Is neoadjuvant (neoadj) treatment necessary prior to liver resection in patients with resectable liver metastases (mets) from colorectal carcinoma (CRC) treated with post-resection hepatic arterial infusion (HAI) plus systemic (SYS) chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14503-14503 ◽  
Author(s):  
N. E. Kemeny ◽  
M. Capanu ◽  
F. Huitzil-Melendez ◽  
D. Haviland ◽  
Y. Fong ◽  
...  
Keyword(s):  
Liver Resection ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Hepatic Arterial Infusion ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Test Results ◽  
Cox Proportional Hazards Models ◽  
Resection Margin Status ◽  
Improvement In Survival

14503 Background: Neoadjuvant therapy in patients (pts) with resectable liver mets has been reported to be associated with improved survival. We evaluated the clinical benefit of neoadj therapy in our pts receiving HAI + SYS after liver resection. Methods: In 4 studies of HAI + SYS after resection of CRC mets, data on neoadj, age, gender, clinical risk score (CRS), number of mets, primary site, resection margin status, presence of synchronous primary and/or bilobar disease were analyzed. Univariate and multivariate Cox proportional hazards models were used to examine differences in overall survival, hepatic or extrahepatic disease-free survival (DFS) between pts who received vs pts who did not receive neoadj. Differences among subgroups were compared using the log-rank test. Results: 234 pts from 4 post-liver resection trials using HAI + SYS were included. Each trial used HAI floxuridine/dexamethasone, with differing SYS regimens: FU/LV (n = 74); CPT11 (n = 98); FOLFOX (n = 31); and FOLFOX or FOLFIRI, ± bevacizumab (n = 31). Neoadj was given to 28% of the pts. Median followup was 4.6 years. No differences in terms of survival, hepatic or extrahepatic DFS were noted between pts who did or did not receive neoadj. Multivariate analyses showed no survival advantage for pts who received neoadj (Y vs N) (HR 0.997, 95% CI, 0.56–1.78). No subsets of pts were identified that showed an improvement in survival from neoadj (table), including pts who responded to neoadj prior to liver resection. Conclusions: Our results do not appear to support the use of neoadj in pts with resectable liver mets from CRC, if they are to be treated with postoperative HAI and SYS chemotherapy. [Table: see text] No significant financial relationships to disclose.

Pharmacogenetics of Tamoxifen Biotransformation Is Associated With Clinical Outcomes of Efficacy and Hot Flashes

2005 ◽  
Vol 23 (36) ◽  
pp. 9312-9318 ◽  
Author(s):  
Matthew P. Goetz ◽  
James M. Rae ◽  
Vera J. Suman ◽  
Stephanie L. Safgren ◽  
Matthew M. Ames ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Proportional Hazards ◽  
Hot Flashes ◽  
Disease Free Survival ◽  
Metabolic Activation ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Buccal Cells ◽  
Cancer Trial ◽  
Adjuvant Breast Cancer

Purpose Polymorphisms in tamoxifen metabolizing genes affect the plasma concentration of tamoxifen metabolites, but their effect on clinical outcome is unknown. Methods We determined cytochrome P450 (CYP)2D6 (*4 and *6) and CYP3A5 (*3) genotype from paraffin-embedded tumor samples and buccal cells (living patients) in tamoxifen-treated women enrolled onto a North Central Cancer Treatment Group adjuvant breast cancer trial. The relationship between genotype and disease outcome was determined using the log-rank test and Cox proportional hazards modeling. Results Paraffin blocks were obtained from 223 of 256 eligible patients, and buccal cells were obtained from 17 living women. CYP2D6 (*4 and *6) and CYP3A5 (*3) genotypes were determined from 190, 194, and 205 patient samples and in 17 living women. The concordance rate between buccal and tumor genotype was 100%. Women with the CYP2D6 *4/*4 genotype had worse relapse-free time (RF-time; P = .023) and disease-free survival (DFS; P = .012), but not overall survival (P = .169) and did not experience moderate to severe hot flashes relative to women heterozygous or homozygous for the wild-type allele. In the multivariate analysis, women with the CYP2D6 *4/*4 genotype still tended to have worse RFS (hazard ratio [HR], 1.85; P = .176) and DFS (HR, 1.86; P = .089). The CYP3A5*3 variant was not associated with any of these clinical outcomes. Conclusion In tamoxifen-treated patients, women with the CYP2D6 *4/*4 genotype tend to have a higher risk of disease relapse and a lower incidence of hot flashes, which is consistent with our previous observation that CYP2D6 is responsible for the metabolic activation of tamoxifen to endoxifen.

