What factors affect long-term survival after responding to gefitinib in advanced non-small cell lung cancer? Real-world evidence.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18007-e18007
Author(s):  
Yoshiko Takeuchi ◽  
Fumio Imamura ◽  
Satoshi Morita ◽  
Masahide Mori ◽  
Kiyoshi Komuta ◽  
...  
Keyword(s):  
Survival Time ◽  
Treatment Regimen ◽  
Medical Records ◽  
Egfr Mutation ◽  
Performance Status ◽  
Primary Objective ◽  
Term Survival ◽  
Long Term Survival ◽  
Gefitinib Treatment

e18007 Background: After gefitinib was approved in July 2002, we experience long-term surviving patients in the actual clinical setting. However, it is not clear how the factors or treatment strategy are contributing to the long-term surviving patients.We evaluated the effects of clinical backgrounds and treatment histories on overall survival (OS). Methods: We extracted information on advanced NSCLC patients with the following inclusion criteria from the medical records: 1) Patients who were diagnosed by October 2010 and treated with gefitinib after July 2002: 2) Performance status (PS) 0 – 2, 3) PR, CR, or long SD (6 months or more) by gefitinib treatment : 4) Patients who had not received curative surgical operation or curative radiation therapy. Primary objective is to evaluate survival time of the patients who responded to gefitinib and clarify the relationship between clinical factors and survival time. We also conducted “Dynamic Treatment Regimen Analysis (DTRA)” to explore key treatment regimen and sequence of regimens contributing to long-term survival. Results: The medical records of total of 275 patients were extracted. 44% (122/275) were EGFR mutation examined and 93% (114/122) has shown the EGFR mutation positive. The mean age was 65 years, 72% (198/275) were women, 66% (182/275) were non-smokers, and 90% (247/275) had adenocarcinoma histology. 20% (54/275) and 21% (58/275) underwent re-administration and beyond PD administration of gefitinib respectively. Median survival time (MST) was 615 day (95% C.I; 519-691). 10% patients survived for more than 5 years. The multivariate Cox analysis demonstrated that sex (p=0.0108) and gefitinib re-administration (p=0.0012) were significant independent factors for long-term OS. Grade 3/4 interstitial lung disease, skin, diarrhea, and liver dysfunction were observed in 1.5%, 4.4%, 1.1%, and 13.1% of the patients, respectively. Conclusions: This study suggests that sex and gefitinib re-administration, may have significant affects on OS in long survivors after responding gefitinib treatment.

scholarly journals Long-term Glioblastoma Multiforme Survivors: a Population-based Study

1998 ◽  
Vol 25 (3) ◽  
pp. 197-201 ◽  
Author(s):  
J.N. Scott ◽  
N.B. Rewcastle ◽  
P.M.A. Brasher ◽  
D. Fulton ◽  
N.A. Hagen ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Performance Status ◽  
Population Based ◽  
Patient Treatment ◽  
Ki 67 ◽  
Term Survival ◽  
Population Based Study ◽  
Long Term Survival ◽  
Dismal Prognosis

ABSTRACT:Background:Long-term glioblastoma multiforme survivors (LTGBMS) are uncommon. The frequency which these occur in an unselected population and factors which produce these unusually long survivors are unknown.Objectives:To determine in a population- based study 1) the frequency of LTGBMS in a population and 2) identify which patient, treatment or tumor characteristics would predict which glioblastoma (GBM) patient would become a LTGBMS.Methods:The Alberta Cancer Registry was used to identify all patients diagnosed with GBM in southern Alberta between 1/1/75 - 12/31/91. Patient charts were reviewed and histology re-examined by a blinded neuropathologist. LTGBMS were defined as GBM patients surviving ≥ 3 years after diagnosis. Each LTGBMS was compared to three age-, gender-, and year of diagnosis-matched controls to compare patient, treatment, and tumor factors to GBM patients without long-term survival.Results:There were 279 GBMs diagnosed in the study period. Five (1.8%) survived ≥ three years (range, 3.2-15.8 years). Seven additional long-term survivors, who carried a diagnosis of GBM, were excluded after neuropathologic review; the most common revised diagnosis was malignant oligodendroglioma. LTGBMS (avg. age = 45 years) were significantly younger when compared to all GBM patients (avg. age = 59 years, p - 0.0001) diagnosed in the study period. LTGBMS had a higher KPS at diagnosis (p = 0.001) compared to controls. Tumors from LTGBMS tended to have fewer mitoses and a lower Ki-67 cellular proliferative index compared to controls. Radiation-induced dementia was common and disabling in LTGBMS.Conclusions:These data highlight the dismal prognosis for GBM patients who have both a short median survival and very small chance (1.8%) of long-term survival. The LTGBMS were younger, had a higher performance status, and their tumors tended to proliferate less rapidly than control GBM patients. When long-term survival does occur it is often accompanied by severe treatment-induced dementia.

