Outcome after liver transplantation compared with chemotherapy in colorectal cancer patients with nonresectable liver-only disease.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 531-531
Author(s):  
Svein Dueland ◽  
Tormod Kyrre Guren ◽  
Morten Hagness ◽  
Bengt Glimelius ◽  
Pål-Dag Line ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Second Line ◽  
First Line ◽  
Liver Malignancies ◽  
Data Set ◽  
The Difference ◽  
Third Line ◽  
Colorectal Cancer Patients ◽  
Clinical Trial Information ◽  
Line Chemotherapy

531 Background: Surgical treatment of colorectal liver metastases (CLM) is the only treatment option with curative potential; however, only about 10-20% of the patients are candidates for surgical resection. The majority of CLM patients has non-resectable disease, and receives palliative chemotherapy. These patients have poor prognosis with median OS of about 20-24 months after starting first-line chemotherapy and only about 10% survive five years. Methods: Individual data from patients with non-resectable liver only disease who had received liver transplantation (Ltx) (SECA-study, Hagness et al., Ann Surg. 2013) were compared to a similar group of patients with non-resectable liver only metastases included in the NORDIC VII study (first-line Flox chemotherapy ± Cetuximab, Tveit et al., J Clin Oncol. 2012). Twenty one patient included in the Ltx study were compared to 47 patients with liver only metastases included in the NORDIC VII study. All patients in the NORDIC VII study started first-line chemotherapy, whereas 57% of patients in the Ltx study had received second- or third-line chemotherapy at time of Ltx. Results: Median age of the Ltx group was 56 years (range 45-65 years) and 57 years (range 34-65 years) in the Nordic VII study. Median tumor size was 4.5cm (range 2.8-13.0cm) and 5.0cm (range 1.4-16.0cm) in the Ltx and Nordic VII groups, respectively. 5 year OS in the Ltx group was 60% compared to a 5 year OS of 9% in the NORDIC VII group. The 5 year OS of the 21 patients in the NORDIC VII data set with the longest OS was 19%. The patients in the Ltx study who had received only first-line chemotherapy at time of Ltx had a 5 year OS of 80%. Patients in the NORDIC VII study had an OS from end of second-line chemotherapy of 6-7 months. In comparison, patients with progressive disease on second-line/third-line chemotherapy at time of Ltx, had a median OS of 39 months and a 5 year OS of 30%. Conclusions: Patients with non-resectable CLMonly, has a dramatic improved OS after Ltx compared to chemotherapy. The difference could not be explained by patient selection. Selected patients with CRC obtain OS similar to Ltx patients transplanted for primary liver malignancies. Selected CRC patients should therefore be considered for Ltx. Clinical trial information: NCT01311453.

Less toxic chemotherapy on the uptake of all lines of chemotherapy in advanced non-small cell lung cancer: A 10-year retrospective population-based review.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19131-e19131
Author(s):  
Cheryl Ho ◽  
Katherine Ramsden ◽  
Nevin Murray ◽  
Sophie Sun ◽  
Barbara L. Melosky ◽  
...  
Keyword(s):  
Systemic Therapy ◽  
Advanced Nsclc ◽  
Geographical Area ◽  
Population Based ◽  
Second Line ◽  
First Line ◽  
Data Set ◽  
Third Line ◽  
Line Chemotherapy ◽  
Over Time

