Comorbidity and other predictors of survival in veterans with colorectal cancer (CRC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14125-e14125
Author(s):  
Fengming Zhong ◽  
Trent P Wang ◽  
Tanganyika Barnes ◽  
Melanie L. Gonzalez ◽  
Victor T Chang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rating Scale ◽  
Cox Regression ◽  
Medical Center ◽  
Performance Status ◽  
Ecog Performance Status ◽  
History Of ◽  
Study Population ◽  
Comorbidity Index ◽  
Ecog Ps

e14125 Background: The role of comorbidity as a prognostic marker is an area of great interest. This study aimed to determine whether comorbidity indices predict survival in Veterans with CRC. Methods: In an IRB-approved protocol, we reviewed the records of pts diagnosed with CRC at a VA Medical Center from 1/1/2003 to 12/31/2007. Demographics, stage, grade, ECOG performance status (PS), CEA, hemoglobin (HGB), Albumin (ALB) at diagnosis, history of surgical resection (SR) were abstracted. Comorbidity was assessed with the Charlson Comorbidity Index (CCI), the Kaplan-Feinstein Index (KFI), the Cumulative Illness Rating Scale (CIRS), and VA Comorbidity Scale (VACS). We developed a survival model with stage, ECOG PS, HGB, ALB, SR, and ECOG PS. Comorbidity indices were tested by determining if they were independent predictors of survival after inclusion in this model. Cox regression analyses were performed with SAS V9.2. Results: There were 175 pts with colorectal ca with 111 colon (C) and 64 rectal ca (R) pts. The median (M) age at diagnosis was 71 (45-90). 54% of study population was deceased at the time of data collection. Median survival was 1157 days (5-3256). Results of multivariate analyses with comorbidity indices are summarized in the table. Conclusions: Charlson, CIRS 16 and CIRS 19 comorbidity indices were significant predictors for veterans with colorectal cancer and appear to be important for the subset of veterans with colon cancer. Confirmatory studies should be done in larger populatins. These indices may be used in the design of future clinical trials. This was supported by the New Jersey Commission for Cancer Research 09-1133-CCR-EO. [Table: see text]

scholarly journals Beneficial Treatment Management with Trifluridine/Tipiracil in a Patient with Metastatic Colorectal Cancer and Pronounced Hematological Event History during Previous Treatments

2018 ◽  
Vol 11 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Volker Kaechele ◽  
Jürgen Hess ◽  
Wolfgang Schneider-Kappus
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Dose Reduction ◽  
Performance Status ◽  
Recommended Dose ◽  
Hematological Toxicity ◽  
Ecog Performance Status ◽  
History Of ◽  
Grade 3

Trifluridine/tipiracil (FTD/TPI) significantly improves overall survival in patients with metastatic colorectal cancer (mCRC). The most common treatment-related event (grade ≥3) was hematological toxicity. We here report long-term disease-stabilizing FTD/TPI treatment of an mCRC patient (KRAS wild-type, ECOG performance status 1 at baseline and at the end of FTD/TPI therapy) with multifocal synchronous metastases and a longstanding history of extensive hematological events during previous treatments. Finally, this 62-year-old male patient was treated for 10 months with FTD/TPI by consecutive alteration of treatment parameters: (i) initial daily dose reduction to 80 mg (72% of the recommended dose), (ii) 20 days dose delay, (iii) a second and later third dose reduction to 70 mg and 60 mg (about 64% and 55%, respectively, of the recommended dose), and (iv) 30 µg per day of granulocyte colony-stimulating factor administration first for 3 days, and later for 5 days, for each treatment cycle.