Specific Adverse Events Predict Survival Benefit in Patients Treated With Tamoxifen or Aromatase Inhibitors: An International Tamoxifen Exemestane Adjuvant Multinational Trial Analysis

2013 ◽  
Vol 31 (18) ◽  
pp. 2257-2264 ◽  
Author(s):  
Duveken B.Y. Fontein ◽  
Caroline Seynaeve ◽  
Peyman Hadji ◽  
Elysée T.M. Hille ◽  
Willemien van de Water ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adverse Events ◽  
Endocrine Therapy ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Cox Proportional Hazards ◽  
Endocrine Treatment ◽  
Survival Outcomes ◽  
Cox Proportional Hazards Models

Purpose Specific adverse events (AEs) associated with endocrine therapy and related to depletion or blocking of circulating estrogens may be related to treatment efficacy. We investigated the relationship between survival outcomes and specific AEs including vasomotor symptoms (VMSs), musculoskeletal adverse events (MSAEs), and vulvovaginal symptoms (VVSs) in postmenopausal patients with breast cancer participating in the international Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial. Patients and Methods Primary efficacy end points were disease-free survival (DFS), overall survival (OS), and distant metastases (DM). VMSs, MSAEs, and VVSs arising in the first year of endocrine treatment were considered. Patients who did not start or who discontinued their allocated therapy and/or had an event (recurrence/death) within 1 year after randomization were excluded. Landmark analyses and time-dependent multivariate Cox proportional hazards models assessed survival differences up to 5 years from the start of treatment. Results A total of 9,325 patients were included. Patients with specific AEs (v nonspecific or no AEs) had better DFS and OS (multivariate hazard ratio [HR] for DFS: VMSs, 0.731 [95% CI, 0.618 to 0.866]; MSAEs, 0.826 [95% CI, 0.694 to 0.982]; VVSs, 0.769 [95% CI, 0.585 to 1.01]; multivariate HR for OS: VMSs, 0.583 [95% CI, 0.424 to 0.803]; MSAEs, 0.811 [95% CI, 0.654 to 1.005]; VVSs, 0.570 [95% CI, 0.391 to 0.831]) and fewer DM (VMSs, 0.813 [95% CI, 0.664 to 0.996]; MSAEs, 0.749 [95% CI, 0.601 to 0.934]; VVSs, 0.687 [95% CI, 0.436 to 1.085]) than patients not reporting these symptoms. Increasing numbers of specific AEs were also associated with better survival outcomes. Outcomes were unrelated to treatment allocation. Conclusion Certain specific AEs are associated with superior survival outcomes and may therefore be useful in predicting treatment responses in patients with breast cancer treated with endocrine therapy.

Is more aggressive lymph node assessment associated with improved survival in stage II-III colorectal cancer? Evidence from the Surveillance, Epidemiology and End Results (SEER) cancer registry

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4048-4048
Author(s):  
Y. Yeh ◽  
Q. Cai ◽  
J. Chao ◽  
M. Russell
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Stage Ii ◽  
Rank Test ◽  
Stage Iiia ◽  
Nccn Guidelines ◽  
Cox Proportional Hazards Models

4048 Background: NCCN guidelines recommend assessment of =12 lymph nodes (LN) to improve accuracy in colorectal cancer (CRC) staging. Previous studies have used various cut-points to assess the relationship between the number of LN sampled and survival. The association between NCCN guideline-compliant nodal sampling and survival is assessed, while controlling for other risk factors. Methods: We selected 145,485 adult patients newly diagnosed with stage II or III from SEER during 1990–2003. Kaplan-Meier curves were compared using the log-rank test. Cox proportional hazards models were constructed to determine the effect of sampling ≥ 12 LN on survival. Results: Median patient follow-up was 5.7 years. The table shows overall survival rates in CRC patients with < 12 versus =12 LN assessed: After adjusting for age, sex, tumor size and grade, sampling ≥ 12 LN was independently associated with improved survival. For patients with =12 versus <12 LN assessed, survival increased by 13% for stage IIa [HR=0.75; 95%CI 0.72–0.78; p< .001], 16% for stage IIb [HR=0.69; 95%CI 0.67- 0.71; p< .001], 12% for stage IIIb [HR=0.75; 95%CI 0.72–0.77], and 10% for stage IIIc [HR=0.85, 95%CI 0.81–0.89]. The association was not statistically significant for stage IIIa patients. Conclusion: Consistent with previous reports, this analysis found that optimal nodal sampling increased survival across stage II and III, specifically when ≥ 12 LN are sampled and when controlling for other risk factors. Furthermore, the results underscore the need for adhering to the NCCN guidelines. The lack of a statistically significant association in stage IIIa patients may be due to small cohort size. [Table: see text] [Table: see text]

