Estimating long-term survival of PD-L1-expressing, previously treated, non-small cell lung cancer patients who received pembrolizumab in KEYNOTE-001 and -010.

2017 ◽  
Vol 35 (7_suppl) ◽  
pp. 77-77 ◽  
Author(s):  
Matthew David Hellmann ◽  
Junshui Ma ◽  
Edward B. Garon ◽  
Rina Hui ◽  
Leena Gandhi ◽  
...  
Keyword(s):  
Survival Rate ◽  
Survival Models ◽  
Small Cell Lung ◽  
Stat Assoc ◽  
Term Survival ◽  
Long Term Survival ◽  
Previously Treated ◽  
Term Benefit

77 Background: Pembrolizumab showed promising activity in patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-001 study (NCT01295827) and significantly prolonged overall survival (OS) compared with docetaxel in the randomized KEYNOTE-010 study (NCT01905657). Responses to pembrolizumab appear to be remarkably durable, making long-term survival possible in some patients. Typical parametric survival models do not account for the possibility of long-term survival. An alternative, well-established class of statistical models called long-term survival models can be used to directly estimate the percentage of patients achieving long-term survival (>5 years), called “long-term survival rate.” (Berkson J, Gage RP. J Am Stat Assoc. 1952;47:501-515.)(Tsodikov AD et al. J Am Stat Assoc. 2003;98:1063-1078.) Methods: Data from patients with PD-L1–expressing (tumor proportion score ≥1%), previously treated, advanced NSCLC in KEYNOTE-001 and KEYNOTE-010 were used. KEYNOTE-001 data were used to initially estimate the long-term survival rate of pembrolizumab, while KEYNOTE-010 data were used for subsequent independent validation. Point estimates of long-term survival rates with their 95% CIs based on the model described above are reported. Results: Based on the long-term survival model, the estimated long-term survival rate in pembrolizumab-treated population in KEYNOTE-001 (n = 306) is 25.4% (95% CI, 15.2%-33.3%) and the intention-to-treat population who received pembrolizumab in KEYNOTE-010 (n = 690) is 25.3% (95% CI, 8.9%-36.9%). In contrast, the long-term survival rate of docetaxel arm (n = 343) in KEYNOTE-010 is estimated to be 3.2% (95% CI, 0%-17.4%). Conclusions: In 2 independent data sets, it is estimated that 25% of patients with previously treated PD-L1–expressing NSCLC may achieve long-term benefit from pembrolizumab monotherapy. Long-term survival models can provide an early estimate of long-term benefit from pembrolizumab using data with limited follow-up time. Long-term follow-up from these trials will further validate this finding. MDH and JM are co-first authors.

scholarly journals Retrospective Treatment Analysis of a Series of 104 Patients with Adult Onset Hemophagocytic Lymphohistiocytosis in a Single Institution of China

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4882-4882 ◽  
Author(s):  
Xiao Shuai ◽  
Juan Xu ◽  
Xushu Zhong ◽  
Yan Li ◽  
Wenjiao Tang ◽  
...  
Keyword(s):  
Survival Rate ◽  
Treated Group ◽  
Initiation Time ◽  
Adult Onset ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Underlying Diseases

Abstract Objective. Hemophagocytic lymphohistiocytosis (HLH), also known as Hemophagocytic Syndrome (HPS), is an increasingly recognized clinical syndrome that is characterized by extreme immune activation. HLH was first described as an inherited immune disorder in pediatrics, but it may also arise in adults as the result of persistent antigen stimulation due to infections, autoimmune disorders or malignancies. Early recognition of HLH and appropriate treatment are critically important. For the pediatric patients, the Histiocyte Society Study Group for HLH has developed the HLH-94 and HLH-2004 treatment protocols, but there is no such guideline or consensus for adult HLH. Although there were increasing amount of clinical studies in adult HLH, the majority of them just described the etiologies and clinical profiles, and failed to analyze the treatment effects on outcomes. Therefore, there is an urgent need for more clinical data focusing on treatment in adult HLH patients, in order to clarify optimal therapeutic regimens. Our study retrospectively analyzed the causes, treatment strategies, and relevant outcomes in 104 adult HLH patients in our institution, and with the goal of identifying more appropriate therapeutic strategies for adult HLH patients. Methods. After the approval of our protocol by local institutional Ethics Committee, the medical records of 104 consecutive patients with adult onset HLH in West China Hospital from June 2008 to February 2016 were reviewed. The diagnosis was re-confirmed according to HLH-04 criteria, and demographic data, clinical profiles, treatments and outcomes were collected and analyzed. The latest follow-up visit occurred on 1st July 2016. The different therapeutic effects on prognosis were discussed based on the endpoints which were defined as short-term (30 days) and long-term (last follow-up date) survival rates. Statistical analysis was performed on SAS 9.4 software, and was involved in Log-rank test in univariate analysis and Cox proportional hazard regression model in multivariate analysis. All p values were two-sided and p<0.05 were considered statistically significant. Results. All of 104 consecutive patients with adult HLH were enrolled in this study. The male/female ratio was 1.6:1 with the median age of 35 (range 16-77). In etiological classification, 75 cases were lymphoma-associated HLH, 13 cases were infection-associated HLH, 2 cases were with autoimmune disorders, and for the remaining 14 cases, the underlying diseases could not be identified. In treatment analysis, corticosteroids were used in 91 cases (87.5%), the median initiation time was 0 day (range 0-26 days) after HLH diagnosis, the median four-week accumulating dosage was 236.57mg dexamethasone. Etoposide was employed in 55 cases (52.9%), the median initiation time was 3.5 days (range 0-62 days), the median four-week accumulating dosage was 590.00mg. Cyclosporine A (CSA) was used in 42 cases (40.4%), the median initiation time was 2 days (range 0-51 days), the median four-week accumulating dosage was 7100.00mg. The median survival time for all patients was 46 days (1-2529 days). On the 30th day after admission, 27 patients (26.0%) had died, and 77 patients (74.0%) had survived. At the last follow-up visit, 74 patients (71.2%) had died, 17 patients (16.2%) were still alive, and 13 patients had been lost to follow-up. Statistical analysis indicated that patients in etoposide-treated group was associated with superior short-term survival rate, compared with non-etoposide-treated group (p=0.0471), but there was no difference in long-term survival rate between the two groups. CSA-treated group was associated with inferior long-term survival rate (p=0.0214), compared with non-CSA-treated group. In patients with lymphoma-associated HLH, those who received antineoplastic chemotherapy had a higher long-term survival rate than those who did not receive it (HAZARD=0.07, p<0.0001). Conclusion. The major underlying diseases of adult onset HLH are malignant lymphomas. Etoposide might only improve the short-term survival, but fail to change the long-term survival. Immunosuppressor CSA seems to be associated with negative effects on long-term survival rate. For patients with lymphoma-associated HLH, antineoplastic chemotherapy might improve the long-term outcome. More clinical prospective studies should be initiated for adult acquired HLH. Disclosures No relevant conflicts of interest to declare.