scholarly journals Soluble E-Cadherin is an Independent Pretherapeutic Factor for Long-Term Survival in Gastric Cancer

2003 ◽  
Vol 21 (12) ◽  
pp. 2288-2293 ◽  
Author(s):  
Annie On-On Chan ◽  
Kent-Man Chu ◽  
Shiu-Kum Lam ◽  
Benjamin Chun-Yu Wong ◽  
Ka-Fai Kwok ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Time ◽  
Enzyme Linked Immunosorbent Assay ◽  
Independent Factor ◽  
Term Survival ◽  
Long Term Survival ◽  
The World ◽  
The Mean ◽  
E Cadherin

Purpose: To evaluate whether pretherapeutic serum soluble E-cadherin is an independent factor predicting long-term survival in gastric cancer. Gastric cancer remains the second leading cause of cancer-related deaths in the world, but a satisfactory tumor marker is currently unavailable for gastric cancer. Soluble E-cadherin has recently been found to have prognostic value in gastric cancer. Patients and Methods: One hundred sixteen patients with histologically proven gastric adenocarcinoma were included in the trial. Pretherapeutic serum was collected, and soluble E-cadherin was assayed using a commercially available enzyme-linked immunosorbent assay kit. The patients were followed up prospectively at the outpatient clinic. Results: There were 75 men and 41 women, with a mean (± SD) age of 66 ± 14 years. Forty-eight percent of tumors were located in the gastric antrum. The median survival time was 11 months. The mean pretherapeutic value of soluble E-cadherin was 9,159 ng/mL (range, 6,002 to 10,025 ng/mL), and the mean pretherapeutic level of carcinoembryonic antigen was 11 ng/mL (range, 0.3 to 4,895 ng/mL). On multivariate analysis, soluble E-cadherin is an independent factor predicting long-term survival. Ninety percent of patients with a serum level of E-cadherin greater than 10,000 ng/mL had a survival time of less than 3 years (P = .009). Conclusion: Soluble E-cadherin is a potentially valuable pretherapeutic prognostic factor in patients with gastric cancer.

scholarly journals Older patients/older donors: choosing wisely

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Andrew S. Artz
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Older Patients ◽  
Hematopoietic Cell Transplantation ◽  
Performance Status ◽  
Self Report ◽  
Term Survival ◽  
Long Term Survival ◽  
Matched Sibling

Two lingering problems regarding transplantation in older adults have been how to select patients appropriately and whether to use older sibling donors. Allogeneic hematopoietic cell transplantation (HCT) of older patients may result in long-term survival due to GVL, but the data remain observational and mostly restricted to those 50 to 69 years of age. Patients with excellent performance status and low comorbidity have the best long-term survival after HCT. Novel measures of health status such as self-report or performance-based functional measures allow “staging the age” and may inform candidacy for less robust patients. Older matched sibling donors should be preferred over matched unrelated donors (MUDs) because outcomes are equivalent to superior for matched sibling donors compared with MUD. However, MUDs also achieve acceptable outcomes and long-term disease control. An alternative donor can be considered based on institutional protocols and expertise. Very limited information is available in patients or related donors 70 years of age and older. Future efforts to more completely characterize patient health status before transplantation will allow better application of HCT in older adults.

Dynamic treatment regimen analysis to determine which treatment sequence can prolong survival of NSCLC patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19010-e19010
Author(s):  
Taro Koba ◽  
Fumio Imamura ◽  
Satoshi Morita ◽  
Masahide Mori ◽  
Kiyoshi Komuta ◽  
...  
Keyword(s):  
Overall Survival ◽  
Treatment Regimen ◽  
Performance Status ◽  
Treatment Sequence ◽  
Term Survival ◽  
Gefitinib Treatment ◽  
Dynamic Treatment ◽  
Nsclc Patients ◽  
Egfr Tki ◽  
Challenge Group