Adherence and cumulative bisphosphonate dose in relation to risk of skeletal-related events among older patients with multiple myeloma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18250-e18250
Author(s):  
Jifang Zhou ◽  
Karen Sweiss ◽  
Pritesh Rajni Patel ◽  
Edith Nutescu ◽  
Naomi Ko ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cumulative Dose ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Competing Risk ◽  
Rank Test ◽  
Subdistribution Hazard ◽  
Cox Proportional Hazards Models ◽  
Utilization Patterns ◽  
Skeletal Related Events

e18250 Background: Adjuvant intravenous bisphosphonates (IV BP) reduce the risk of skeletal-related events (SRE) in patients with multiple myeloma (MM). We examined the effects of bisphosphonate utilization patterns (adherence, cumulative dose and frequency) on risk of SRE. Methods: Patients aged 65 years or older and diagnosed with first primary MM between 2001 and 2011 were identified using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. Patients receiving at least one dose of IV BP after MM diagnosis were identified and 5-year SRE-free survival was estimated using the Kaplan-Meier method stratified by demographic groups and compared with the log rank test. Cox proportional hazards models were fit to determine the association between IV BP utilization patterns and SRE after propensity score matching. We investigated the outcome of multiple recurrent SRE using the approach of Andersen-Gill, and estimated subdistribution hazard ratios (SHR) and 95% confidence intervals for risk of first SRE, accounting for death as competing risk. Results: The final cohort included 9176 MM patients with a median age of 76 years. The adjusted 5-year competing-risk SRE model showed a 48% reduction in risk of SRE (95% CI 0.49-0.55) with use of IV BP. In multivariable analyses taking into account competing risks, greater adherence to IV BP, higher cumulative IV BP dose and more frequent administration were all associated with a statistically significant reduction in SRE risks (See Table). Conclusions: Use of IV BP in patients with MM was associated with significant reduction in SRE risk over the 5-year period after MM diagnosis. The effectiveness of IV BP therapy was greater with increasing cumulative dose, adherence to and greater frequency of IV BP administration. [Table: see text]

scholarly journals Study Of The Association Of Tumor Deposits With Tumour-infiltrating Lymphocytes And Prognosis In Gastric Cancer Patients

2021 ◽  
Author(s):  
Xinyue Li ◽  
Jing Yang
Keyword(s):  
Gastric Cancer ◽  
Proportional Hazards ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Clinicopathological Characteristics ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Tumour Infiltrating Lymphocytes ◽  
Infiltrating Lymphocytes

Abstract Background: To investigate the relationship between tumour deposits(TDs) with the clinicopathological characteristics,prognosis of gastric cancer and tumour-infiltrating lymphocytes( TILs）.Methods: The pathological findings of 369 patients with gastric cancer were retrospectively analysed to observe the expression of TDs, and the levels of stromal TILs . The relationships between TDs status, clinicopathological characteristics, and TILs infiltration level were compared using the chi-square test, and rank data were tested using the rank sum test. Kaplan-Meier was used for survival analysis, and the log-rank test was used to determine the differences in survival curves between groups. The prognostic value of TDs was assessed using multivariate Cox proportional hazards regression analysis.Results: TDs were significantly associated with sex, Lymphovascular invasion, Perineural invasion, pathological TNM stage, and clinical stage (all P<0.05). TILs levels were lower in TDs(+) group and higher in TDs(-) group. TDs(+) group had poor Disease-free survival, cancer-specific survival , and overall survival as compared with TDs(-) groups.Conclusions: TDs is negatively correlated with TILs , and TDs+ was an Independent predictors of the prognosis of gastric cancer.

