scholarly journals Overall Survival and Response to Systemic Therapy in Metastatic Extrauterine Leiomyosarcoma

Sarcoma ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
A. N. Shoushtari ◽  
J. Landa ◽  
D. Kuk ◽  
A. Sanchez ◽  
B. Lala ◽  
...  
Keyword(s):  
Overall Survival ◽  
Systemic Therapy ◽  
Objective Response ◽  
Soft Tissue Sarcomas ◽  
Older Age ◽  
First Line ◽  
Risk Of Death ◽  
First Line Therapy ◽  
Line Therapy ◽  
Male Sex

Background. Leiomyosarcomas (LMS) represent a heterogeneous subset of soft tissue sarcomas. Factors influencing prognosis for patients with metastatic extrauterine LMS (euLMS) are not well described. Limited data are available regarding responses to systemic therapy.Methods. We collected clinical and pathologic information for all patients with metastatic euLMS seen at Memorial Sloan Kettering Cancer Center between 1989 and 2012. Objective responses to first-line therapy were analyzed for a subset of patients with available baseline and on-treatment imaging using RECIST 1.1.Results. 215 patients with metastatic euLMS had a median overall survival (OS) of 2.6 years from the time of metastasis. Older age, male sex, and ≥3 initial sites of metastasis were associated with worse OS on multivariate analysis. Objective response rate (ORR) inN=113was 19% overall and 25%, 26%, and 25% for gemcitabine, gemcitabine plus docetaxel, and anthracycline-alkylator combinations. Patients whose tumors objectively responded to first-line therapy had a lower risk of death versus those who did not (Hazard Ratio 0.46; 95% CI: 0.26–0.79,p=0.005).Conclusions. Anthracycline- and gemcitabine-based regimens have similar activity in this cohort of euLMS. Prognostic factors for OS include older age, male sex, and ≥3 initial sites.

scholarly journals Efficiency of lenalidomide, bortezomib and prednisone (RVP) in patients with newly diagnosed multiple myeloma

2019 ◽  
Vol 14 (1) ◽  
pp. 14-19 ◽  
Author(s):  
K. A. Belousov ◽  
T. A. Mitina ◽  
Yu. Yu. Chuksina ◽  
A. K. Golenkov ◽  
E. V. Kataeva ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Objective Response ◽  
Hematological Toxicity ◽  
Efficacy And Safety ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Objective: to study the efficacy and safety of the antitumor RVP program (lenalidomide, bortezomib, prednisone) as a first-line therapy in patients with multiple myeloma (MM). Materials and methods. A prospective study involved 39 patients with MM (15 women, 24 men), median age 61 years (30–76 years). All patients had Durie–Salmon stage III disease. According to the paraprotein isotype variant, 19 patients (48.7 %) had Gk myeloma, 8 (20.5 %) had Gλ, 4 (10.2 %) – Ak, 1 – Aλ, 1 – Dk, 1 – paraproteinemia Bens-Jones k and 1 – Bens-Jones λ, 2 – Dλ, and 2 patients – nonsecreting MM. The average level of plasma cells in the bone marrow was 31.7 % (0.8–80.0 %). In 14 (35.8 %) patients there were plasmacytomas of various localization (spine, cranial bones, clavicle, pleura). Nine (23.0 %) patients had renal failure, requiring the start of renal replacement therapy. The average Karnovsky index in the study group was 50 %. All patients received RVP therapy (lenalidomide 25 mg in 1–14 days, bortezomib 1.3 mg subcutaneously in 1, 4, 8, 11 days, prednisolone 60 mg/m2; the interval between courses was 42 days) as the first line therapy. Evaluation of therapy efficacy, characterized by overall survival, objective response rates (the number of complete, very good partial and partial remissions) was performed after 6 treatment courses. Results. The median follow-up was 15 months; the median of overall survival was not achieved. Objective antitumor response achieved in 29 (74.3 %) patients, including complete remissions in 3 (7.6 %), very good partial remissions – in 7 (17.9 %), partial remissions – in 19 (48.7 %) patients. In 2 out of 9 patients who received renal replacement therapy, independence from dialysis therapy was achieved. Cases of III–IV stage hematological and non-hematological toxicity in the study were not noted. Conclusion. The antitumor RVP program showed high efficacy and safety as a first-line therapy in a non-selective group of patients, including those with a complicated MM course.