e19010^ Background: We often experience the re-challenge of EGFR-TKI on practice. However, it has not been reported which treatment sequence for EGFR-TKI re-challenge will contributes to long-term survival of NSCLC patients. Methods: We extracted information from retrospective cohort of advanced NSCLC patients with the following inclusion criteria: 1) Japanese patients who were diagnosed by October 2010 and treated with gefitinib after July 2002. 2) Performance status (PS) 0-2. 3) PR, CR, or long SD (6 months or more) by gefitinib. 4) Patients who had not received curative surgical operation or radiation therapy. The primary objective was to evaluate the effects of treatment histories on Overall Survival (OS). We also conducted a “Dynamic Treatment Regimen Analysis (DTRA)”. DTRA can be used to compare multiple treatment strategies/sequences in terms of time-to-event data like overall survival time. Results: A total of 335 NSCLC patient details were extracted. Sixty five patients experienced gefitinib re-challenge. There was a statistical difference in OS between gefitinib re-challenge group and non re-challenge group (median OS was 1272 days vs 774 days; p<0.001). We confirmed this result using DTRA, “Gefitnib-Singlet chemo-Gefitinib” treatment sequence extended survival most out of all treatment sequence. Conclusions: This study suggests that gefitinib re-challenge may have significant affects on OS in long survivors after responding gefitinib treatment. Clinical trial information: UMIN000006913. [Table: see text]

Long-term survival (over 10 years) of inoperable/metastatic GISTs: A retrospective series of 141 patients (pts) of the french sarcoma group (FSG).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11041-11041
Author(s):  
Florence Duffaud ◽  
Edouard Auclin ◽  
Antoine Italiano ◽  
Julien Mancini ◽  
Francois Bertucci ◽  
...  
Keyword(s):  
Medical Records ◽  
Univariate Analysis ◽  
Median Number ◽  
Term Survival ◽  
Primary Tumors ◽  
Long Term Survival ◽  
Factors Associated ◽  
Metastatic Gist ◽  
Median Size

11041 Background: A subset of metastatic GIST exhibit very long-term survival after imatinib (IM) introduction. The aim of this study was to analyse the clinico-biological characteristics of GIST pts alive > 10 years (yrs) after diagnosis (dx) of metastases (mets) and identify possible factors associated with long-term survival. Methods: Pts were identified from 2 sarcoma databases; NetSarc and ConticaGIST. Clinical data prospectively registered in the databases were supplemented with retrospective review of medical records. Results: We identified 141 pts (75 men, 66 women) with median age 54 (17-84) yrs and median ECOG 0 (0-2). Primary tumors (T) were all CD117+, and mainly gastric or intestinal (64 & 45 pts), with median size 10 (2-40) cm, CD34+ (82 pts), mitoses/50 HPF ≤ 5 (n = 36), or > 5 (n = 81). Genotype was documented in 82 (58%) pts with 73 (89%) KIT mutations (in exons 11,9 and 12 of 69, 3, and 1 pts respectively) and 9 WT KIT. 129 (91%) T were resected, 124 upfront, 5 post IM, with R0/R1/R2 resections in 61, 11, and 10 pts. Mets were mainly hepatic or peritoneal (78 & 51 respectively). 1st line TKI was given to 139 pts: 130 received IM; 88 (63%) within a clinical trial (CT), 41 (29%) had mets resection. Second, 3d and 4th line TKI were given to 81, 51 and 37 pts respectively, comprising 27, 7 and 10 from CT. Median number of TKIs was 2 (0-7), but 60 (44%) pts received only 1st line with no GIST progression within or after 10 yrs. 2 pts never received TKI but had mets resection. After median FU of 14.3 yrs (10-34.5), 104 remain alive, 37 died. Mean and Median OS from initial dx are 24 yrs (CI95% 21.6-27) and 20,8 yrs. Median PFS on TKIs are 127, 29, 21 and 22 mos on 1st, 2d, 3d and 4th line of TKI. In univariate analysis no factor is significantly associated with OS, but T size (≤ 10 vs > 10 cm) and oligometastatic disease (≤5 vs > 5 mets) are borderline significant (p = 0.056 and 0.07), and good PS (ECOG ≤ 1) at 2dline TKI initiation is associated with better PFS (p = 0.03). Conclusions: This large series of long-term ( > 10 yrs) survivors of metastatic GIST shows a high proportion of mets resection and a longer duration of PFS for TKI at any line. In this selected population, no prognostic factor is associated with long OS.

Long-term survival and performance status of cancer patients after discharge from ICU (intensive care unit).