Comorbidity and survival in cancer patients receiving palliative care

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9066-9066
Author(s):  
V. T. Chang ◽  
N. Sambamoorthi ◽  
B. Zhou ◽  
H. Yan ◽  
M. L. Gonzalez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Rating Scale ◽  
Cox Regression ◽  
Early Stage ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Survival Analyses ◽  
Comorbidity Index

9066 Background: Comorbidity has received increasing attention in the assessment of patients with early stage cancer, or at diagnosis. We studied whether three indices of comorbidity, the Charlson Comorbidity Index (CMI), the Cumulative Illness Rating Scale (CIRS), and the Kaplan Feinstein Index (KFI) add prognostic information for cancer patients receiving palliative care. Methods: In an IRB approved protocol, 103 patients with advanced cancer were seen at the time they were starting palliative care. They had a Karnofsky Performance Status (KPS) determination, and were followed longitudinally. Comorbidity scores were coded from the medical record. At this time, all patients had died and survival analyses were performed. Results: The median age was 69 years (range 41–87), median Karnofsky Performance Status (KPS) was 70% (range 20–90); primary sites were lung 41 pts (40%), prostate 23pts (22%), colorectal 10 pts (10%), other cancers 29 pts (28%). Median survival was 111 days (range 4–1,145 days). Median CMI was 10 (range 4–14), CIRS15 4 (2–5), CIRS16 9 (4–12), CIRS17 2.3 (1.5–3.33), CIRS18 1 (0–3), KFI 2 (0–3). In univariate survival analyses, when bisected by median values, the KPS, age, CMI, and subscales of the CIRS (CIRS 16, CIRS 17, CIRS18) were significantly related to survival, but not the KFI. In multivariate Cox regression analyses that included KPS (p<0.0001) and age (p<0.003) and a comorbidity index, the CMI (p<0.0001), and certain subscales of the CIRS were independently predictive of survival, specifically the CIRS 15 (p<0.0001), CIRS16 (p<0.0001), CIRS 17 (p<0.0001), and CIRS18 (p<0.0001). The primary site was not an independent survival predictor. Conclusion: In patients with advanced cancer receiving palliative care, measures of comorbidity may contribute to refining estimates of prognosis and ultimately to health care resource utilization. The optimal comorbidity measure remains to be determined. These results will be confirmed in larger populations. Supported in part by the Soros Open Society Institute Project Death in America and VA HSRD IIR 02–103 No significant financial relationships to disclose.

Effect of statin and metformin on survival in veterans (V) with B-cell lymphoproliferative disorders (BLD).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1602-1602
Author(s):  
Shanthi Srinivas ◽  
Melanie L. Gonzalez ◽  
Sunniya Khan ◽  
Arpita Gandhi ◽  
Barbara Crump ◽  
...  
Keyword(s):  
Rating Scale ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Cox Regression Analysis ◽  
Comorbidity Index ◽  
Beta 2 Microglobulin ◽  
Ecog Ps ◽  
The Impact ◽  
Statin Use

1602 Background: The incidence of BLD has been increasing in V. As many V are on statin and metformin for comorbid conditions, we evaluated the impact of their use on survival. Methods: In an IRB-approved protocol, we reviewed the records of 332 V diagnosed with BLD from January 1997 to Dec 2011 for demographics, height(H),weight(W), BMI,statin and metformin use, clinical and laboratory data and ECOG PS. Comorbidity was assessed using the Charlson Comorbidity Index (CCI),Kaplan-Feinstein Index (KFI) and Cumulative Illness Rating Scale (CIRS). Cox regression analysis was performed using SAS v 9.2. Results: There were 332 V with a median (M) age of 70 years (27-94). The M for H 70 inches (58-78), W 183lbs (99-356.5) and BMI 26.7 kg/m2 (15.54 -48.45). The M for hemoglobin(Hgb) 12.8 g/dl (7.3-17.4), albumin 3.9(1.2-5.4), lactate dehydrogenase( LDH) 183 IU/L (85-1905), beta 2-microglobulin 2.6 mg/dl (0.8-39) . The M for CCI was 4.7 (0.8-12), KFI 2 (0-3), CIRS15 3 (0-6), CIRS16 6(0 -14), CIRS17 1.9(0-6), CIRS18 0(0-3), CIRS19 0(0-3). M survival was 1297days(4-7468).The number of V receiving statin was 167 (51%) and metformin 46 (14%). Statin use was a predictor of survival by both univariate and multivariate analysis but metformin was a predictor only by univariate analysis. Conclusions: Statin use was an independent and significant predictor of survival in this group of V with BLD and needs to be validated in a larger group of patients. [Table: see text]