Co-Morbidity Score at the Time of Transplant Determines Prognosis in Older Patients Who Develop Acute Graft-Vs.-Host Disease (GVHD).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2244-2244
Author(s):  
Amin M Alousi ◽  
Gabriela Rondon ◽  
Grace-Julia Okoroji ◽  
Uday Popat ◽  
Leandro De Padua Silva ◽  
...  
Keyword(s):  
Systemic Therapy ◽  
Acute Gvhd ◽  
Univariate Analysis ◽  
Conditioning Regimen ◽  
Older Age ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Morbidity Score ◽  
Co Morbidity

Abstract Abstract 2244 Poster Board II-221 Background: Older age patients are increasingly being considered for allogeneic hematopoietic cell transplants (HCT). Concerns related to early treatment related mortality (TRM), namely from acute GVHD, often limit referrals. Outcomes for older age patients who develop acute GVHD remain unknown. Methods: We performed a retrospective analysis of 83 adult patients enrolled onto two consecutive trials at MD Anderson to determine predictors for TRM at 6 months following systemic treatment of acute GVHD. These trials enrolled patients with newly diagnosed acute GVHD between 2000-2008 and included a single-center randomized trial of infliximab + methylprednisolone (MP) vs. MP alone and a multicenter trial of MP + one of 4 agents (mycophenolate, etanercept, denileukin diftitox or pentostatin). Results: Median age was 49 yrs (range, 20-70 yrs) and 63% of patients (pts) were male. 52% had acute leukemia and 31% were in remission at the time of transplant. Myeloablative condition and/ or peripheral blood HCT were performed in 52% and 54% of pts, respectively. Matched sibling, matched unrelated and mismatched transplants were 49%, 40% and 11%. GVHD prophylaxis was tacrolimus/ methotrexate in 87% of pts. Grades I/II, III/IV and visceral-organ acute GVHD represented 68%, 32% and 60% of pts occurring at a median time of onset of 25 days post-HCT. Day 28 acute GVHD response (defined as complete or partial response) was 63%. The median co-morbidity score at the time of HCT was 3 (range 0-11). Co-morbidity scores >3 were more common in pts >50 yrs (47%) than in those '50 yrs (24%), p=0.03. The proportion of responders on day 28 was comparable in pts >50 yrs (60%) and those '50 yrs (64%), p=0.7. On univariate analysis, significant predictors of higher TRM rate at 6 months following initiation of systemic therapy for acute GVHD were lack of response on day 28 post therapy (Hazard Ratio (HR) 3.6, p= 0.004), age > 50 yrs (HR 2.9, p=0.03) and co-morbidity score >3 (HR 3.1, p=0.01). There was no significant impact on the rate of TRM for donor type, cell source, intensity of conditioning regimen, donor/recipient sex mismatch, disease status at the time of transplant, GVHD grade at the time of initiation of systemic therapy or protocol assigned therapy. To adjust for potential interaction and confounding effects, multivariate analysis was performed by classifying pts into mutually exclusive groups according to day 28 response status, age, and co-morbidity score (see table). The cumulative incidence of TRM was lowest in pts who were '50 yrs of age and who responded to first line therapy with co-morbidity scores not impacting outcomes. TRM was comparably low (15%) in the absence of co-morbidity scores >3 in pts >50 yrs who responded to first line therapy. In contrast, in the presence of co-morbidity scores >3, TRM rate was high in pts >50 yrs regardless of whether pts responded (40%) or did not respond (100%) to first line therapy. Conclusion: The ability to withstand acute GVHD and/ or its therapy in pts older than 50 yrs depends on co-morbidity scores at the time of transplant. Disclosures: No relevant conflicts of interest to declare.