e19131 Background: The platinum doublet is standard first-line therapy in advanced NSCLC. Over the past decade, well-tolerated second-line therapies have been approved, including erlotinib and pemetrexed. We hypothesize that the introduction of less-toxic chemotherapy has increased treatment of advanced NSCLC, resulting in improved survival. Methods: The BC Cancer Agency provides cancer care to a population of 4.5 million. A retrospective review was conducted of all referred stage IIIB/IV patients in four 1-yr time cohorts; C1 baseline (1998) and 6 months after the provincial approval of C2 docetaxel (2001), C3 erlotinib (2006) and C4 pemetrexed (2007). Results: 2,623 patients were referred and 720 had systemic therapy. Characteristics: M/F 55%/45%, median age 67 (33-101), ECOG <=1/>=2/unknown 33%/56%/11%, never/former/current/unknown smoker 9%/35%/36%/20%, squam/nonsquam/NOS 18%/41%/41%. More patients received first-line chemotherapy over time; 16%, 23%, 34%, 33% C1-4 respectively. In C1 to C4 uptake of second line (21%, 27%, 38%, 55%) and third line (10%, 10% 14%, 18%) increased. In C1 the most common first-line doublet was cis/vino (70%) and in C4, cis/gem (45%). Second-line doce was frequently used in C2 (51%) but usage decreased in C4 to 7% vs. erlo 50% and pem 26%. In the >=70 group (n=1,118), first-line usage increased from C1 9% to C4 19% and second-line in the C2 (doce) 4% to C4 (erlo+pem avail) 56%. The increased use of systemic therapy was associated with improved survival in all patients: C1 4.56 m vs C4 4.98 m (p=0.004) and treated patients; C1 9.48 m vs C4 12.07 m (p=0.014) and the >= 70 group; C1 9.7 m vs C4 12.5 m (p=0.07). Conclusions: This population-based data set represents the trend of treatments over time in a large geographical area, including community and tertiary care cancer treatment sites. The introduction of less-toxic systemic therapy for advanced NSCLC resulted in an increased proportion of patients treated with first-line chemotherapy and an even greater increase in second-/third-line treatment. This trend was particularly evident in the elderly. Associated with this was a significant improvement in overall survival for all subsets.

Analysis and follow-up of the patients diagnosed with metastatic gastric adenocarcinoma in the Parc Taulí Hospital, Sabadell, between 2010 and 2013.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 169-169
Author(s):  
Marta Ferrer ◽  
Carles Pericay ◽  
Ismael Macias ◽  
Emma Dotor ◽  
Aleydis Pisa ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Clinical Information ◽  
Gastric Body ◽  
Second Line ◽  
First Line ◽  
Kaplan Meier ◽  
Secondary Endpoints ◽  
Third Line ◽  
Line Chemotherapy

169 Background: The primary endpoint of this study was to know the incidence and treatment of gastric carcinoma in our area. Other secondary endpoints were percentage of treated patients, overall survival (OS), survival in subgroups, and more frequent treatments. Methods: Since 2010 to 2013 all the patients diagnosed with metastatic gastric adenocarcinoma and treated at the hospital Parc Taulí from Sabadell were registered. The clinical information was compiled and analyzed. Survivals curves were determined with Kaplan-Meier functions Results: 168 patients were studied, with 79 metastatic (47%). 56% men and median age 67 years. Localizations were gastric body 52%, gastro-esophageal junction 20%, and antrum 25%. OS of the series was 5,05 months (95% CI, 2,99-7,10). 60% of the patients were treated with first line chemotherapy (CT). From them, 42% had a second line and 25% a third line. DFS were respectively 6,62 months (4,06-9,17), 4,29 months (2,28-6,30), and 2,88 months (1,12-4,64) for every line of treatment. OS of the patients that received chemotherapy was 9.7 months (6,40-13,00). CT more used in first line were triplets of fluropyrimidines, platinum and taxanes, in 45% (21 patients). Also just fluoropyrimidines and platinum without taxanes, in 38%. As a second line the predominant CT is also platinum and fluoropyrimidines (37%), and irinotecan (30%). In third line, 50% are combinations based on irinotecan. Conclusions: The OS of the patients who received CT is significantly prolonged respect the ones who didn’t. The data obtained matches the data already published in the literature, even the more frequent chemotherapy.

scholarly journals Lapatinib as second-line treatment after the double block pertuzumab-trastuzumab: a case report

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 185-190
Author(s):  
Valentina Magri ◽  
Simone Scagnoli ◽  
Gabriele Piesco ◽  
Giulia Pomati
Keyword(s):  
Whole Brain Radiotherapy ◽  
Trastuzumab Emtansine ◽  
Second Line ◽  
First Line ◽  
Her2 Positive ◽  
Early Recovery ◽  
Brain Radiotherapy ◽  
Free Interval ◽  
Third Line ◽  
Line Chemotherapy