scholarly journals Relationship Between Change in Serum Uric Acid and Ischemic Stroke in Chinese Hypertensive Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiu-hong Tan ◽  
Lin Liu ◽  
Yu-qing Huang ◽  
Yu-ling Yu ◽  
Jia-yi Huang ◽  
...  
Keyword(s):  
Uric Acid ◽  
Ischemic Stroke ◽  
Serum Uric Acid ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Elevated Risk ◽  
Rank Test ◽  
Hypertensive Patients ◽  
Cox Proportional Hazards Models ◽  
The Relationship

Background: Limited studies focused on the association between serum uric acid (SUA) change with ischemic stroke, and their results remain controversial. The present study aimed to investigate the relationship between change in SUA with ischemic stroke among hypertensive patients.Method: This was a retrospective cohort study. We recruited adult hypertensive patients who had two consecutive measurements of SUA levels from 2013 to 2014 and reported no history of stroke. Change in SUA was assessed as SUA concentration measured in 2014 minus SUA concentration in 2013. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). The Kaplan–Meier analysis and log-rank test were performed to quantify the difference in cumulative event rate. Additionally, subgroup analysis and interaction tests were conducted to investigate heterogeneity.Results: A total of 4,628 hypertensive patients were included, and 93 cases of ischemic stroke occurred during the mean follow-up time of 3.14 years. Participants were categorized into three groups according to their SUA change tertiles [low (SUA decrease substantially): &lt;-32.6 μmol/L; middle (SUA stable): ≥-32.6 μmol/L, &lt;40.2 μmol/L; high (SUA increase substantially): ≥40.2 μmol/L]. In the fully adjusted model, setting the SUA stable group as reference, participants in the SUA increase substantially group had a significantly elevated risk of ischemic stroke [HR (95% CI), 1.76 (1.01, 3.06), P = 0.0451], but for the SUA decrease substantially group, the hazard effect was insignificant [HR (95% CI), 1.31 (0.75, 2.28), P = 0.3353]. Age played an interactive role in the relationship between SUA change and ischemic stroke. Younger participants (age &lt; 65 years) tended to have a higher risk of ischemic stroke when SUA increase substantially.Conclusion: SUA increase substantially was significantly correlated with an elevated risk of ischemic stroke among patients with hypertension.

Impact of clinical and pathological variables on stage I non-small cell lung cancer outcomes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21071-e21071
Author(s):  
Matthew C Lee ◽  
Dimitre C Stefanov ◽  
Mallorie B Angert ◽  
Erica C Cohn ◽  
Nina Kohn ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Regression ◽  
Neuroendocrine Differentiation ◽  
Clinical Importance ◽  
Recurrence Risk ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Rank Test ◽  
Histological Features ◽  
Cox Proportional Hazards Models

e21071 Background: Stage I patients (pts) have 5-year survival ranging 50-75% suggesting heterogeneity within. While American Joint Committee on Cancer 8th edition upstages tumors with visceral pleural invasion (VPI) to IB, other histological features namely lymphovascular invasion (LVI), micropapillary pattern (MIP), spread through airspace (STAS) & neuroendocrine differentiation (NE) may also affect prognosis. This retrospective single institution study evaluated influence of these factors along with pt variables age, gender, smoking, Charleston comorbidity index (CCI) & chemotherapy (CT) on recurrence & mortality. Methods: 351 resected stage I cases from 2015-2019 were included. Data was summarized as means (standard deviation/SD) or percentages. Association between variables & outcomes (measured from diagnosis till event or last visit if no event) were investigated using Univariate & Multiple Cox proportional hazards models. Survival curves were compared using the Log-Rank test when the assumption for the proportional hazards was not satisfied. All predictors were included in the multiple Cox regression models based on their clinical importance. P < 0.05 was considered statistically significant. SAS 9.4 (SAS Institute, Cary, NC) was used for the analysis. Results: Mean age was 69.62 years (9.83). Majority were female (57.3%), smokers (76.9%), & had adenocarcinoma (AC) (78.6%). 39% had COPD & mean CCI was 6.3 (1.74). 193 (55%) pts had lobectomy or larger procedure while 158 (45%) had sub-lobar resection. 45 (12.8%) pts received CT. Recurrence & death occurred in 33 (9.4%) & 15 (4.3%) pts respectively. Univariate models indicated higher recurrence risk with NE (HR = 4.18 95% CI 1.47-11.9, p = 0.0075), LVI (HR = 2.68, 95% CI 1.03-6.94, p = 0.0423), COPD (HR = 3.28 95% CI 1.56-6.9, p = 0.0017), age (HR = 1.05 95% CI 1.01-1.09, p = 0.0212), & CCI (HR = 1.57 95% CI 1.35-1.83, p < .0001). CT was also associated with increased recurrence risk (HR = 8.61, 95% CI 4.28-17.33, p < .0001). Multivariable model for recurrence retained significance for CT & CCI. Age (HR = 1.07 95% CI 1.01-1.14, p = 0.0312), CCI (HR = 1.27 95 % CI 1.02-1.59, p = 0.0347) were associated with mortality in univariate models. Multivariate analysis for mortality wasn’t feasible due to few events. Conclusions: Histological features other than VPI may be associated with recurrence. Pts who received CT had increased recurrence but they possibly had multiple risk factors or other adverse features not assessed here. Limitations included retrospective nature, limited sample size & small number of events.

