Post-treatment prognostic model for patients (pts) with metastatic urothelial cancer (UC) treated with first-line chemotherapy.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 256-256 ◽  
Author(s):  
Matt D. Galsky ◽  
Erin L. Moshier ◽  
Susanne Krege ◽  
Chia-Chi Lin ◽  
Noah M. Hahn ◽  
...  
Keyword(s):  
External Validation ◽  
Post Treatment ◽  
Treatment Discontinuation ◽  
White Blood Count ◽  
Concordance Index ◽  
First Line ◽  
Duration Of Treatment ◽  
End Of Treatment ◽  
Metastatic Urothelial Cancer ◽  
Line Chemotherapy

256 Background: Models to predict the outcome of pts with metastatic UC, based on pre-treatment variables, have previously been developed. However, pts often request “updated” prognostic estimates based on their response to treatment. This is particularly relevant in first-line treatment of metastatic UC, a disease state for which a fixed number of cycles of chemotherapy are typically administered. Methods: Data were pooled from 317 pts enrolled on eight trials evaluating first-line cisplatin-based chemotherapy in metastatic UC. Variables were combined in a Cox proportional hazards model to produce a nomogram to predict survival from end of treatment. The nomogram was validated externally using data from a trial of MVAC versus docetaxel plus cisplatin (n=148). Results: The median survival from end of treatment was 10.65 months [95% CI 9.20 – 13.24]; 69% of patients had died. Baseline (white blood count, ECOG performance status, number of visceral metastatic sites) and post-treatment (treatment response, duration of treatment, reason for treatment discontinuation) variables were evaluated. The Cox proportional hazard model is shown in the Table. The duration of treatment and reason for treatment discontinuation were not significantly associated with survival. The four significant variables were included in a nomogram. The nomogram achieved a bootstrap-corrected concordance index of 0.68. Upon external validation, the nomogram achieved a concordance index of 0.67. Conclusions: A model derived from pre- and post-treatment variables was constructed to predict survival from the end of first-line chemotherapy in pts with metastatic UC. This model may be useful for pt counseling and for stratification of trials exploring “maintenance” treatment. [Table: see text]

Conditional Survival of Patients Treated With First-Line Chemotherapy for Metastatic Urothelial Cancer

2015 ◽  
Vol 13 (3) ◽  
pp. 244-249 ◽  
Author(s):  
Matteo Santoni ◽  
Simon J. Crabb ◽  
Alessandro Conti ◽  
Lorena Rossi ◽  
Luciano Burattini ◽  
...  
Keyword(s):  
Urothelial Cancer ◽  
Conditional Survival ◽  
First Line ◽  
Metastatic Urothelial Cancer ◽  
Line Chemotherapy

Immunohistochemistry (IHC) to enhance the prognostic allocation of locally advanced and metastatic urothelial cancer (UC) undergoing first-line chemotherapy (CT).

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 4547-4547
Author(s):  
Patrizia Giannatempo ◽  
Biagio Paolini ◽  
Salvatore Lo Vullo ◽  
Manuela Marongiu ◽  
Elena Farè ◽  
...  
Keyword(s):  
Urothelial Cancer ◽  
Locally Advanced ◽  
First Line ◽  
Metastatic Urothelial Cancer ◽  
Line Chemotherapy

Molecular subtyping of metastatic urothelial bladder cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 326-326
Author(s):  
Charlotte Ackerman ◽  
Sanjeev Mariathasan ◽  
Dorothee Nickles ◽  
Alfonso Gomez De Liano Lista ◽  
Akhila Ganeshi Wimalasingham ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Immune Therapy ◽  
Clinical Information ◽  
Progression Free Survival ◽  
The Cancer Genome Atlas ◽  
Urothelial Bladder Cancer ◽  
First Line ◽  
Metastatic Urothelial Cancer ◽  
Urothelial Bladder ◽  
Line Chemotherapy