We report the case of a young, 36-year-old patient diagnosed with multifocal breast carcinoma, undergoing neoadjuvant chemotherapy, surgery and adjuvant treatment. The patient presented an early recovery of liver disease after only 7 months of free interval. Histological reevaluation after liver biopsy revealed a HER2-positive disease, for which it was treated with first line chemotherapy including double anti-HER2 block. After 3 cycles the disease progressed at liver and encephalic level. It was therefore decided to treat brain localizations with whole-brain radiotherapy and to start a second line with capecitabine associated with lapatinib. This chemo-radiotherapy approach allowed to control the disease for 8 months. Following further progression (lymph node and bone), a third line was chosen with trastuzumab emtansine (TDM1). The encephalic disease remained stable for another 8 months, when due to visceral progression and worsening of clinical picture, TDM1 was interrupted and supportive therapies were started (Oncology). .

Chemothery (pacitaxol or irinotecan), plus apatinib and sintilimab as second-/third-line treatment for advanced gastric cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16080-e16080
Author(s):  
Ting Deng ◽  
Le Zhang ◽  
Jingjing Duan ◽  
Hongli Li ◽  
Shaohua Ge ◽  
...  
Keyword(s):  
Adverse Events ◽  
Objective Response ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Elevated Alkaline Phosphatase ◽  
Second Line Chemotherapy ◽  
Third Line ◽  
Line Chemotherapy ◽  
Third Line Treatment

e16080 Background: Patients with advanced gastric or gastro-esophageal junction cancer have poor prognosis after progression on first-line chemotherapy. We investigated to combine second-line chemotherpy with third-line drugs, apatinib and anti-PD-1 antibody in these patients. Methods: This study is a single center, exploratory study in China. Eligible patients are adults with histologically confirmed advanced gastric or GEJ adenocancinoma, who were failure of first-line or second-line chemotherapy. Subjects receive chemotherapy, pacitaxol or iritecan (investigator choice), apatinib 250mg po qd, sintilimab 200mg ivd q3w. Response was assessed every 6 weeks. (RECIST version1.1) Primary endpoint was progression free survival (PFS). Results: Between May 30, 2019 and November 5, 2020, a total of 26 patients were enrolled in this study, and 4 (15.4%) patients were failure of second-line chemotherapy. There were 21 males and 5 females, and the median age was 61. The total number of treatment cycles was 140 and the median number was 5.5. Among 24 patients who were evaluated, partial response (PR) was obtained in 12 cases, stable disease (SD) in 8 cases and progressive disease (PD) in 4 cases. Objective response rate was 50.0%，and disease control rate was 83.3%. The median PFS was 7.06 months (95% CI 5.52-8.60), and the median overal survival has not yet been reached. The most common adverse events (AE) were leukopenia (61.5%), anemia (57.7%), neutropenia (53.8%), proteinuria (42.3%), alopecia (42.3%), hypothyroidism (38.5%), elevated alanine aminotransferase (34.6%), elevated aspartate aminotransferase (34.6%) and elevated alkaline phosphatase (34.6%), but most of them were grade 1 or 2, and the most common grade 3 or 4 treatment-related adverse events was neutropenia (11.5%). Conclusions: Chemotherapy, plus apatinib and sintilimab demonstrated promising activity and manageable safety profile as second- even third-line treatment in advanced gastric or GEJ cancer. Demographics and baseline characteristics.[Table: see text]

Second-line chemotherapy in advanced gastric cancer: A retrospective, single-center analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15170-15170
Author(s):  
C. Herrmann ◽  
D. Jaeger ◽  
T. Herrmann
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Advanced Gastric Cancer ◽  
Chemotherapy Regimen ◽  
Salvage Chemotherapy ◽  
Second Line ◽  
First Line ◽  
Second Line Chemotherapy ◽  
Third Line ◽  
Line Chemotherapy