TP53 Gain-of-Function and Non–Gain-of-Function Mutations Are Differentially Associated With Sidedness-Dependent Prognosis in Metastatic Colorectal Cancer

2021 ◽  
Author(s):  
Minggui Pan ◽  
Chen Jiang ◽  
Pam Tse ◽  
Ninah Achacoso ◽  
Stacey Alexeeff ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cox Regression ◽  
Performance Status ◽  
Wild Type ◽  
Gain Of Function ◽  
Pik3ca Mutations ◽  
Prognostic Stratification ◽  
Comorbidity Index ◽  
Generation Sequencing

PURPOSE To examine the association of gain-of-function (GOF) and non–gain-of-function (non-GOF) TP53 mutations with prognosis of metastatic right-sided (RCC) versus left-sided colorectal cancer (LCC). METHODS This cohort study included patients with metastatic colorectal cancer (CRC) who had next-generation sequencing performed from November 2017 to January 2021. We defined R175H, R248W, R248Q, R249S, R273H, R273L, and R282W as GOF and all other mutp53 as non-GOF. We used Cox regression modeling to examine the association between GOF and non-GOF mutp53 and overall survival (OS), adjusting for age, sex, ethnicity, performance status, Charlson comorbidity index and receipt of chemotherapy. RESULTS Of total 1,043 patients, 735 had tumors with mutp53 and 308 had wild-type p53 (wtp53). GOF was associated with worse OS than non-GOF mutp53 only in LCC (hazard ratio [HR] = 1.66 [95% CI, 1.20 to 2.29]), but not in RCC (HR = 0.79 [95% CI, 0.49 to 1.26]). Importantly, RCC was associated with worse OS than LCC only in the subset of patients whose CRC carried non-GOF (HR = 1.76 [95% CI, 1.30 to 2.39]), but not GOF mutp53 (HR = 0.92 [95% CI, 0.55 to 1.53]) or wtp53 (HR = 0.88 [95% CI, 0.60 to 1.28]). These associations were largely unchanged after also adjusting for RAS, BRAF, and PIK3CA mutations, and microsatellite instability-high. CONCLUSION Poorer survival of patients with metastatic RCC versus LCC appeared to be restricted to the subset with non-GOF mutp53, whereas GOF versus non-GOF mutp53 was associated with poorer survival only among patients with LCC. This approach of collectively classifying mutp53 into GOF and non-GOF provides new insight for prognostic stratification and for understanding the mechanism of sidedness-dependent prognosis. If confirmed, future CRC clinical trials may benefit from incorporating this approach.

Use of circulating endothelial cells to predict response to FOLFOX4 plus bevacizumab in metastatic colorectal cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 427-427
Author(s):  
S. Matsusaka ◽  
N. Mizunuma ◽  
M. Suenaga ◽  
K. Chin ◽  
E. Shinozaki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cox Regression ◽  
Performance Status ◽  
Univariate Analysis ◽  
Eastern Cooperative Oncology Group ◽  
Circulating Endothelial Cells ◽  
Ecog Performance Status ◽  
Cox Regression Analysis ◽  
The Government