scholarly journals Connecting METTL3 and intratumoural CD33+ MDSCs in predicting clinical outcome in cervical cancer

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Huan-he Ni ◽  
Lin Zhang ◽  
He Huang ◽  
Shu-qin Dai ◽  
Jiang Li
Keyword(s):  
Cervical Cancer ◽  
Proportional Hazards ◽  
Cox Model ◽  
Disease Free Survival ◽  
Suppressor Cells ◽  
Cox Proportional Hazards ◽  
Tumour Cells ◽  
Rank Test ◽  
Independent Factor

Abstract Background Methyltransferase-like 3 (METTL3) is a member of the m6A methyltransferase family and acts as an oncogene in cancers. Recent studies suggest that host innate immunity is regulated by the enzymes controlling m6A epitranscriptomic changes. Here, we aim to explore the associations between the levels of METTL3 and CD33+ myeloid-derived suppressor cells (MDSCs) in tumour tissues and the survival of patients with cervical cancer (CC). Methods Specimens of paraffin embedded tumour from 197 CC patients were collected. The expression levels of METTL3 and CD33 were measured by immunohistochemical (IHC) staining. The clinical associations of the IHC variants were analysed by Pearson’s or Spearman’s chi-square tests. Overall survival (OS) and disease-free survival (DFS) were estimated by the Kaplan–Meier method and log-rank test. Hazard ratios (HRs) and independent significance were obtained via Cox proportional hazards models for multivariate analyses. METTL3 in CD33+ cells or CC-derived cells was knocked down by METTL3-specific siRNA, and MDSC induction in vitro was performed in a co-culture system in the presence of METTL3-siRNA and METTL3-knockdown-CC-derived cells compared with that of the corresponding controls. Results We found that tumour tissues displayed increased levels of METTL3 and CD33+ MDSCs compared with tumour-adjacent tissues from the same CC patients. Importantly, METTL3 expression was positively related to the density of CD33+ cells in tumour tissues (P = 0.011). We further found that the direct CD33+CD11b+HLA-DR− MDSC induction and tumour-derived MDSC induction in vitro were decreased in the absence of METTL3. The level of METTL3 in tumour microenvironments was significantly related to advanced tumour stage. The levels of METTL3 and CD33+ MDSCs in tumour tissues were notably associated with reduced DFS or OS. Cox model analysis revealed that the level of METTL3 in tumour cells was an independent factor for patient survival, specifically for DFS (HR = 3.157, P = 0.022) and OS (HR = 3.271, P = 0.012), while the CD33+ MDSC number was an independent predictor for DFS (HR: 3.958, P = 0.031). Interestingly, in patients with advanced-disease stages (II–IV), METTL3 in tumour cells was an independent factor for DFS (HR = 6.725, P = 0.010) and OS (HR = 5.140, P = 0.021), while CD33+ MDSC density was an independent factor for OS (HR = 8.802, P = 0.037). Conclusion Our findings suggest that CD33+ MDSC expansion is linked to high levels of METTL3 and that METTL3 and CD33+ MDSCs are independent prognostic factors in CC.