15170 Background: The role of second-line chemotherapy in advanced gastric cancer is not yet established. We analyzed patients with advanced gastric cancer treated at our department between 2002 and 2005 comparing the outcome of patients with first-line chemotherapy only and those who received second-line chemotherapy. Patients and Methods: 51 patients with metastatic or recurrent histologically confirmed gastric cancer were analyzed in this retrospective study. The choice of chemotherapy depended on the attending physician. Results: Altogether, 17 patients (33.3 %) were treated with only one chemotherapy regimen, whereas 34 patients (66.6 %) received at least two different chemotherapy regimens. During the last years, the preference for certain chemotherapy regimens changed. At the time of analysis, 9 patients were still alive. Median overall survival was 11 months (range: 1–41). Patients who received only one chemotherapy regimen were older (median age 70, range: 47–81), had a shorter TTP (3.5 months, range: 1–15) and a shorter overall survival (6 months, range: 2–25) than patients receiving sequential chemotherapies (median age 61.5 (range: 33–79) p = 0,009, TTP under first-line therapy 5 months (1–17), p = 0,45, overall survival 14.5 months (2–41), p = 0,001). Response to second-line chemotherapy was assessed in 32 patients: Partial remission was detected in 4 patients (12.5 %), stable disease for = 3 months in 15 patients (46.8 %), whereas disease progression occurred in 12 patients (37.5 %). 10 of 51 patients (19.6 %) received more than two different treatments: 4 patients had third-line chemotherapy, 6 patients had more than 3 different therapies. Overall survival was 13 months (11–22) for patients with third-line chemotherapy and 29 months (16–41) for patients receiving more than three different treatment regimens. Conclusion: Although a number of active antineoplastic drugs are available for the treatment of advanced gastric cancer, the prognosis is still poor. Selected patients may benefit from salvage chemotherapy after failure of first-line chemotherapy. No significant financial relationships to disclose.

scholarly journals Phase II Study of S-1 Monotherapy as a First-line, Combination Therapy of S-1 plus Cisplatin as a Second-line, and Weekly Paclitaxel Monotherapy as a Third-line Therapy in Patients with Advanced Gastric Carcinoma

2008 ◽  
Vol 2 ◽  
pp. CMO.S610
Author(s):  
Yasushi Rino ◽  
Norio Yukawa ◽  
Nobuyuki Wada ◽  
Makoto Suzuki ◽  
Hitoshi Murakami ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Effect ◽  
Phase Ii Study ◽  
Sequential Therapy ◽  
Second Line ◽  
First Line ◽  
Line Therapy ◽  
Third Line Therapy ◽  
Third Line ◽  
Line Chemotherapy

Background We conducted a pilot phase II study to evaluate the efficacy and safety of S-1 as a first-line, S-1 plus cisplatin as a second-line, and weekly paclitaxel as a third-line therapy for advanced gastric cancer. Patients and Methods Between 2002 and 2005, 19 patients were enrolled in this study. Chemotherapy consisted of either 60 mg/m2 of S-1 for 4 weeks at 6 weeks interval, a combination of 60 mg/m2 S-1 for 3 weeks and 60 mg/m2 cisplatin on day 8 at 5 weeks interval, or 60 mg/m2 paclitaxel at day 1, 8, 15, at 4 weeks interval. The regimen was repeated until the occurrence of unacceptable toxicities, disease progression, or patient refusal. The primary end point was the overall survival. Results The response rates were 33.3%, 12.5%, and 0% after the first, second, and third line chemotherapy, respectively. The mean overall survival time was 994 days. The median survival time could not be calculated because 12 out of 19 patients were still alive when the study was concluded. Regarding hematological toxicity, the major adverse effect was leukopenia, which reached grades 3–4 in all lines of chemotherapy investigated. In addition, regarding non-hematological toxicities, the major adverse effect was anorexia, which reached grade 3–4 in the second line chemotherapy, and no deaths were attributable to the adverse effects of the drugs. Conclusion This sequential therapy was an effective treatment for advanced gastric cancer with acceptable toxic side-effects. We considered this sequential therapy to be effective because of the smooth switch to the next regimen.

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