427 Background: The purpose of this study was to identify CEC threshold proposal for determining response to FOLFOX4 plus bevacizumab in metastatic colorectal cancer (mCRC). Methods: All patients were enrolled using institutional review board-approved protocols at the Cancer Institute Hospital and provided informed consent. From July 2007 to June 2008, 33 patients treated with FOLFOX4 plus bevacizumab were enrolled in a prospective study. From January 2007 to June 2007, before bevacizumab was approved by the government in Japan, 31 patients treated with FOLFOX4 as a control were enrolled. The study population consisted of patients aged 18 years or older with histologically proven mCRC. Other inclusion criteria were Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, adequate organ function. CECs of whole blood at the baseline, day 4, 2 weeks after initiation of chemotherapy were isolated and counted using immunomagnetics. Results: There was no correlation between CEC levels and the outcome in the FOLFOX4. In the FOLFOX4 plus bevacizumab, CEC levels at the baseline were significantly associated with the outcome. Patients with 65 or more CECs at the baseline had shorter median PFS (9.2 months), than the median PFS of fewer than 65 CECs at the baseline (18.9 months) in the FOLFOX4 plus bevacizumab (p = 0.003). Patients with 65 or more CECs at the baseline had shorter median OS (23.3 months), than the median OS of fewer than 65 CEC s at the baseline in the FOLFOX4 plus bevacizumab (p = 0.027). In the univariate analysis, lung metastasis, lymph node metastasis, and CEC levels at the baseline predicted PFS. In the univariate Cox regression analyses, peritoneal metastasis, CEC levels at the baseline were associated with OS. In order to evaluate the independent predictive effect of FOLFOX4 plus bevacizumab, multivariate Cox regression analysis was carried out. CEC levels at the baseline were the strongest predictor. Conclusions: A threshold of lower than 65 CEC/4mL at the baseline was a significant predictor of the outcome for colorectal cancer patients treated with FOLFOX4 plus bevacizumab. No significant financial relationships to disclose.

Comparison of clinical parameters and survival in Vietnam era (V) versus non-Vietnam era (non-V) veterans with non-Hodgkin lymphoma (NHL).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18516-e18516
Author(s):  
Shanthi Srinivas ◽  
Victor T Chang ◽  
Leroy Cordero Floyd ◽  
Basil Kasimis ◽  
Melanie L. Gonzalez ◽  
...  
Keyword(s):  
Rating Scale ◽  
Cox Regression ◽  
Performance Status ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Agent Orange ◽  
Ecog Performance Status ◽  
Eligibility Criteria ◽  
Non Hodgkin Lymphoma ◽  
Vietnam Era

e18516 Background: The incidence of NHL has been increasing in the US population. Agent Orange exposure has been implicated in the development of B cell lymphoproliferative disorders including NHL. We explored possible differences in the clinical and lab parameters and predictors of survival in V versus Non-V veterans with diagnosis of NHL at the VAHCSNJ. Methods: In an IRB-approved protocol, the records of veterans diagnosed with NHL from January 1997 to December 2011 were reviewed for demographic, clinical, and pathology data, including HIV, Hep B, Hep C titers, Vietnam Veteran status and survival. We tabulated the ECOG Performance Status (PS), International Prognosis Index (IPI)/ Follicular Lymphoma International Prognostic Index (FLIPI), Charlson Comorbidity Index (CMI), the Kaplan-Feinstein Index (KFI), the Cumulative Illness Rating Scale (CIRS) and Vietnam status. Cox regression analyses were performed to determine predictors of survival. Results: There were 152 veterans who met the eligibility criteria; 78 V and 74 non-V; the groups did not differ by PS, stage, beta 2microglobulin (b2m), and HIV status, IPI/FLIPI. Differences in their clinical features are summarized (Table). The proportion of V vets with high grade lymphomas was greater than non V vets (p .036). Survival predictors for both the V and non-V veterans were the age, PS, hemoglobin, LDH, albumin, grade, IPI/FLIPI. However, in V veterans, b2m (p< 0.001) and stage were additional predictors of survival. Median survival for V veterans was 1454 days (95%CI 864-3377) and Non-V was 1824 days (95% CI 560-2075). Conclusions: The V veterans were younger with higher grade disease compared to the Non-V veterans. While their stage and PS were not different, survival was shorter. These should be studied further in a larger sample. [Table: see text]