Long-term survival follow-up of atezolizumab in combination with platinum-based doublet chemotherapy in patients with advanced non–small-cell lung cancer

2018 ◽  
Vol 101 ◽  
pp. 114-122 ◽  
Author(s):  
Stephen V. Liu ◽  
D. Ross Camidge ◽  
Scott N. Gettinger ◽  
Giuseppe Giaccone ◽  
Rebecca S. Heist ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Term Survival ◽  
Long Term Survival ◽  
Doublet Chemotherapy

scholarly journals Multicenter, Phase III Trial Comparing Selenium Supplementation With Observation in Gynecologic Radiation Oncology

2014 ◽  
Vol 13 (6) ◽  
pp. 463-467 ◽  
Author(s):  
Ralph Muecke ◽  
Oliver Micke ◽  
Lutz Schomburg ◽  
Michael Glatzel ◽  
Berthold Reichl ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Survival Rate ◽  
Cancer Patients ◽  
Uterine Cancer ◽  
Phase Iii ◽  
Term Survival ◽  
Long Term Survival ◽  
Positive Effects

Purpose. In 2010, we reported that selenium (Se) supplementation during radiation therapy (RT) is effective for increasing blood Se levels in Se-deficient cervical and uterine cancer patients, and reduced the number of episodes and severity of RT-induced diarrhea. In the current study, we examine whether of Se supplementation during adjuvant RT affects long-term survival of these patients. Patients and Methods. Former patients were identified and questioned with respect to their health and well-being. Results. A total of 81 patients were randomized in the initial supplementation study, 39 of whom received Se (selenium group, SeG) and 42 of whom served as controls (control group, CG). When former patients were reidentified after a median follow-up of 70 months (range = 0-136), the actuarial 10-year disease-free survival rate in the SeG was 80.1% compared to 83.2% in the CG ( P = .65), and the actuarial 10-year overall survival rate of patients in the SeG was 55.3% compared to 42.7% in the CG ( P = .09). Conclusions. Our extended follow-up analysis demonstrates that Se supplementation had no influence on the effectiveness of the anticancer irradiation therapy and did not negatively affect patients’ long-term survival. In view of its positive effects on RT-induced diarrhea, we consider Se supplementation to be a meaningful and beneficial adjuvant treatment in Se-deficient cervical and uterine cancer patients while undergoing pelvic radiation therapy.

scholarly journals Impact of gender and age on long-term outcomes of isolated coronary bypass surgery

2021 ◽  
Vol 102 (2) ◽  
pp. 167-175
Author(s):  
M A Poteev ◽  
R A Yakubov ◽  
A G Khaisanov
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
End Point

Aim. Search for predictors of death and analysis of long-term survival after coronary bypass surgery. Methods. The study included 1742 patients who underwent isolated coronary bypass surgery in Emergency Hospital (Naberezhnye Chelny) between 2011 and 2019, of whom 345 (19.8%) women and 1397 (80.2%) men. The women were older: their average age was 65.896.98 years versus 61.297.71 years for men (p 0.001). The primary end point was death from any cause in the long-term postoperative period. Results. The primary end point occurred in 170 patients (9.8% of the total sample), including 19 women and 151 men (11.2 vs. 88.8%). The average follow-up period was 43.6527.55 months, the median follow-up period 41 months. Both the 5-year survival rate (89% for women against 76% for men; p=0.042) and overall survival rate for the entire observation period were higher in women (86% versus 74%; p=0.042). Multivariate Cox regression analysis revealed that the long-term survival statistically significantly associated with age: up to 59 years [hazard ratio (HR) 0,43; confidence interval (CI) 0,280,65; р 0,001] and aged between 60 and 69 years (HR 0,62; CI 0,410,9; р 0,018), with gender: for female (HR 0,46; CI 0,290,77; р 0,002) and with factor of aortic occlusion during extracorporeal circulation (HR 2,42; CI 1,13-5,17; р 0,022) as well as the number of used internal thoracic arteries: one (HR 0,12; CI 0,020,65; р 0,015) or two (HR 0,08; CI 0,010,95; р 0,045). Conclusion. Both 5-year and overall survival in women was higher; factors such as female gender and young age significantly influence survival in the long-term follow-up period after coronary bypass surgery, increasing it.

scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

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