Metastatic Adenocarcinomas of the Stomach or Esophagogastric Junction (UICC Stage IV) Are Not Always a Palliative Situation: A Retrospective Analysis

Abstract Abstract 4942 INTRODUCTION. Patients with Mantle cell lymphoma (MCL) have an adverse outcome after relapse due to chemorefractory disease with conventional treatments. Bendamustine, a nitrogen mustard compound chemically related to the alkylating agents, has demonstrated high efficacy with a low toxicity profile in reported clinical trials. AIM. To analyze the Spanish experience in patients with relapsed/refractory MCL treated with Bendamustine. METHODS. Retrospective analysis of spanish experience in relapsed/refractory MCL treated with Bendamustine alone or in combination. This study has been approved by local ethical committees. RESULTS. Currently, there are 36 patients registered and 28 are available for this analysis. Patients'characteristics: 69% male, median age 65 years old (range 41–81), 87% ECOG≤ 1, 83% Ann Arbor stage IV, 37% high risk MIPI and 9% blastic variant. Previous regimens were CHOP or CHOP like ± R in 42.5%, HyperCVAD/MtxAraC ± R in 42.5%, R-CVP in 9% and other regimens in 6%. Median number of previous treatments were 2.6 (range 1–6), all patients had received prior Rituximab and 73% had chemosensitive disease to the last treatment. Bendamustine regimen was R-B (R-375mg/m2 D1, B-90 mg/m2 D1-2) in 78% patients, R-B with B-70 mg/m2 in 8%, B alone in 3%, R-B-Bortezomib in 3% and R-B plus consolidation (SCT, Y90Ibritumomab-tiuxetan) in 8%. Median number of cycles was 4.61 (range 1–7). G- CSF support was administered in 43% of cycles. Response: Overall response rate was 73%, with 43% CR & uCR and 30% PR. Survival: Median overall survival from diagnosis is 8,26 years (range: 1.6–11,6 years) without plateau. Median progression free survival (PFS) after Bendamustine treatment was 16 months (95% CI: 11.7–20.4), data that compares favourably with patients' PFS to previous therapy (12 months, 95% CI: 6.5–17.5). Median PFS for patients who achieved CR/uCR is 32.6 months (95% CI: 19.9–45.4) versus 11 months in patients with PR (95% CI: 3.9–18.8). With a median follow-up for surviving patients of 12 months since Bendamustine treatment, the estimated OS at 3 years is 47% (+ SD 14%). Toxicity: No treatment related mortality has been described so far. Over 152 cycles, only 10 hospitalizations due to febrile neutropenia were reported. No one case of lysis tumoral syndrome has been reported. CONCLUSION. Bendamustine plus Rituximab is a good rescue treatment in non selected pretreated patients with mantle cell lymphoma. CR rate and duration of response seem to reproduce in current clinical practice the good data reported in previous clinical trials and compares favourably with other available treatments. Disclosures: No relevant conflicts of interest to declare.

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Palliative systemic combination chemotherapy with gemcitabine (GEM) and weekly 24h-infusion of high-dose 5-fluorouracil (5- FU) in patients with metastatic pancreatic cancer (UICC stage IV)

Journal of Clinical Oncology ◽

10.1200/jco.2008.26.15_suppl.15644 ◽

2008 ◽

Vol 26 (15_suppl) ◽

pp. 15644-15644

Author(s):

S. Roehrig ◽

A. Wein ◽

H. Albrecht ◽

U. Reulbach ◽

G. Maennlein ◽

...

Keyword(s):

Pancreatic Cancer ◽

Combination Chemotherapy ◽

Stage Iv ◽

Metastatic Pancreatic Cancer ◽

High Dose ◽

Uicc Stage

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Palliative systemic chemotherapy with gemcitabine (GEM) and 5-fluorouracil (5-FU) as 24h-infusion in patients with advanced inoperable biliary tract cancer (UICC stage IV)

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15633 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15633-e15633

Author(s):

S. Kersten ◽

A. Wein ◽

H. Albrecht ◽

U. Reulbach ◽

G. Maennlein ◽

...

