A 10-year Retrospective Study of Lung Cancer in Uganda

Abstract Background: Lung cancer is a leading cause of cancer-related deaths in Uganda. In this study, we aimed to describe the baseline characteristics and survival of patients with lung cancer at Uganda Cancer Institute (UCI). Methodology: We retrospectively reviewed medical records of all patients with a histological diagnosis of lung cancer registered at UCI between January 2008 and August 2018. Data on demographic, clinical, and treatment characteristics, and vital status were abstracted and analyzed. Patients with undocumented vital status on the medical records were contacted through phone calls. We determined survival as time from histological diagnosis to death. The Kaplan-Meier survival analysis was performed to estimate the median survival time and the 5-year overall survival rate. Results: Of the 207 patients enrolled, 56.5% (n=117) were female, median age was 60 years (range: 20-94), 78.7% (n=163) were never-smokers and 18 (8.7%) were living with HIV. Presumptive anti-tuberculosis treatment was given to 23.2% (n=48). Majority had non-small cell lung cancer (96.6%, n=200) with 74.5% (n=149) adenocarcinoma and 19% (n=38) squamous cell carcinoma. All had advanced (stage III or IV) disease with 96.1% (n=199) in stage IV. Chemotherapy (44.9%, n=93) and biological therapy (34.8%, n=72) were the commonest treatments used. Overall survival at 6 months, 1-, 2- and 5-years was 41.7%, 29.7%, 11.8% and 1.7% respectively. The median survival time was 4.4 months and was not different between NSCLC and SCLC (4.5 vs. 3.9 months respectively, p=.335). Conclusion: In Uganda, adenocarcinoma is the predominant histologic subtype of lung cancer predominantly occurring in females and non-smokers. Patients present late with advanced disease and poor overall survival. Public awareness should be heightened to facilitate early screening and improve outcomes.

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Comparative analysis of concurrent and sequential chemoradiation in locally advanced lung cancer: a single institution experience

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195504 ◽

2019 ◽

Vol 7 (12) ◽

pp. 4479

Author(s):

Shelly Srivastava ◽

Surendra Kumar Saini ◽

S. K. Agarwal

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Small Cell Lung Cancer ◽

Survival Time ◽

Median Survival ◽

Cell Lung Cancer ◽

Median Survival Time ◽

Concurrent Chemoradiotherapy ◽

Small Cell ◽

Small Cell Lung

Background: Outcome of various treatment regimen are dismal in non-small cell lung cancer. This analysis is done to find possible care in authors institutional set up and to see how these protocols have effect in Indian patients in term of toxicity.Methods: Medical records and data on patients who had been diagnosed with non-small cell lung cancer histologically or cytologically, and who had been treated with sequential chemoradiation and concurrent chemoradiation at the hospital from January 2007 to March 2015 was retrospectively reviewed and analyzed. Two groups of sequential chemoradiotherapy and concurrent chemoradiotherapy were formed and compared for outcomes.Results: Of the 114 evaluable patients in sequential chemoradiotherapy group, the median survival time was 16.0 months and the 1, 3- and 5-years overall survival were 57.0, 26.9 and 21.2%, respectively. Median progression free survival (PFS was 13.0 months and the 1, 3 and 5 years PFS were 52.6, 14.6 and 7.8%, respectively. In concurrent chemoradiotherapy group (105 patients), the overall median survival time was 15 months and the 1, 3- and 5-year overall survival were 56.2, 20.6 and 14.7%, respectively. Median PFS was 13 months and the 1, 3 and 5-year PFS were 48.8, 19.7 and 10.3%, respectively. Grade 3 and 4 toxicity in both regimen groups are same and statistically not significant.Conclusions: Analysis confirm dismal outcome with standard treatment and signifies to search for care beyond conventional chemoradiotherapy.

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ctDNA Predicts Overall Survival in Patients With NSCLC Treated With PD-L1 Blockade or With Chemotherapy

JCO Precision Oncology ◽

10.1200/po.21.00057 ◽

2021 ◽

pp. 827-838

Author(s):

Wei Zou ◽

Stephanie J. Yaung ◽

Frederike Fuhlbrück ◽

Marcus Ballinger ◽

Eric Peters ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Small Cell Lung Cancer ◽