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e18744-e18744
Author(s):  
Marta Zafra ◽  
Andres Carrillo ◽  
Maria Angeles Vicente ◽  
Manuel Sánchez Cánovas ◽  
Alejandra Ivars Rubio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cancer Patients ◽  
Performance Status ◽  
Term Survival ◽  
Long Term Survival ◽  
And Performance

IMMU-26. SAFETY AND EFFICACY OF PVSRIPO IN RECURRENT GLIOBLASTOMA: LONG-TERM FOLLOW-UP AND INITIAL MULTICENTER RESULTS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi97-vi97
Author(s):  
Annick Desjardins ◽  
Matthias Gromeier ◽  
Henry Friedman ◽  
Daniel Landi ◽  
Allan Friedman ◽  
...  
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Recurrent Glioblastoma ◽  
External Control ◽  
Published Data ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract BACKGROUND Recurrent glioblastoma (rGBM) is rapidly fatal (median overall survival [mOS] of ~9 months; OS at 12 months [OS12] &lt; 35%) with approved therapies (lomustine±bevacizumab). PVSRIPO is an intratumoral immunotherapy targeting CD155 on antigen-presenting and malignant cells of solid tumors. Preclinically, PVSRIPO delivers a systemic, tumor antigen-specific, polyfunctional T-cell mediated anti-tumor response. Interim, single-center, phase (Ph) 1 results showed greater long-term survival with PVSRIPO vs. criteria-matched external control rGBM patients (Desjardins 2018). Updates to Ph1 safety (at the Ph2 dose) and efficacy and interim multicenter (Ph2) results are presented. METHODS Adults with histologically-confirmed rGBM, Karnofsky performance status ≥ 70, and an active, supratentorial, contrast-enhancing lesion (1-5.5cm) received PVSRIPO (5x107 TCID50) intratumorally via convection-enhanced delivery on Day 1, with a planned follow-up of 24 months. Safety (treatment-emergent adverse events [TEAEs]), efficacy (reported as OS12, OS24, mOS), and blood/tissue were assessed. RESULTS 149 patients (&gt;90% with 1-2 prior progressions, including failure of SOC and patients with prior bevacizumab failure) received the Ph2 dose of PVSRIPO (n=30 received other doses in Ph1 with safety summarized previously). Follow-up durations for surviving patients were 51-74 months (Ph1) and 10-44 months (Ph2). No dose-limiting toxicities occurred; up to 97% of patients experienced mostly grade 1-2 related TEAEs; ≤ 23% patients experienced grade ≥ 3 related events. Neurologic symptoms related to peritumoral edema were most common ( &gt; 90% patients) and were effectively managed with low-dose bevacizumab/corticosteroids. Survival estimates were: OS12: 54%, 50%; OS24: 18%, 17%; mOS: 12.3 (95% CI 10,15.3), 12 (10.6,13.7) months, for the Ph1 and Ph2 trials, respectively. Baseline correlates of longer survival included smaller lesions and methylated MGMT-promoter status. CONCLUSIONS The multicenter/Ph2 study replicated the single-center/Ph1 results. Relative to published data with approved therapies, PVSRIPO was associated with greater long-term survival and mOS in patients with rGBM and was generally well-tolerated.

scholarly journals Morse taper implant macrodesign, loading protocol and site of installation – retrospective study of 5,601 implants

2019 ◽  
Vol 48 ◽  
Author(s):  
Rafael Coutinho Mello MACHADO ◽  
Geninho THOMÉ ◽  
Sergio Rocha BERNARDES ◽  
Ana Claudia Moreira MELO
Keyword(s):  
Survival Rate ◽  
Medical Records ◽  
Survival Rates ◽  
The Body ◽  
Insertion Torque ◽  
Term Survival ◽  
Long Term Survival ◽  
Treatment Objective ◽  
Final Survival

Abstract Introduction The long-term implant-supported prosthetic rehabilitation monitoring is extremely important in evaluating parameters that could interfere in the success of the treatment. Objective To evaluate the influence of macrodesign (shape of the body and apex), length and diameter, insertion torque, site of installation as well as the loading protocol, on long-term survival rates. Material and method The data obtained was from the medical records of rehabilitated patients who had had at least one Morse taper implant surgery done at ILAPEO School between 2006 -2012. Incomplete medical records, from which it would have been impossible to extract all data essential to complete the study, were excluded. Result A total of 1,142 patient’s medical records comprised the sample; documenting the progress of 5,601 implants, done in both jaws and mandibles. The final survival rate was 98.31%, over an average time of 37.54 months. The type of implant most used was cylindrical (70.33%). The mean installation torque most evidenced in the study was between 41 and 50 Ncm. A logistical regression analysis showed that none of the following variables, site of installation, body and apex shape designs and length, had any significant statistical influence on implant loss. Torque increase and diameter influenced implant loss while immediate loading favored implant maintenance. Conclusion It can be concluded that Morse taper implants present a long-term survival rate that can be lowered by excessive torque, as well as by the diameter of the implant.

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