Patterns of recurrence in patients with sinonasal undifferentiated carcinoma (SNUC) treated with multimodality therapy at a single center.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17575-e17575
Author(s):  
Cristina P. Rodriguez ◽  
Jay Justin Liao ◽  
Andrew W. Liu ◽  
Upendra Parvathaneni ◽  
George E Laramore ◽  
...  
Keyword(s):  
Overall Survival ◽  
Skull Base ◽  
Tobacco Use ◽  
Median Overall Survival ◽  
Medical Center ◽  
Demographic Data ◽  
Locally Advanced ◽  
Cribriform Plate ◽  
Nodal Disease ◽  
Base Extension

e17575 Background: SNUCs are rare and without established therapeutic standards. This is a retrospective review of therapeutic outcomes in pts with SNUCs treated at our center. Methods: Data was collected retrospectively on pts with a confirmed diagnosis of SNUC treated at the University of Washington Medical Center. Demographic data, tumor/treatment characteristics,and dates of recurrence/progression and death were recorded. The Kaplan Meier method was used to estimate survival outcomes; the log-rank and Wilcoxon tests were used to explore associations of clinical characteristics with outcome. Results: Between 5/1992 and 11/2016, 32 pts were treated, 1 was excluded due to incomplete data. The median age was 52 (range 22-82) years, 14(45%) were female, 26(83%) were white, 17(54%) reported current or former tobacco use. One presented with distant metastases, 1 had T2N0 disease, and all other pts had locally advanced disease. Six pts had nodal involvement on initial staging, and 25 patients had T4 disease. Eleven(35%) pts had no skull base/CNS invasion, 7(22%) had skull base extension up to the cribriform plate, 13(42%) had extension beyond the cribriform plate and into the CNS. Twenty-one(67%) pts underwent surgical resection, 29(93%) underwent radiation(XRT) with a median dose of 70 (range 54-72) Gy, and 28(90%) received cisplatin based chemotherapy, with 24 of these given concurrent with XRT, 19(60%) were treated with surgery followed by chemoradiation. With a median 61 months of follow up, 15 pts have recurred, 10 of these recurrences occurred in local sites, with 6 having intracranial progression, 2 of which were leptomeningeal. The median time to progression was 15 months and median overall survival was 58 months . Any vs no tobacco use (58 vs 35 mo p = 0.8), was not predictive of overall survival. The presence of nodal disease (87 vs 7 mo p = 0.005), and CNS invasion beyond the cribriform plate (NR vs 14 mo p = 0.04) was associated with inferior median overall survival. Conclusions: Local/CNS recurrence was the predominant failure pattern in our pts. CNS invasion beyond the cribriform plate and nodal disease were associated with significantly worse survival.

Preoperative radiotherapy and docetaxel in resectable pancreatic adenocarcinoma: A phase II trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4099-4099 ◽  
Author(s):  
F. Viret ◽  
M. Ychou ◽  
V. Moutardier ◽  
V. Magnin ◽  
P. Rouanet ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pancreatic Adenocarcinoma ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Pathological Response ◽  
Phase Iii ◽  
Additional Patient ◽  
Curative Intent ◽  
Grade 3

4099 Background: We previously reported results a phase I trial of weekly docetaxel concurrently with radiation therapy in patients (pts) with locally advanced pancreatic adenocarcinoma (Pancreas, Vol 27, N°3, 2003). We prospectively explored this regimen in 34 pts with biopsy proven potentially resectable pancreatic adenocarcinoma. Methods: Treatment consisted of concomitant radiotherapy (45 Gy within 5 weeks directed at the pancreatic tumor and regional lymphatics) with 5 weekly doses of docetaxel (30 mg/m2/week) by 1-hour infusion, followed by a complete staging evaluation 3–4 weeks after chemo-radiation. Pts without disease progression underwent surgery. Results: From May, 2003 to July, 2005, this study enrolled 34 pts (59% men) with median age 62 years (range 45–72). Median tumor size was 3 cm. Pretreatment Endoscopic Ultrasound (EUS) staging was uT1 (7 pts), uT2 (25 pts), uT3 (2pts), uN0 (26 pts) and uN1 (8 pts). Median pretreatment CA 19.9 levels was 114 (range 1–9432). All pts (97%) but one completed radiation and 91% (31 pts) received the 5 weekly doses of docetaxel. Adverse events included grade 3/4 asthenia (28%), grade 3/4 nausea/vomiting (10%), grade 3/4 anemia (7%) and grade 3/4 neutropenia (7%). Median time between diagnosis and surgery was 3.7 months (range 2.8–8.7). Ten pts (29%) presented progressive disease after chemo-radiation and one additional patient (pt) voluntary stopped treatment procedure. Twenty three pts (68%) underwent surgical procedure, which was with curative intent in 17 pts (50%). One pt died within the 30-day post operative period. Pathological response was observed in 7 pts (30%), including 2 complete response. The median Disease Free Survival (DFS) was 11 months and the 2-year DFS was 21%. The median overall survival (OS) was 14 months. The 2-year DFS for the 17 pts resected with a curative intent was 50.4%. In this subgroup, median overall survival was not reached. Conclusions: Pre-operative combination of radiotherapy and docetaxel is feasible with tolerable toxicity and with promising pathological response. A randomized phase III study comparing this regimen (radiotherapy and docetaxel) and surgery versus surgery alone is starting. Supported in part by Sanofi Aventis, France. No significant financial relationships to disclose.