Keyword(s):

Biliary Tract ◽

Biliary Tract Cancer ◽

Bile Ducts ◽

Stage Iv ◽

Tumor Control ◽

Low Grade ◽

Treatment Schedule ◽

Advanced Tumor Stage ◽

Uicc Stage ◽

Tract Cancer

e15633 Background: Due to the late diagnosis of biliary tract carcinomas in an advanced tumor stage, the application of palliative chemotherapy frequently remains as a possible treatment option. The aim of this study is to evaluate the efficacy and toxic side effects of a chemotherapy schedule consisting of GEM combined with 5-FU in patients (pts.) with metastatic biliary tract cancer. Methods: Evaluation of 35 pts. based on our prospective tumor registry data; essential inclusion criteria: histologically proven adeno-carcinoma, UICC stage IV, chemonaivity; all the pts. were presented in the interdisciplinary tumorboard of Erlangen University and were primarily non-curatively-resectable (n = 35); evaluation period: 11/1998 - 09/2008; treatment schedule: 1.000 mg/m2 of GEM as a 0.5h-infusion (inf.) combined with 2.000 mg/m2 of 5-FU as a 24h-inf. via port catheter on day 1, 8, 15 qd 22. Results: Median age: 64 years; men/women: n=18/17; ECOG 0/1/2: n=10/21/4; localisation: intrahepatic bile ducts: n=19, extrahepatic bile ducts: n=11; gall bladder: n=4; metastases: liver: 91.4%, lymph nodes: 51.4%, peritoneum: 28.8%, bones: 8.6%, intestine: 8.6%, skin: 2.9%, lungs: 2.9%; chemotherapy applications: total number: 486, average value/patient: 13.9; CA 19–9 elevated yes/no: n=13/22 (37.1%/62.9%); CEA elevated yes/no: n=15/9 (42.9%/25.7%, not evaluable: 11); higher grade toxicity (III or IV): leukocytopenia III: 14.3%, thrombocytopenia III: 2.9%, weariness III: 2.9%, diarrhea III: 5.7%, diarrhea IV: 2.9%, vomiting IV: 2.9%, pain III: 5.7%, ascites III: 5.7%, infections III: 2.9%, thromboembolia IV: 2.9%, elevated bilirubin value III: 1.7%, grade IV: 8.3%; deep leg vein thrombosis: 15%; median TTP: 5.1 months (95% CI: 2.9 - 7.2); median overall survival: 10.4 months (95% CI: 7.9 - 12.9); 6-months-/1-year-/2-year-survival rate: 65.7%/45.7%/17.1%; response rate: PR: n=5 (14.3%), SD: n=18 (51.4%), PD: n=7 (20%), not evaluable: n=5 (14.3%); tumor control (PR/SD): n=23 (65.7%); median follow-up: 10.4 months. Conclusions: Combination chemotherapy with weekly GEM as a 0.5h-inf. and 5-FU as a 24h-inf. on an out-patient basis is an effective palliative treatment schedule with solely low grade toxicity. No significant financial relationships to disclose.

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MicroRNA signatures from FFPE tissue distinguish patients with colorectal cancer of UICC stage I from those with metastatic disease of stage IV.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.15_suppl.e14055 ◽

2011 ◽

Vol 29 (15_suppl) ◽

pp. e14055-e14055

Author(s):

T. Mayr ◽

P. Pechanska ◽

K. Ridwelski ◽

R. Mantke ◽

M. Pross ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Disease ◽

Stage Iv ◽

Ffpe Tissue ◽

Stage I ◽

Uicc Stage

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Retrospective analysis of pathologic response in colorectal cancer liver-only metastases following treatment with bevacizumab.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.674 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 674-674

Author(s):