Negative impact of cachexia during chemotherapy on survival as first-line chemotherapy for metastatic colorectal cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 126-126
Author(s):  
Kazuki Nozawa ◽  
Toshiki Masuishi ◽  
Ryosuke Kumanishi ◽  
Taiko Nakazawa ◽  
Takatsugu Ogata ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Negative Impact ◽  
Performance Status ◽  
Muscle Loss ◽  
First Line ◽  
Ecog Performance Status ◽  
Skeletal Muscle Index ◽  
Ecog Ps

126 Background: Sarcopenia and muscle loss during chemotherapy (Cx) have a poor prognosis in metastatic colorectal cancer (mCRC). It is unclear whether cachexia during Cx has a survival impact. Methods: mCRC patients (pts) receiving first-line Cx at a single institution between Jan 2010 and Jun 2018 were retrospectively evaluated. Pts receiving doublet Cx with bevacizumab or anti-EGFR agents, ECOG Performance Status (PS) 0–2, and abdominal computed tomography (CT) before and after initiating first-line Cx at least once were included and classified pts into those with (cachexia group) or without (non-cachexia group) cachexia. The skeletal muscle index (SMI) was calculated from the CT cross-section area at L3 divided by the length squared. Muscle loss was defined as a < 5% reduction in the SMI. The association between muscle loss and cachexia during Cx, time to treatment failure (TTF) and overall survival (OS) was determined by univariate and multivariate analysis including muscle loss, primary tumor location, ECOG PS, number of metastatic sites, ALP, WBC, LDH, KRAS status, and BRAF status as independent variables. Results: Of 562 included pts, 185 were eligible and 69 (37%) experienced cachexia. Differences in all patient characteristics such as muscle loss, ECOG PS 2, KRAS mutant, and BRAF mutant (28%, 8%, 32%, and 10% with cachexia group and 27%, 3%, 32%, and 8% with non-cachexia group) were not significant. Median follow-up was 26.8 months. Muscle loss was not associated with TTF (13.3 vs. 15.5 months, HR = 1.05; 95% CI: 0.76–1.45, p = 0.76). OS was shorter (24.4 vs. 29.9 months, HR = 1.23; 95% CI: 0.86–1.76, p = 0.25), but the difference was not significant in univariate and multivariate analysis. However, cachexia group presented significantly shorter TTF [median TTF 11.9 vs. 16.9 m; HR 1.52, 95% CI: 1.12-2.07, p < 0.01; adjusted HR (aHR) 1.53, 95% CI: 1.12-2.11, p < 0.01] and shorter OS (median OS 21.4 vs. 34.1 m; HR 1.81, 95% CI: 1.29-2.55, p < 0.01; aHR 1.97, 95% CI: 1.38-2.81, p < 0.01) than non-cachexia group. Conclusions: Cachexia during Cx may have a negative impact on survival in pts with mCRC.

Comparison of predictors of survival in colon and rectal cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14681-e14681
Author(s):  
Ying Margie Tang ◽  
Nneoma Olivia Okoronkwo ◽  
Neal Patel ◽  
Victor Tsu-Shih Chang ◽  
Trent P Wang ◽  
...  
Keyword(s):  
Rating Scales ◽  
Medical Center ◽  
Performance Status ◽  
Univariate Analysis ◽  
Ecog Performance Status ◽  
Colon And Rectal Cancer ◽  
Increased Risk ◽  
Asco 2012 ◽  
Ecog Ps ◽  
Survival Predictors