Association of neoadjuvant chemotherapy on survival in locally advanced gallbladder cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16716-e16716
Author(s):  
Syed Mohammad Ali Kazmi ◽  
Suleyman Yasin Goksu ◽  
Muhammet Ozer ◽  
Nina Niu Sanford ◽  
Matthew R. Porembka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Gallbladder Cancer ◽  
Propensity Score Matching ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Node Positive

e16716 Background: Gallbladder cancer (GBC) is an uncommon but highly fatal malignancy. Surgery remains the only potentially curative treatment for GBC. The role of neoadjuvant chemotherapy in patients with locally advanced GBC undergoing surgery is unknown. We studied the association of neoadjuvant chemotherapy on survival in locally advanced GBC patients who underwent resection. Methods: We identified adult patients with locally advanced (stage III-IV) GBC who underwent definitive surgery between 2004 and 2016 using the National Cancer Database. Treatment was categorized as neoadjuvant chemotherapy plus surgery (NAT), surgery plus adjuvant therapy (AT), and surgery alone (SA). Categorical variables were compared using the chi-square test with Bonferroni correction. Kaplan-Meier and Cox regression were used for survival analyses. We used 1:3 nearest neighbor propensity score matching based on NAT for each group. Results: Out of a total of 5,962 patients, 122 (2.2%) received NAT, 2934 (53.6%) AT, and 2421 (44.2%) SA. NAT was associated with private insurance and treatment at an academic/research facility (all p < .001) while SA patients were older, Hispanic, had government insurance, and higher comorbidities (all p < .001). Although all groups had similar lymph node assessment (NAT: 45%, AT: 46%, SA: 37%, p < .001), NAT was associated with lymph node negative disease (NAT 23%, AT 13.2%, SA 13.2%, p < .001). Median overall survival was higher in NAT compared to AT or SA (21 vs. 14 vs. 6 months, p < .001) which persisted after propensity score matching (21 vs. 15 vs. 9 months, p < .001) and multivariable regression analysis (Table). In node positive GBC, NAT was associated with improved median overall survival (NAT 24, AT 18, SA 8 months, p < .001). Conclusions: NAT is infrequently used in patients with locally advanced GBC. NAT is associated with improved median overall survival compared to AT and SA, and appears to be most beneficial in node positive disease. Prospective studies are needed to evaluate the role of neoadjuvant chemotherapy in locally advanced GB. [Table: see text]

scholarly journals Impact of New Chemotherapy Regimens on the Treatment Landscape and Survival of Locally Advanced and Metastatic Pancreatic Cancer Patients

2020 ◽  
Vol 9 (3) ◽  
pp. 648 ◽  
Author(s):  
Markus Kieler ◽  
Matthias Unseld ◽  
Daniela Bianconi ◽  
Martin Schindl ◽  
Gabriela V. Kornek ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Median Overall Survival ◽  
Systemic Treatment ◽  
Locally Advanced ◽  
Survival Rates ◽  
Cox Proportional Hazards Model ◽  
Metastatic Pancreatic Cancer ◽  
Line Treatment ◽  
First Line