The outcome of vincristine, dactinomycin D, ifosfamide and doxorubicin (VAIA) as first-line therapy for adult-patients with metastatic ewing sarcoma; a single-center experience.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23501-e23501 ◽  
Author(s):  
Jean Paul Atallah ◽  
Mahmoud Abdelsatar Elshenawy ◽  
Ahmed ali Badran ◽  
Maaz Kamal Alata ◽  
Ahmed Gad ◽  
...  
Keyword(s):  
Overall Survival ◽  
Ewing Sarcoma ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Objective Response ◽  
Adult Patients ◽  
Categorical Variables ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

e23501 Background: Ewing sarcoma family of tumors (ESFT) is a rare malignancy among adults. Most studies from western countries have reported improvement in outcomes following multi-agent chemotherapy. We report our experience in the management of this disease among Arab ethnicity. The aim of this study is to assess the outcome of VAIA combination as a first-line treatment in Adult-patients with metastatic Ewing sarcoma. Methods: Patients who were newly diagnosed as metastatic Ewing sarcoma between 03/1997 and 11/2016 at King Faisal Specialist Hospital and Research Center, who received VAIA as first-line therapy were eligible. The patient's characteristics were summarized using Medians with interquartile ranges (IQR) and frequencies for continuous and categorical variables, respectively. Variables including age, sex, primary tumor size, site (skeletal vs extraskeletal) and extent of metastasis in correlation with progression and overall survival were analyzed using the Kaplan–Meier method and Cox proportional hazards regression. Results: Thirty-nine patients were identified. Male (26, 66.7%), Female (13, 33.3%). Skeletal (27, 69.2%), Extraskeletal (12, 30.8%). The median longest diameter of the primary tumor 9.75 (IQR 8-15). The most common metastatic sites were Lungs (22, 56.4%) & Bone (10, 25.6%), however, the least common sites were Bone Marrow (3, 7.7%) and liver (2, 5.1%). The median number of VAIA cycles was 10 cycles (IQR 5-14). Objective response rate (ORR) was noticed in 20 patients (51.2%) (Complete Remission (7, 17.9%), Partial Remission (13, 33.3%). One patient had stable disease and 12 (30.8%) patients had progressive disease. The assessment was not feasible in 3 (7.7%) patients. With a median follow up duration of 18 months (1-44).20 patients died (62.5%). The median PFS and OS was 10,18 months respectively with 3,5 years overall survival rate of;35.7%,26.9% respectively. Univariate analysis correlation among different variables were insignificant. Conclusions: VAIA chemotherapy combination showed poor outcomes among our patients in comparison to literature further improvement is needed in this aggressive malignancy in our region.

scholarly journals Сurrent options and perspectives of systemic therapy for advanced or metastatic adrenocortical cancer

2022 ◽  
Vol 11 (3) ◽  
pp. 36-44
Author(s):  
Ya.  A. Zhulikov ◽  
E.  I. Kovalenko ◽  
V.  Yu. Bokhian ◽  
E.  V. Artamonova
Keyword(s):  
Systemic Therapy ◽  
Chemotherapy Regimen ◽  
Objective Response ◽  
Adrenocortical Cancer ◽  
First Line ◽  
Second Line Therapy ◽  
Therapeutic Concentration ◽  
The Third ◽  
First Line Therapy ◽  
Line Therapy

Adrenocortical cancer is an orphan tumor with poor prognosis. The combination of EDP chemotherapy regimen and mitotane is the standard for the first‑line therapy. But there are no effective options for the second and consequent lines of therapy. The standard of second‑line therapy is the combination of gemcitabine, capecitabine and mitotane, which provides an objective response in 4–7 % of patients. Achievement of the therapeutic concentration of mitotane is the most important predictive factor of efficiency of GemCap + mitotane regimen, and, therefore, it is recommended to continue mitotane therapy after progression to mitotane. Recently, many researches regarding the efficiency of targeted and immunotherapy of adrenocortical cancer have been published. However, there are no standards for the third and subsequent lines of treatment. This review outlines the current views and perspectives of systemic therapy for advanced and metastatic adrenocortical cancer.

scholarly journals The first-line therapy of aggressive non-Hodgkin’s lymphomas in russian clinical practice: data from the EQUILIBRIUM study

2020 ◽  
Vol 15 (2) ◽  
pp. 10-18
Author(s):  
L. G. Babicheva ◽  
I. V. Poddubnaya
Keyword(s):  
Overall Survival ◽  
Clinical Practice ◽  
Complete Remission ◽  
B Cell ◽  
Long Term Results ◽  
First Line ◽  
Therapy Efficacy ◽  
First Line Therapy ◽  
Line Therapy ◽  
Hodgkin's Lymphomas