e14681 Background: We studied comorbidity and other predictors of survival for patients (pts) with colorectal cancer (CRC) and compared pts with colon (C) vs rectal (R) cancer (ca). Methods: In an IRB-approved protocol, we reviewed the records of pts diagnosed with CRC at a VA medical center from 01/01/2003 to 12/31/2011 for demographics, stage, grade, ECOG performance status (PS), CEA, Hemoglobin (HGB), and Albumin (ALB) at diagnosis (dx). Comorbidity was assessed with the Charlson Comorbidity Index (CCI), the Cumulative Illness Rating Scales (CIRS), and the Kaplan-Feinstein Index (KFI). Statistical analyses were performed with SAS 9.2/Stata 11.0. We compared the pts with C vs R ca. Results: There were 279 men. 191 pts (68.5%) had C ca and 88 pts (31.5%) had R Ca. The two groups were similar for stage, grade, age, HGB, CEA, ALB, and ECOG PS. For R ca pts, Median (M) CCI is 3.7 (0.4-13.9), M CIRS15 2.5 (0-5), M CIRS16 5 (0-13), M CIRS 17 2.0 (0-8), M CIRS18 0 (0-1), M CIRS19 0 (0-1), and M KFI 1 (0-3). For C ca pts, M CCI is 4.3 (0.9-19.6), M CIRS15 3.0 (0-6), M CIRS16 6.0 (0-13), M CIRS17 2.0 (0-9), M CIRS18 0 (0-1), M CIRS19 0 (0-2), and M KFI 2 (0-3). In univariate analysis, stage, ECOG PS, HGB, and ALB were significant survival predictors in R ca pts. Age, stage, grade, ECOG PS, HGB, CCI, CIRS16, CIRS17, CIRS19 and KFI were significant for C ca pts. Other significant multivariate predictors are summarized in the table. R ca pts are more likely to die (P=0.003, HR=0.51). Conclusions: In this larger population of pts with CRC, we confirmed our previous findings (ASCO 2012 e14125). Grade, stage, ECOG PS, and CIRS 19 are important independent survival predictors for veterans with CRC. Age, grade, stage, ECOG PS, CCI, CIRS 16 and CIRS 19 are independent predictors for colon ca pts. Only Stage and ECOG PS are independent predictors for rectal ca pts. Rectal ca pts are at increased risk of dying. More research is needed to confirm this. Supported by New Jersey Commission for Cancer Research. [Table: see text]

KEYNOTE-048: Progression after the next line of therapy following pembrolizumab (P) or P plus chemotherapy (P+C) vs EXTREME (E) as first-line (1L) therapy for recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6505-6505 ◽  
Author(s):  
Kevin Joseph Harrington ◽  
Danny Rischin ◽  
Richard Greil ◽  
Denis Soulieres ◽  
Makoto Tahara ◽  
...  
Keyword(s):  
Cox Regression ◽  
Performance Status ◽  
Population Data ◽  
Anticancer Therapy ◽  
Ecog Performance Status ◽  
Kaplan Meier ◽  
Hpv Status ◽  
Prior Systemic Therapy ◽  
Line Of Therapy ◽  
Ecog Ps

6505 Background: 1L P vs E improved OS in PD-L1 CPS ≥20 and CPS ≥1 populations, and led to noninferior OS in the total population, with favorable safety; 1L P+C vs E had superior OS in CPS ≥20, CPS ≥1, and total populations with comparable safety in the phase 3 KEYNOTE-048 study (NCT02358031) in patients with R/M HNSCC. Neither P vs E nor P+C vs E improved PFS in the PD-L1 CPS ≥20, CPS ≥1, or total populations. Here, we present the progression after the next line of therapy (PFS2) to assess the effect of 1L P or P+C and subsequent anticancer therapy on patient outcomes. Methods: Patients with locally incurable R/M HNSCC and no prior systemic therapy in the R/M setting were randomly assigned 1:1:1 to P, P+C, or E. PFS2 was defined as time from randomization to objective tumor progression on next-line therapy or death from any cause. PFS2 was estimated using the Kaplan-Meier method as an exploratory outcome confined to those receiving subsequent therapy after 1L P. HR and 95% CIs were based on a Cox regression model with Efron’s method of tie handling with treatment as a covariate (stratified by ECOG performance status [PS], HPV status, and PD-L1 for CPS ≥1 and total populations; by ECOG PS and HPV status for CPS ≥20 population). Data cutoff: Feb 25, 2019. Results: Of 882 (301 [P]; 281 [P+C]; 300 [E]) treated patients,422 (P: 148 [49.2%]; P+C: 115 [40.9%]; E: 159 [53.0%]) received subsequent anticancer therapy after 1L P, most commonly C (P: 135 [44.9%]; P+C: 88 [31.3%]; E: 102 [34.0%]); EGFR inhibitor (P: 59 [19.6%]; P+C: 37 [13.2%]; E: 19 [6.3%]); and immune checkpoint inhibitor (P: 6 [2.0%]; P+C: 12 [4.3%]; E: 50 [16.7%]); patients may have received more than one type of subsequent therapy. Median PFS2 is reported in Table. Conclusions: In patients with R/M HNSCC, longer median PFS2 was observed in the CPS ≥20 and CPS ≥1 populations for P vs E, and in the CPS ≥20, CPS ≥1, and total populations for P+C vs E. These data further support use of 1L P or P+C in patients with R/M HNSCC. Clinical trial information: NCT02358031 . [Table: see text]