Ruth Vera ◽

Joan Figueras ◽

Maria Luisa Gomez Dorronsoro ◽

S. Lopez-Ben ◽

Antonio Viúdez ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Retrospective Analysis ◽

Hepatic Metastases ◽

Stage Iv ◽

Poor Response ◽

Pathological Response ◽

Residual Tumour ◽

Tumour Location ◽

Baseline Characteristics

674 Background: Recent reports have shown that pathological response predicts for better outcome (overall survival) following preoperative chemotherapy and surgical resection of colorectal cancer (CRC) liver-only metastases. The aim of this retrospective analysis was to evaluate the effect of adding bevacizumab to standard chemotherapy on pathological response in patients with CRC liver only metastases. Methods: Patients with stage IV CRC with liver metastases who received neoadjuvant chemotherapy (oxaliplatin-or irinotecan-based) at two Spanish centres were analysed retrospectively. Pathological response was evaluated as follows: complete pathological response (cPR), PR1 (25% of residual tumour), PR2 (25–50% of residual tumour), PR3 (>50% of residual tumour). cPR or PR1 was considered to be a good response, and PR2 or PR3 a poor response. Results: A total of 81 patients were evaluated. Of these, 43 received chemotherapy alone and 38 received chemotherapy plus bevacizumab. Baseline characteristics were as follows: median age 61.0 years (range 43.0–80.0 years); male/female (67%/33%); tumour location – colon (69%) / rectum (31%); hepatic metastases – synchronous (74%) / metachronous (26%); In terms of pathological response, 58% of patients receiving bevacizumab had a good response (cPR + PR1) compared with 28% of those receiving chemotherapy alone. At the end of the analysis, 68% of patients were still alive. Conclusions: Adding bevacizumab to oxaliplatin-based chemotherapy in the neoadjuvant setting improves the pathological response of liver metastases in patients with stage IV CRC. These findings indicate that pathological response might be a good indicator of outcome for patients receiving bevacizumab in the neoadjuvant setting.

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Clinical outcomes of stage IV colorectal cancer after R0 resection: a multi-institutional retrospective analysis

International Journal of Clinical Oncology ◽

10.1007/s10147-016-1043-4 ◽

2016 ◽

Vol 22 (2) ◽

pp. 297-306 ◽

Cited By ~ 1

Author(s):

Harunobu Sato ◽

◽

Koutarou Maeda ◽

Zenichi Morise ◽

Hiroshi Takahashi ◽

...

Keyword(s):

Colorectal Cancer ◽

Retrospective Analysis ◽

Clinical Outcomes ◽

Stage Iv ◽

R0 Resection ◽

Stage Iv Colorectal Cancer

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Alcohol Consumption is associated with Increased CEA Levels in Male Patients with Stage IV Colorectal Cancer- A Single-Institution Retrospective Analysis

Graduate Medical Education Research Journal ◽

10.32873/unmc.dc.gmerj.3.1.001 ◽

2021 ◽

Vol 3 (1) ◽

Keyword(s):

Colorectal Cancer ◽

Alcohol Consumption ◽

Retrospective Analysis ◽

Stage Iv ◽

Single Institution ◽

Stage Iv Colorectal Cancer ◽

Male Patients

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Colorectal cancer under 20 years old: a retrospective analysis from three tertiary hospitals

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-020-03397-2 ◽

2020 ◽

Author(s):

Chengjing Zhou ◽

Weiwei Xiao ◽

Xiaohao Wang ◽

Haiyang Chen ◽

Shaoqing Niu ◽

...