The objective: evaluation of effectiveness of the first-line therapy with rituximab of B-cell lymphoproliferative diseases in Russian clinical practice in the period from 2014 to 2017.Materials and methods. The EQUILIBRIUM post-registration multicenter study included 1000 patients aged 21 to 91 years old with a verified diagnosis of B-cell non-Hodgkin’s lymphoma, or chronic lymphocytic leukemia, who received at least 4 cycles of rituximab-containing therapy with Acellbia®. The group of aggressive non-Hodgkin’s lymphomas (aNHL), which is the subject of this article, included 295 patients with a median age of 55.9 years: diffuse B-large cell lymphoma – 87 %, primary mediastinal lymphoma – 11 %, Burkitt’s lymphoma – 1 %. Group characterized by the presence of aggressive clinical signs reflecting the poor prognosis: in the majority of patients, generalized stages were diagnosed (61 %), in half of the cases (50.2 %), extranodal localization of tumor foci was detected (in 32.4 % of patients there were 2 or more). The overwhelming majority of patients (84.5 %) received adequate treatment complying with national and international recommendations (R-CHOP, R-CHOEP and R-EPOCH, high-intensity NHL-BFM-R, R-HyperCVAD and R-MACOP-B regimes). The use of R-CVP, FCR, RB, Chl-R, R-monotherapy treatment programs (which received 15.5 % of patients) was considered inadequate for this category of patients.Results. According to the results of the final assessment, high therapy efficacy was established: the overall response exceeded 90 %, complete remission was achieved in most patients with aNHL (68.5 %), partial remission – in every 5th patient (21.8 %). With a median follow-up of 15 months, 16 (5.42 %) deaths and 34 (11.53 %) events were registered. Median of event-free survival and overall survival have not been achieved. Statistically significant differences depending on first-line therapy efficacy were found in overall survival (p = 0.00000) and eventfree survival (p = 0.00000), once again confirming that the main goal of aNHL treatment is to achieve complete remission.Conclusion. Available and compliant with national clinical guidelines treatment of aNHL patients with Russian bioanalogue of anti-CD20 monoclonal antibodies (Acellbia®) demonstrates high immediate efficacy and acceptable long-term results, comparable to a retrospective analysis of previous clinical studies of the original drug rituximab.

Prognostic impact of prior local therapy in castration-resistant prostate cancer

2021 ◽  
Author(s):  
Mikifumi Koura ◽  
Masaki Shiota ◽  
Shohei Ueda ◽  
Takashi Matsumoto ◽  
Satoshi Kobayashi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Free Survival ◽  
First Line Therapy ◽  
Castration Resistant ◽  
Line Therapy

Abstract Objective This study aimed to reveal the prognostic values of prior local therapy in first-line therapy using androgen receptor-axis targeting agents (abiraterone or enzalutamide) or docetaxel for castration-resistant prostate cancer (CRPC). Methods The study included 303 patients treated with first-line therapy for non-metastatic and metastatic CRPC. The association between prior local therapy and therapeutic outcome including progression-free survival and overall survival was investigated by univariate and multivariate analyses as well as propensity score-matched analysis. Results In univariate analysis, local prior therapy was associated with a lower risk of all-cause mortality (hazard ratio, 0.56, 95% confidence interval, 0.40–0.79; P = 0.0009). Overall survival, but not progression-free survival, was better among patients with prior local therapy compared with patients without prior local therapy even after multivariate analysis and propensity score-matched analysis. Conclusions This study robustly indicated that prior local treatment was prognostic for overall survival among patients with CRPC. This finding is useful to predict patient prognosis in CRPC.

scholarly journals Long-Term Overall Survival From KEYNOTE-021 Cohort G: Pemetrexed and Carboplatin With or Without Pembrolizumab as First-Line Therapy for Advanced Nonsquamous NSCLC

2021 ◽  
Vol 16 (1) ◽  
pp. 162-168
Author(s):  
Mark M. Awad ◽  
Shirish M. Gadgeel ◽  
Hossein Borghaei ◽  
Amita Patnaik ◽  
James Chih-Hsin Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Nonsquamous Nsclc

scholarly journals Overall Survival In Patients With Metastatic Urothelial Cancer By First-Line Therapy

2017 ◽  
Vol 20 (9) ◽  
pp. A421
Author(s):  
NS Vander Velde ◽  
A Guerin ◽  
R Ionescu-Ittu ◽  
S Shi ◽  
E Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Urothelial Cancer ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Metastatic Urothelial Cancer
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