Background: New chemotherapy regimens for the treatment of metastatic pancreatic cancer have changed the therapy paradigm. We aimed to assess their impact on the treatment landscape and clinical outcome at our academic institution. Methods: In this single institutional posthoc registry analysis, we assessed characteristics and survival rates from all patients with locally advanced and metastatic pancreatic cancer who started a systemic treatment between 01/2011 and 12/2017. Survival analyses were performed by Kaplan-Meier and Cox proportional hazards model. Results: A total of 301 patients started a systemic treatment in the observation period. In the first line treatment, we observed a shift from the four different main regimens (gemcitabine/nab-paclitaxel, modified FOLFIRINOX, gemcitabine/oxaliplatin +/− erlotinib or gemcitabine alone) to gemcitabine/nab-paclitaxel and modified FOLFIRINOX that add up to more than 80% of administered first line treatments in each of the time cohorts (2011–2013 vs. 2014–2017). The rate for first line modified FOLFIRINOX treatment was balanced between the two groups (19% and 15%). Median overall survival differed significantly between the two time cohorts (8.89 versus 11.9 months, p = 0.035). Survival rates for different first to second line treatment sequences (modified FOLFIRINOX to gemcitabine/nab-paclitaxel, gemcitabine/nab-paclitaxel to fluoropyrimidines plus nanoliposomal irinotecan, or gemcitabine/nab-paclitaxel to fluoropyrimidines plus oxaliplatin) were not significantly different and median overall survival ranged from 14.27 to 15.64 months. Conclusion: Our study provides real-world evidence for the effectiveness of the new chemotherapy regimens and underscores the importance of the choice of the front-line regimen when considering different sequencing strategies.

Effect of Margin Status on Survival After Resection of Hilar Cholangiocarcinoma in the Modern Era of Adjuvant Therapies

2020 ◽  
pp. 000313482097340
Author(s):  
Michael D. Watson ◽  
Maria R. Baimas-George ◽  
Michael J. Passeri ◽  
Jesse K. Sulzer ◽  
Erin H. Baker ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hilar Cholangiocarcinoma ◽  
Demographic Data ◽  
Locally Advanced ◽  
Resection Margins ◽  
R0 Resection ◽  
Complication Rates ◽  
Curative Intent ◽  
Adjuvant Therapies

Introduction Studies have shown that for patients with hilar cholangiocarcinoma (HC), survival is associated with negative resection margins (R0). This requires increasingly proximal resection, putting patients at higher risk for complications, which may delay chemotherapy. For patients with microscopically positive resection margins (R1), the use of modern adjuvant therapies may offset the effect of R1 resection. Methods Patients at our institution with HC undergoing curative-intent resection between January 2008 and July 2019 were identified by retrospective record review. Demographic data, operative details, tumor characteristics, postoperative outcomes, recurrence, survival, and follow-up were recorded. Patients with R0 margin were compared to those with R1 margin. Patients with R2 resection were excluded. Results Seventy-five patients underwent attempted resection with 34 (45.3%) cases aborted due to metastatic disease or locally advanced disease. Forty-one (54.7%) patients underwent curative-intent resection with R1 rate of 43.9%. Both groups had similar rates of adjuvant therapy (56.5% vs. 61.1%, P = .7672). Complication rates and 30 mortality were similar between groups (all P > .05). Both groups had similar median recurrence-free survival (R0 29.2 months vs. R1 27.8 months, P = .540) and median overall survival (R0 31.2 months vs. R1 38.8 months, P = .736) with similar median follow-up time (R0 29.9 months vs. R1 28.5 months, P = .8864). Conclusions At our institution, patients undergoing hepatic resection for HC with R1 margins have similar recurrence-free and overall survival to those with R0 margins. Complications and short-term mortality were similar. This may indicate that with use of modern adjuvant therapies obtaining an R0 resection is not an absolute mandate.