scholarly journals CMET-12. EFFICACY OF UPFRONT IMMUNE CHECKPOINT INHIBITORS IN LUNG CANCER BRAIN METASTASIS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi53-vi53
Author(s):  
Addison Barnett ◽  
Adam Lauko ◽  
Hong Li ◽  
Assad Ali ◽  
Soumya Sagar ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Proportional Hazards ◽  
Checkpoint Inhibitors ◽  
Tertiary Care ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Cox Proportional Hazards Models

Abstract INTRO/OBJECTIVE Immune checkpoint inhibitors (ICI) have improved outcomes in a subset of patients with lung cancer. However, data describing the efficacy of ICI in lung cancer brain metastasis (LCBM) is limited. We analyzed overall survival (OS) in patients with LCBM treated with upfront ICI, defined as having received ICI within 90-days of LCBM diagnosis, compared to non-ICI therapies. METHODS We reviewed 665 patients with LCBM diagnosed between 2000 and 2018 at a major tertiary care institution. Of those patients, 240 received ICI, 164 of which received ICI after 90-days and 76 received ICI within 90-days. Propensity score (PS) was calculated by logistic regression model including age, KPS, number of baseline brain lesions, and presence of extra-cranial metastasis (ECM) at time of LCBM diagnosis. OS from LCBM diagnosis between PS matched cohorts were compared using Kaplan-Meier, the Log-Rank test, and Cox proportional hazards models. RESULTS Prior to PS matching, median survival between ICI and non-ICI cohorts was not significantly different (10.9 months for both, p=0.81), although more ICI patients had ECM (57.1% vs 40.9%, p=0.006). Following PS matching, the ICI (n=76) and non-ICI (n=76) cohorts had median age (62.4 vs 62.3 years), KPS (80 for both), lesion number (2 for both), and ECM (56.6% for both). Of matched patients, 94% received SRS, 52% received WBRT, and 29% underwent surgical resection. Compared to non-ICI, the ICI cohort had a 2-year OS hazard ratio=0.87 (95% CI=0.58–1.31, p=0.51). Median and 1-year survival were not significantly different between ICI and non-ICI cohorts (median: 10.9 vs 9.1 months; 1-yr: 43.0% vs 42.4%). CONCLUSION Patients with LCBM who received ICI within 90-days of their diagnosis did not have improvement in OS compared to patients who received non-ICI therapies. Evaluation of clinical factors that may affect the efficacy and durability of immunotherapy is ongoing and will be presented.

scholarly journals Clinical outcomes in patients with metastatic renal cell carcinoma receiving everolimus or temsirolimus after sunitinib.

2014 ◽  
Vol 8 (3-4) ◽  
pp. 121 ◽  
Author(s):  
Roberto Iacovelli ◽  
Giacomo Cartenì ◽  
Michele Milella ◽  
Rossana Berardi ◽  
Giuseppe Di Lorenzo ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Kinase Inhibitor ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Clinical Activity ◽  
Second Line ◽  
Cox Proportional Hazards Models ◽  
Line Setting

Introduction: There are little data on the clinical activity of temsirolimus (TM) and everolimus (EV) when used as second-line therapy after sunitinib (SU) in patients with metastatic renal cellcarcinoma (mRCC).Methods: Patients with mRCC treated with EV or TM after SU were included in this retrospective analysis. Progression-free survival (PFS), time to sequence failure (TTSF) from the start of SU to disease progression with EV/TM and overall survival (OS) were estimated using Kaplan-Meier method and compared across groups using the log-rank test. Cox proportional hazards models were applied to investigate predictors of TTSF and OS.Results: In total, 89 patients (median age 60.0 years) were included. At baseline 43% were classified as MSKCC good-risk, 43% as intermediate-risk and 14% as poor-risk. Median OS was 36.3 months and median TTSF was 17.2 months. Sixty-five patients received SU-EV and 24 patients SU-TM. Median PFS after the second-line treatment was 4.3 months in the EV group and 3.5 months in the TM group (p = 0.63). Median TTSF was 17.0 and 18.9 months (p = 0.32) and the OS was 35.8 and 38.3 months (p = 0.73) with SU-EV and SU-TM, respectively. The prognostic role of initial MSKCC was confirmed by multivariable analysis (hazard ratio 1.76, 95% confidence interval 1.08-2.85. p = 0.023).Conclusions: This study did not show significant differences in terms of disease control and OS between EV and TM in the second-line setting. EV remains the preferred mTOR inhibitor for the treatment of mRCC patients resistant to prior tyrosine kinase inhibitor treatment.

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