326 Background: TCGA molecular sybtyping is established in metastatic urothelial bladder cancer (UBC). It remains unclear if it is of prognostic importance with chemotherapy in metastatic UBC. Data into immune therapy suggests TCGA subtyping is predictive to response. Methods: Archival formalin-fixed paraffin embedded (FFPE) tissue were analysed from 170 patients that had consented into a clinical trial (NCT00949455) after first line chemotherapy for metastatic disease. Gene expression levels were quantified by NanoString technology. Molecular subtypes were assigned according to The Cancer Genome Atlas (TCGA) subtypes. Clinical information was available for all patients and analysis on individual genes were explored. Results: 170 patients were analysed, 75% male. 107 (64%) patients received cisplatin based first-line chemotherapy, with 36% receiving carboplatin based regimen. Median overall survival (OS) was 15.73 months [95% CI: 13.87-17.58], and median progression free survival (PFS) was 10.71 months [95% CI: 8.97-12.45]. Samples were initially clustered into luminal (n=109) and basal (n=61) subtypes. Response to first line chemotherapy occurred in all subtypes but was shown to be significantly higher in the luminal subtype versus the basal subtype [58% vs 20%, p=0.01]. PFS was superior in luminal subtypes [11.8 months vs 8.9 months, p=0.005]. Exploratory analysis showed that luminal II subtype had the best outcome for OS [20.3 months, p=0.03] compared to the other subtypes. Outcomes with other genes including immune markers were explored. TCGA outcomes can be summarised in the table. Conclusions: In metastatic urothelial cancer, TCGA subclassifying influences outcome of patients post chemotherapy. [Table: see text]

scholarly journals Phase II trial of palbociclib in patients with metastatic urothelial cancer after failure of first-line chemotherapy

2018 ◽  
Vol 119 (7) ◽  
pp. 801-807 ◽  
Author(s):  
Tracy L. Rose ◽  
David D. Chism ◽  
Ajjai S. Alva ◽  
Allison M. Deal ◽  
Susan J. Maygarden ◽  
...  
Keyword(s):  
Phase Ii ◽  
Urothelial Cancer ◽  
Phase Ii Trial ◽  
First Line ◽  
Metastatic Urothelial Cancer ◽  
Line Chemotherapy

Prognostic model for overall survival in patients with metastatic urothelial cancer treated with cisplatin-based chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4524-4524 ◽  
Author(s):  
Matt D. Galsky ◽  
Susanne Krege ◽  
Chia-Chi Lin ◽  
Noah M. Hahn ◽  
Thorsten Ecke ◽  
...  
Keyword(s):  
Median Survival ◽  
Urothelial Cancer ◽  
Performance Status ◽  
External Validation ◽  
Prognostic Significance ◽  
Multivariable Analysis ◽  
Phase Iii ◽  
White Blood Count ◽  
P Value ◽  
Metastatic Urothelial Cancer

4524 Background: Patients with metastatic urothelial cancer (UC) treated with cisplatin-based chemotherapy have heterogeneous clinical outcomes. Pretreatment prognostic variables have previously been defined (Bajorin, JCO, 1999) but have not been extensively validated or expanded upon. Methods: Pretreatment clinical parameters from 400 international patients with metastatic UC treated on phase II and III first-line clinical trials with cisplatin-based chemotherapy from 11/1997 to 10/2011 were evaluated (cisplatin + gemcitabine +/- paclitaxel or +/- antiangiogenic agent = 235; MVAC = 83; cisplatin + 5FU +/- paclitaxel = 79). Parameters were subjected to multivariable regression analysis to determine which patient characteristics had independent prognostic significance for survival. Results: Complete data were available on 361 patients, median survival was 13.9 months (95% CI 12.4, 16.5); 247 have died. In multivariable analysis, ECOG performance status (≥1), visceral metastases (lung, liver, bone), and white blood count (WBC, continuous variable) were significantly associated with poor survival (P < .05), whereas perioperative chemotherapy, hemoglobin, platelets, creatinine clearance, site of primary tumor, and number of metastatic sites were not (Table). The cut-off for WBC was established at 10. Median survival times for patients with 0, 1, 2, or 3 risk factors were 26.9, 16.8, 12.8, 9.7 months (log rank p value < 0.0001). When subjected to internal validation, the model achieved a bootstrap-corrected c-index of 0.60. External validation is ongoing utilizing data from a phase III trial (n=186) of MVAC versus docetaxel plus cisplatin. Conclusions: A model derived from pretreatment parameters from an international cohort of patients was constructed that confirmed, and expanded upon, known prognostic factors in metastatic UC. This model may be useful for patient counseling and clinical trial design. Better predictions require the identification of additional factors that affect survival. [Table: see text]

scholarly journals Combination of Alarm-intervention and Reboxetine in Therapy- Resistant Enuresis