Efficacy and tolerability of gemcytabine plus docetaxel in patients with locally advanced or metastatic adenocarcinoma of the lung

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17134-17134
Author(s):  
M. Krzakowski ◽  
D. M. Kowalski ◽  
K. Zajda ◽  
T. Denisso ◽  
P. Jaskiewicz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Total Dose ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Stage Iv ◽  
Stage Iiib ◽  
Phase Iii ◽  
Second Line Therapy ◽  
Phase Iii Trial ◽  
Adenocarcinoma Of Lung

17134 Background: Chemotherapy prolongs survival of patients with advanced non-small cell lung cancer (NSCLC). Subanalysis of a phase III trial suggests better outcome of treatment with platinum and gemcytabine containing combinations in patients with adenocarcinoma. Also docetaxel is active in NSCLC. The aim of this phase II trial was to wvaluate the efficacy and tolerability of third generation doublet (GCB and DXL) in cheminaive patients with advanced adenocarcinoma of lung. Methods: Chemonaive patients with biopsy proven stage IIIB or IV adenocarcinoma of lung not suitable for curative radical treatment witk KPS 80–100 received 2 to 6 chemotherapy cycles (DXL 80 mg/m2 day 1 plus GCB 1000 mg/m2 day 1 and 8; every 21 days). Response rate and tolerability were the primary endpionts, while the overall survival and 1-year survival were secondary objectives. Results: Twenty eigth patients (15 women, 13 men) with median age 59,04 (range 40–74) were treated. Twenty three patients was analysed. Stage IV was found in 23 (95.8%) and stage IIIB in 1 (4.2%) patients. Partial response was achiwed in 9 (37,5%), stable disease in 12 (50%) and pregressive disease in 3 (12,5%) patients. Median time to progression was 8, 37 months (range: 1.5–14 months). Median overall survival was 12,87 months (range: 4–35 months). Eleven (11) patients received second-line therapy (6-RT, 11-CTH). All patients received 94 cycles of chemotherapy (range: 2, median 3,9). Total dose of docetaxel on each patients was fro 120 to 960 mg (median 556 mg). Total dose of gemcytabine on each patients was from 2100 mg to 21000 mg (median 10475 mg). Treatment toxicicy presents on the table . Conclusions: First line gemcytabine and docetaxel containing chemotherapy is effective palliative treatment for patients with advanced AC of the lung. Toxicity was within acceptable limits. [Table: see text] No significant financial relationships to disclose.

FOLFIRINOX for the treatment of advanced pancreatic cancer: U.K. West Midlands experience.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 450-450
Author(s):  
Ankit Jain ◽  
Martin Scott-Brown ◽  
Peter Denzil Correa ◽  
Sharmila Sothi ◽  
Amy Davies ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Median Overall Survival ◽  
Hospital Admissions ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Response Rates ◽  
Disease Stage ◽  
Response To Chemotherapy ◽  
West Midlands

450 Background: The PRODIGE 4/ACCORD 11 trial demonstrated that FOLFIRINOX significantly improved response rates and survival in patients with metastatic pancreatic cancer, compared to gemcitabine. However this regimen is associated with significant toxicity. We have thus analysed the safety, tolerability and efficacy of FOLFIRINOX given outside a clinical trial setting. Methods: A retrospective analysis was conducted on all patients treated with FOLFIRINOX for advanced pancreatic cancer between July 2012 and July 2014, within the West Midlands region in the UK. Data was collected on baseline demographics, disease stage, toxicity and response to chemotherapy. Results: A total of 60 patients were identified (28 locally advanced, 32 metastatic). The median age was 59 (range 34-74) and 12% of patients were aged 70 or over. The primary tumour was located in the head of the pancreas in 68% of patients and 38% of patients had a biliary stent. All patients had an ECOG performance status of 0 or 1 (45% and 55% respectively), and had received no prior chemotherapy for advanced pancreatic cancer. FOLFIRINOX was commenced at reduced doses in 79% of patients, and subsequent dose reductions were required in 81% of patients. The median number of FOLFIRINOX cycles administered was 6 (range 1-14) but 33% of patients currently remain on treatment. Hospital admissions were required in 58% of patients but only 22% of hospital admissions were for neutropenic sepsis. FOLFIRINOX was discontinued in 30% of patients due to toxicity. There were no treatment related deaths. Of 40 patients who were eligible for assessment of response, 38% achieved a partial response and a further 45% achieved stable disease. Four patients with LA pancreatic cancer became suitable for curative surgical resection following chemotherapy; 2 of these also received chemoradiotherapy. The median overall survival for patients with metastatic disease was 12 months and the median overall survival for patients with locally advanced disease has not been reached. Conclusions: Our data shows that FOLFIRINOX can be safely delivered in a real world setting. Even with reduced doses, the response rates and survival outcomes are comparable with the results from the PRODIGE 4/ACCORD 11 trial.

