy subjects silently read correct and incorrect versions of simple sentences with predictable color endings, and of more complex sentences with predictable composite word endings. Color endings appeared in verbal and nonverbal form. Measures of map topography (centroids of the positive and negative areas of the average referenced maps) and strength (Global Field Power) were analyzed. Adaptive segmentation distinguished a pre-N400 and a N400 microstate in the N400 time range. Topography differed between these two microstates, between verbal and nonverbal endings, and between correct color, incorrect color, and incorrect noncolor words. All verbal endings evoked left-laterlized negativity and right lateralized positivity in the pre-N400 microstates. Correct verbal endings evoked consistent posterior postivity and anterior negativity with left-lateralized gradient strength suggesting language-specific processing. New, incorrect noncolor words evoked reversed anterior-posterior N400 and pre-N400 map topographies with more anterior positivity and more posterior negativity than correct colors in each subject. Gradient strength and current source density maps also differed from those to correct colors. Strongest gradients were left-posterior in the pre-N400 but anterior in the N400 microstate, consistent with anterior activity contributing to the posterior N400 negativity. Incorrect and correct colors, which were semantically primed and repeated, showed smaller topographic differences and N400 effects with a different topography. These different maps can not arise by modulation of a single pattern of neural activity and show that the N400 time range consists of multiple distinct microstates.
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Affiliation(s)
- D Brandeis
- Department of Neurology, University Hospital, Zürich, Switzerland.
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