Survival Time ◽

Median Survival ◽

Cell Lung Cancer ◽

Median Survival Time ◽

Small Cell ◽

Phase Iii ◽

Small Cell Lung

PURPOSE Identification of predictors for overall survival (OS) allows timely detection of clinical efficacy signals and therefore facilitates treatment decisions. We assessed the association between circulating tumor DNA (ctDNA) metrics and the primary end point of OS in a subset of previously treated patients with locally advanced or metastatic non–small-cell lung cancer, who underwent atezolizumab or docetaxel treatment in the open-label randomized phase III OAK trial. MATERIALS AND METHODS Plasma from 94 patients at baseline and at subsequent cycles of therapy every 3 weeks was analyzed retrospectively for ctDNA. ctDNA was measured by allele frequency and mutant molecules per milliliter (MMPM). Concordance between various per-sample metrics and clinical outcome were assessed using C index. RESULTS Of all the ctDNA metrics tested, the association of median MMPM at 6 weeks with OS in patients treated with atezolizumab or docetaxel had a C index > 0.7. The OS hazard ratios relative to high ctDNA above median MMPM within each arm were 0.28 (95% CI, 0.11 to 0.75) for atezolizumab and 0.19 (95% CI, 0.08 to 0.48) for docetaxel. For patients who had ctDNA median MMPM levels of < 4.79, the median survival time was more than 17 months in docetaxel-treated patients and the median survival time was not reached in the atezolizumab-treated patients. CONCLUSION ctDNA MMPM levels measured at 6 weeks post-treatment are associated with OS in advanced non–small-cell lung cancer. Our results suggest that ctDNA has the potential for a noninvasive early liquid biopsy predictor for OS that warrants further studies to demonstrate its utility in clinical development.

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The survival impact of concurrent chemotherapy and primary tumor radiotherapy on stage IV squamous non-small-cell lung cancer

10.21203/rs.2.16077/v1 ◽

2019 ◽

Author(s):

Yichao Geng ◽

Qiu-Ning Zhang ◽

Yin-Xiang Hu ◽

Zhu Ma ◽

Wei-Wei Ouyang ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Small Cell Lung Cancer ◽

Survival Time ◽

Median Survival ◽

Median Survival Time ◽

Three Dimensional ◽

Stage Iv ◽

Small Cell ◽

Small Cell Lung

Abstract Objective: To analyse the impact of survival with three-dimensional radiotherapy for stage IV squamous non-small cell lung cancer (NSCLC). Methods: Data for 629 eligible patients who received three-dimensional radiotherapy between 2002 and 2016 were retrospectively analyzed.161 of 183 cases were included pre-protocol. Patients received platinum-doublet chemotherapy with concurrent irradiation of the primary tumour. Primary endpoints were overall survival (OS) and progress-free survival (PFS). Results: Of 161 patients, the 1-, 2-, 3- and 5-year OS rates and median survival time (MST) were 45.7%, 14.1%, 11.2%, 2.2% and 11months, respectively. Using contrastive analysis PTV dose ≥63 Gy and <63 Gy, the 1-, 2-,3- and 5-year overall survival (OS) rates and median survival time (MST)were 48.9% vs 43.3%, 21.8% vs 8.2%, 18.4% vs 4.4%, 5.1% vs 0%, and 12 months vs 11months ( χ 2 = 7.222, P=0.007). Contrastive analysis patients received radical concurrent chemoradiation therapy, and the 1-, 2-, 3- and 5-year overall survival (OS) rates and median survival time (MST) were 54.3% vs. 37.2%, 27.2% vs. 7.5%, 24.9% vs. 4.8%, 8.3% vs. 0%, and 14 months vs. 10 months ( χ 2 = 13.180, P=0.000). Multivariate analysis showed that PTV ≥63 Gy was an independent favourable factor for survival. Conclusion: Concurrent chemotherapy and three-dimensional radiotherapy to the primary tumour in stage IV squamous NSCLC could prolong survival, and with increasing intensity of comprehensive treatment, OS gradually improved. PTV ≥63 Gy is the independent prognostic factors for OS. [Key Words] Stage IV; Squamous non-small cell lung cancer (NSCLC); Concurrent chemoradiotherapy; Overall survival

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A Clinicopathological Analysis on Diffuse Midline Glioma in Adults

10.21203/rs.3.rs-507531/v1 ◽

2021 ◽

Author(s):

Xiao Mu Hu ◽

Xiao Yu Nie ◽

Kai Lun Xu ◽

Yin Wang ◽

Feng Tang ◽

...