Randomized Phase III Trial of Gemcitabine Plus Cisplatin Compared With Gemcitabine Alone in Advanced Pancreatic Cancer

2006 ◽  
Vol 24 (24) ◽  
pp. 3946-3952 ◽  
Author(s):  
Volker Heinemann ◽  
Detlef Quietzsch ◽  
Frank Gieseler ◽  
Michael Gonnermann ◽  
Herbert Schönekäs ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Median Overall Survival ◽  
Statistical Significance ◽  
Single Agent ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Phase Iii ◽  
Hematologic Toxicity ◽  
Free Survival

Purpose To compare the effectiveness and tolerability of gemcitabine plus cisplatin with single-agent gemcitabine as first-line chemotherapy for locally advanced or metastatic pancreatic cancer. Patients and Methods Patients with advanced adenocarcinoma of the pancreas were randomly assigned to receive either gemcitabine 1,000 mg/m2 and cisplatin 50 mg/m2 given on days 1 and 15 of a 4-week cycle (GemCis arm) or gemcitabine alone at a dose of 1,000 mg/m2 on days 1, 8, and 15 of a 4-week regimen (Gem arm). The primary end point was overall survival; secondary end points were progression-free survival, response rate, safety, and quality of life. Results One hundred ninety-five patients were enrolled and showed baseline characteristics well balanced between treatment arms. Combination treatment in the GemCis arm was associated with a prolonged median progression-free survival (5.3 months v 3.1 months; hazard ratio [HR] = 0.75; P = .053). Also, median overall survival was superior for patients treated in the GemCis arm as compared with the Gem arm (7.5 v 6.0 months), an advantage which did not, however, reach statistical significance (HR = 0.80; P = .15). Tumor response rates were comparable between treatment arms (10.2% v 8.2%). The rate of stable disease was, however, greater in the combination arm (60.2% v 40.2%; P < .001). Grade 3 to 4 hematologic toxicity did not exceed 15% in both treatment arms. Conclusion These results support the efficacy and safety of an every-2-weeks treatment with gemcitabine plus cisplatin. Median overall survival and progression-free survival were more favorable in the combination arm as compared with gemcitabine alone, although the difference did not attain statistical significance.

Using CHFR expression to predict response and survival after first line treatment with carboplatin-paclitaxel in NSCLC.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10625-10625
Author(s):  
Rathi Narayana Pillai ◽  
Seth Aaron Brodie ◽  
Ge Li ◽  
James Gordon Herman ◽  
Malcolm Brock ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Overall Survival ◽  
Medical Center ◽  
Objective Response ◽  
Subsequent Development ◽  
Predictive Marker ◽  
Staining Intensity ◽  
Adverse Outcomes ◽  
First Line

10625 Background: The identification of resistance mechanisms for conventional chemotherapy in lung cancer is of fundamental importance not only for personalization of chemotherapy but also for the subsequent development of novel targeted approaches to overcome this resistance. Currently, there is no clinically validated test for the prediction of response to tubulin-targeted agents in NSCLC. Our previous preclinical work identified Checkpoint with Forkhead and Ringfinger domain” (CHFR) as a predictor of taxane cytotoxicity in in vitro models. The current work assessed the translational significance of this finding in a cohort of US veterans treated at a single-institution. Methods: We studied a cohort of patients with advanced NSCLC treated with taxane-containing frontline regimens at the Atlanta VA Medical Center between 2000 and 2009. Archived paraffin-embedded tissue was retrieved and stained for CHFR expression using standard immunohistochemical techniques. Level of protein expression was assessed by light microscopy and scored for intensity of CHFR staining. Intensity of staining was correlated with clinical outcome including objective response and median overall survival using Chi-Square test and Cox proportional models. Results: We analyzed tumor samples from 45 eligible patients with median age 62.6 years, M/F (44/1). In this cohort, high expression of CHFR is strongly associated with adverse outcomes: the risk for progressive disease (PD) after first-line chemotherapy with carboplatin-paclitaxel was 54% in patients with CHFR-high vs. only 18% in those with CHFR-low tumors (HR 3.1; 95% CI 1.09-9.04; p=0.02). Median overall survival was strongly correlated with response to first-line therapy (clinical benefit: 9.24 months; PD: 4.7 months; p<0.001) and with CHFR expression status (CHFR low: 10 months; CHFR high: 5.6 months; p =0.01). Conclusions: CHFR expression is a novel predictive marker of response and overall survival in NSCLC patients treated with taxane-containing chemotherapy.