2018 ◽  
Vol 37 (3) ◽  
pp. 213-219
Author(s):  
Kirill Kosilov ◽  
Irina Kuzina ◽  
Yuliya Gainullina ◽  
Vladimir Kuznetsov ◽  
Liliya Kosilova ◽  
...  
Keyword(s):  
Combined Treatment ◽  
Intervention Group ◽  
Monotherapy Group ◽  
First Line ◽  
Duration Of Treatment ◽  
End Of Treatment ◽  
Before And After ◽  
Group A ◽  
Group B

Introduction: The first-line treatments of primary monosymptomatic night enuresis (PMNE) are alarm intervention and desmopressin. Some patients are resistant to these modes of treatment. Therefore Reboxetine has been used to treat PMNE in these scenarios in recent years and published in many studies. The aim of the study was to determine effectiveness and safety of combination of Alarm intervention and Reboxetine, to treat patients with therapyresistant enuresis.Material and Methods: Two hundred and nineteen children of both sexes were participated in the experiment (average age, 11.3 years). Participants were divided into three groups: Group A (71 patients, Alarm intervention), Group B (79 patients, Reboxetine as monotherapy), Group C (69 patients, Alarm intervention + Reboxetine). The duration of treatment was twelve weeks, followed by follow-up period of twelve weeks to see efficacy.Result: There was no significant change in number of enuresis episodes per week before and after treatment in a group B. The number of enuresis episodes per a week (weekly) in a group C reached: before treatment 5.3 (1.5), after treatment 1.0 (0.8), 3 three months after the end of treatment 0.7 (0.7). The percentage of patients with PMNE in a group C was significantly less immediately after the course of treatment (17.4%), and three months after treatment (24.6%).Conclusion: Combined treatment of therapy-resistant enuresis with use of Alarm Intervention and Reboxetine gives a high percentage of cured patients both immediately after therapy (82.6%) and three months after the end (75.4%).

scholarly journals The Role of Irinotecan-Bevacizumab as Rescue Regimen in Children With Low-Grade Gliomas: A Retrospective Nationwide Study in 72 Patients

2021 ◽  
Author(s):  
Charles de Marcellus ◽  
Arnault Tauziède-Espariat ◽  
Aurélie Cuinet ◽  
Claudia Pasqualini ◽  
Matthieu P. Robert ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Low Grade ◽  
First Line ◽  
Standard Chemotherapy ◽  
Duration Of Treatment ◽  
Pilot Studies ◽  
Disease Stabilization ◽  
Line Chemotherapy

Abstract Introduction. At least half of children with low-grade glioma (LGG) treated with first line chemotherapy experience a relapse/progression and may therefore need a second-line chemotherapy. Irinotecan-bevacizumab has been recommended in this setting in France after encouraging results of pilot studies. We performed a retrospective analysis to define the efficacy, toxicity and predictors for response to the combination on a larger cohort. Methods. We reviewed the files from children < 19 years of age with progressive or refractory LGG treated between 2009 and 2016 in 7 French centers with this combination. Results. 72 patients (median age 7.8 years [range, 1-19]) received a median of 16 courses (range, 3-30). The median duration of treatment was 9 months (range, 1.4-16.2). 96% of patients experienced at least disease stabilization. The 6-month and 2-year progression-free survivals (PFS) were 91.7% [IC 95% 85.5-98.3] and 38.2% [IC 95% 28.2-51.8] respectively. No progression occurred after treatment in 18 patients with a median follow-up of 35.6 months (range, 7.6-75.9 months). Younger patients had a worse PFS (p=0.005). Prior chemoresistance, NF1 status, duration of treatment, histopathology or radiologic response did not predict response. The most frequent toxicities related to bevacizumab included grades 1-2 proteinuria in 21, epistaxis in 10, fatigue in 12 and hypertension in 8 while gastro-intestinal toxicity was the most frequent side effect related to irinotecan. Conclusion. Bevacizumab-irinotecan is highly effective for children with recurrent LGG who have failed standard chemotherapy regimens whatever their clinical characteristics, only younger children had a worse PFS.

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