Comorbidity and survival of hepatocellular carcinoma patients at a VA medical canter

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15682-e15682
Author(s):  
F. Zhong ◽  
T. Oliphant ◽  
V. T. Chang ◽  
B. Crump ◽  
M. L. Gonzalez ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Alcohol Use ◽  
Iron Overload ◽  
Rating Scale ◽  
Medical Center ◽  
Stage Iv ◽  
Multivariate Survival ◽  
Comorbidity Index ◽  
Ecog Ps ◽  
Larger Sample

e15682 Background: To determine whether comorbidity indices predict survival in hepatocellular carcinoma (HCC) pts. Methods: In an IRB approved protocol, we reviewed the records of pts with tissue diagnosis of HCC seen at a VA Medical Center between 1/1/1999 to 12/31/2008. Comorbidity was assessed with four comorbidity indices, the Charlson Comorbidity Index (CMI), the Kaplan- Feinstein Index (KFI), the Cumulative Illness Rating Scale (CIRS), and VA Comorbidity Scale (VACS). Demographics, ECOG PS, stage, alpha-fetoprotein (AFP) at diagnosis, hepatitis B (HBV) and C (HCV) status, alcohol use, and iron overload were also reviewed. Cox survival regression analysis was performed. Results: There were 44 pts. All pts were men. The median (M) age at diagnosis was 60.5 years (range 35–86). The overall M survival was 230 days (4–2784). There were Stage I 12 (27%) pts, Stage II 7 (16%) pts, Stage III 14 (32%) pts, and Stage IV 11 (25%) pts. The M ECOG PS was 1.0 (0–4), stage 3 (1–4), CMI 5.75 (1–16), CIRS15 3.0 (1–5), CIRS16 6.0 (1–14), CIRS17 2.0 (0.83–5.0), CIRS18 0 (0–2), CIRS19 0 (0–1), KFI 3.0 (1–3), VACS 6.0 (2–9), and AFP 56.35 (1.1–379567). HBV was positive in 10 pts (23%), HCV 26 (59%) pts, alcohol use 37 (84%) pts, and iron overload 11 (25%) pts. In univariate survival analysis, stage (p<.038), ECOG PS (p<.001), AFP (p<.009), presence of iron overload (p<.006), and CMI (p<.019) were significant in predicting survival. However, age, HBV, HCV, alcohol use, CIRS15, CIRS16, CIRS17, CIRS18, KFI, and VACS were not significant for survival. In multivariate survival analyses that included stage and a comorbidity index, the CMI approaches significance (p<.077). Conclusions: In this sample, the CMI was a predictor for survival in pts with HCC. Further analysis in a larger sample is needed to provide a more definitive conclusion. This was supported by the New Jersey Commission for Cancer Research 09–1133-CCR-EO. No significant financial relationships to disclose.

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