Real-world survival and treatment patterns of patients with locally advanced or metastatic urothelial carcinoma treated with second-line therapy after platinum-based chemotherapy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 466-466
Author(s):  
Jason C Simeone ◽  
Beth L Nordstrom ◽  
Ketan Patel ◽  
Alyssa B Klein ◽  
Laura Horne
Keyword(s):  
Overall Survival ◽  
Real World ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Treatment Patterns ◽  
Second Line ◽  
Second Line Therapy ◽  
Line Therapy ◽  
Platinum Based Chemotherapy ◽  
Metastatic Urothelial Carcinoma

466 Background: Median overall survival for patients with locally advanced/metastatic urothelial carcinoma (UC) who fail standard platinum-containing chemotherapy is 5–7 months, and there is no current standard of care for these patients. As immuno-oncology (IO) therapies are being developed for the treatment of UC, including some recent approvals, a better understanding of the current real-world treatment patterns and effectiveness of treatments is needed. Methods: Patients with locally advanced/metastatic UC receiving second-line therapy after platinum-based chemotherapy were identified from the Flatiron Oncology electronic medical record database from 2011–2016. Treatment patterns, including the most common regimens and total number of systemic therapy treatment lines, were characterized. Median overall survival (OS) and associated 95% confidence intervals (CI) were calculated from the start of second-line therapy using Kaplan-Meier curves. Results: A total of 476 patients met all study criteria; mean age was 70.1 ± 9.2 years and 74.2% were male; <3% were tested for PD-L1 during follow-up. Platinum-based chemotherapies were most commonly prescribed (Table 1), 4.4% received IO during second-line. Median OS from start of second-line therapy was 8.3 months (95% CI: 7.2–8.9). Conclusions: Real-world OS among locally advanced/metastatic UC patients who received second-line therapy after platinum-based chemotherapy was less than one year, similar to prior estimates. It remains to be seen how the introduction and increasing uptake of IO may affect OS. [Table: see text]

Diethylstilboestrol (1 mg) in the Management of Castration-Resistant Prostate Cancer

2014 ◽  
Vol 94 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Rafal Turo ◽  
Kenny Tan ◽  
Helene Thygesen ◽  
Subramanian K. Sundaram ◽  
Rohit Chahal ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Median Overall Survival ◽  
Demographic Data ◽  
Specific Antigen ◽  
Oestrogen Therapy ◽  
Castration Resistant Prostate Cancer ◽  
Optimal Point ◽  
Entire Cohort ◽  
Psa Response

Objective: To investigate the efficacy of diethylstilboestrol (DES) in patients with advanced prostate cancer refractory to androgen suppression. Methods: This retrospective study comprises 194 patients with prostate cancer treated with DES (1 mg daily) between 1976 and 2010. Study outcome parameters included demographic data, tumour characteristics, treatment history, prostate-specific antigen (PSA) responses, radiologic studies, adverse events and overall survival. Results: At initiation of oestrogen therapy the mean patient age was 69 years (range: 48-89) and the median PSA was 96 ng/ml (range: 1.9-9,500). The median duration of prior prostate cancer treatment was 29 months (range: 1-365). DES was the second-line treatment in 58 patients and the third/fourth-line therapy in 136 men. A formal (≥50%) PSA response was observed in 95 patients (48.9%) and the median time to progression (TTP) was 250 days (95% CI, 180-360) for this group. An additional 62 patients (31.9%) had a partial PSA response with a median TTP of 150 days (95% CI, 92-180). Thirty-seven patients (19.1%) did not have a PSA response and the median TTP was 90 days (95% CI, 90-97). The median overall survival from the start of oestrogen therapy for the entire cohort was 576 days (95% CI, 482-690). The median overall survival of patients who had a formal (≥50%), partial (<50%) and no PSA response was 756 (95% CI, 670-1,429), 428 (95% CI, 340-630) and 329 (95% CI, 287-510) days, respectively. Thirty-nine patients (20.1%) were still alive at the end of the study. No treatment-related deaths occurred. Conclusions: In the age of chemotherapy this study highlights the efficacy of oestrogen therapy in castration-refractory prostate cancer. The optimal point in the therapeutic pathway at which DES should be prescribed remains to be established.

Sign in / Sign up

Export Citation Format

Share Document