Keyword(s):

Colorectal Cancer ◽

Retrospective Analysis ◽

Distant Metastasis ◽

Medical Records ◽

Radical Surgery ◽

Rectal Cancer Patient ◽

Stage Iv ◽

Signet Ring Cell ◽

Laboratory Findings ◽

Tertiary Hospitals

Abstract Purpose Colorectal cancer (CRC) rarely occurs in children and adolescents. This study aimed to perform a retrospective analysis and disclose more detailed information about CRC in patients under 20 years old. Methods Medical records of CRCs in patients under 20 years old referred to three tertiary hospitals in China from September 2000 to July 2019 were retrospectively reviewed. Clinicopathological characteristics, treatment processes and laboratory findings were summarized and treatment outcomes and prognostic factors were analyzed. Results A total of 33,394 CRC medical records were analyzed, and we identified seventy (0.21%) CRCs in patients under 20. The most common primary tumor location was the left hemicolon (35.7%). The prominent pathological types were mucinous adenocarcinoma (22.9%) and signet ring cell carcinoma (22.9%). Nearly half (47.1%) of the patients presented with distant metastasis at diagnosis. The fractions of patients with deficient mismatch repair (dMMR) protein expression and microsatellite instability-high (MSI-H) were 23.8% (5/21) and 71.4% (5/7), respectively. Forty-four patients underwent radical surgery. Fifty-five patients received chemotherapy and six patients received radiotherapy. One dMMR/MSI-H rectal cancer patient received immunotherapy and achieved a clinically complete response. The median overall survival (OS) time was 80 months. The 3-year and 5-year OS rates were 61.8% and 57.2%, respectively. An absence of distant metastasis was a favorable factor for OS. For stage II/III CRCs, classic adenocarcinoma and radical surgery were favorable factors for OS. For stage IV CRCs, primary location at the colon was a favorable factor for OS. Conclusion Child and adolescent CRC patients are likely to have distant metastasis, undifferentiated, left hemicolon location, and a dMMR/MSI-H phenotype at diagnosis. Additional efforts are needed to improve their survival outcomes.

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Survival data and toxicity profile in advanced non-small cell lung cancer (NSCLC) patients (PTS) treated within or outside controlled clinical trials.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e18103 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e18103-e18103

Author(s):

Tiziana Vavala ◽

Giulia Rovere ◽

Simonetta Rapetti ◽

Enrica Capelletto ◽

Marina Longo ◽

...

Keyword(s):

Clinical Trials ◽

Retrospective Analysis ◽

Survival Data ◽

Standard Therapy ◽

Statistical Significance ◽

Stage Iv ◽

Line Treatment ◽

Controlled Clinical Trials ◽

Single Institution ◽

Third Line

e18103 Background: Even without well defined data, a common perception is that clinical trials inclusion improve outcomes in pts with cancer. We conducted a retrospective analysis, in a single institution, evaluating survival data and tolerability in advanced NSCLC pts treated with standard therapy or within phase II/III clinical trials. Methods: We analysed 300 consecutive pts treated at the Thoracic Oncology Unit at San Luigi Gonzaga Hospital from 2004, January the 1st to 2011, December 31st having these characteristics: histo/cytological diagnosis of NCSLC, stage IV who received at least 3 chemotherapy cycles, minimum follow-up of 6 months. In this pts population 180 (60%) were enrolled in controlled clinical trials (T), while 120 (40%) were treated with standard therapy (S). Results: The most important differences between the two groups were about median age at the time of starting first line treatment (61.2 in group T vs 64 years in group S), pts older than 70 years (19% vs 27%, respectively) and ECOG/PS distribution (PS=2: 0 vs 9 pts, PS=1: 33 vs 53 pts, PS=0: 145 vs 60 pts in T and S group, respectively). Evaluating T and S population: 106 (59%) vs 43 (36%) pts were eligible for second line treatment and 45 (25%) vs 19 (16%) pts for third line treatment. Median OS was 16,3 in T population vs 14,4 months in S population and PFS was 7.1 vs 6.3 months respectively. Any relevant differences was seen between group T and S in terms of toxicity. Conclusions: This single institution retrospective analysis documented a trend of better outcome for pts enrolled in clinical trials compared to those treated with standard therapy (even without a statistical significance) with an higher percentage of pts reaching second and third line therapies. A larger multicenter prospective dedicated trial is needed to have further, more cleaned, data about this item.

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