Keyword(s):

Overall Survival ◽

Survival Time ◽

Median Survival ◽

Median Survival Time ◽

Age Groups ◽

Young Patients ◽

Imaging Data ◽

Wild Type ◽

Old Patients ◽

Diffuse Midline Glioma

Abstract Purpose: Diffuse midline glioma (DMG), H3K27M mutant is a new entity that has become widely recognized. However, studies concerning DMG in adult patients remains rare. We did a retrospective study covering the largest amount of patients to date to analyze the clinicopathological characteristics of DMG in adult. Methods: We reviewed 117 cases of adult DMG, collected their clinical and imaging data along with pathological results including H3K27M. Summarized their features and the connection with overall survival in different age groups.Results: Among 117 cases, most tumors were located at the thalamus, 39 patients had H3K27M mutation, of whom 38 demonstrated down regulation of H3K27me3. The average overall survival of H3K27M-mutant gliomas was 13 months, while that of 78 H3K27M wild-type gliomas were 11.8 months. For young patients (age＜35), The median survival time of the H3K27M-mutant was 20.1 months, while that of the H3K27M wild-type was 39.5 months. For older patients (age≥35), the median survival time of the H3K27M-mutant was 22.3 months, while that of the H3K27M wild-type was 17.1 months. The OS of patients who received biopsies, subtotal resections, and total resections were 15.8, 17.6, and 11.6 months respectively. Conclusion: The DMG in adults mainly occurred in the thalamus. H3K27M mutations tend to happen more frequently in young adults, and this genetic alteration results in a worse outcome only in young patients. For old patients, age and the approach of surgery are independent prognostic factors. Patients received biopsy instead of total resection had a better prognosis.

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OR25-07 A Multi-Center, Open-Label, Pivotal Phase 2 Study of Azedra® (HSA I-131-MIBG) in Patients with Unresectable, Locally Advanced or Metastatic Pheochromocytoma or Paraganglioma: Updated Long-Term Survival and Safety

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1241 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Camilo Jimenez ◽

Bennett B Chin ◽

Richard B Noto ◽

Joseph Stephen Dillon ◽

Lilja B Solnes ◽

...

Keyword(s):

Overall Survival ◽

Survival Time ◽

Median Survival ◽

Median Survival Time ◽

Locally Advanced ◽

Phase 2 ◽

Pivotal Phase ◽

Term Survival ◽

Phase 2 Study ◽

Therapeutic Doses

Abstract Background: Pheochromocytoma/Paraganglioma (PPGL) are rare neuroendocrine tumors with a 5-yr survival rate as low as 12%. There is a high unmet medical need for effective treatment options for patients with advanced disease. AZEDRA®, a high-specific-activity iodine-131 meta-iodobenzylguanidine (HSA I-131-MIBG), is the first and only FDA-approved therapeutic radiopharmaceutical agent indicated for the treatment of adult and pediatric patients with iobenguane scan positive, unresectable, locally advanced or metastatic PPGL who require systemic anticancer therapy. Methods: Patients with advanced PPGL who were heavily pre-treated and were ineligible for curative surgery or chemotherapy received a dosimetric dose followed by up to two therapeutic doses (each at 296 MBq/kg to a max of 18.5 GBq). The primary endpoint, defined as the proportion of patients with at least 50% reduction of all antihypertensive medication(s) lasting ≥6 months, was met and previously reported. Updated secondary endpoints including overall survival (OS) and safety are reported. Results: A dosimetric dose of HSA I-131-MIBG was administered to 74 patients. Of those, 68 patients received one therapeutic dose and 50 received two doses of HSA I-131-MIBG. Clinical benefit rates (objective tumor responses defined by RECIST 1.0 and stable disease) were observed in 71.4% and 98.0% of patients receiving one and two therapeutic doses, respectively. As of October 10, 2019, median survival time for all patients was 43.2 months (95% CI 31.4, >60). Median survival time was 19.3 months (95% CI 4.5, 32.4) and 49.1 months (95% CI 36.9, >60) in patients receiving one and two doses, respectively. The overall survival was 73.8% at 2 yrs, 47.5% at 4 yrs and 41.5% at 5 yrs. The most common (≥50%) adverse events were nausea, fatigue, and myelosuppression. Myelosuppressive events resolved within 4-8 wks without requiring stem cell transplantation. Late radiation toxicity included 7 patients with secondary malignancies (myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), colon cancer, and lung carcinoma) of which MDS, ALL and AML were considered related to I-131 radiotherapy. Conclusions: Results from this pivotal phase 2 study suggest that HSA I-131-MIBG is an efficacious and safe treatment for advanced PPGL.

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Controlling Nutritional Status (CONUT) Score is Associated with Overall Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Cohort Study

Nutrients ◽

10.3390/nu12041076 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1076 ◽

Cited By ~ 1

Author(s):

Shigeo Shimose ◽

Takumi Kawaguchi ◽

Hideki Iwamoto ◽

Masatoshi Tanaka ◽

Ken Miyazaki ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Nutritional Status ◽

Survival Time ◽

Median Survival ◽

Median Survival Time ◽

Rank Test ◽

Multicenter Cohort Study ◽

The Impact ◽

Conut Score

We aimed to investigate the impact of the controlling nutritional status (CONUT) score, an immuno-nutritional biomarker, on the prognosis of patients with hepatocellular carcinoma (HCC) treated with lenvatinib (LEN). This retrospective study enrolled 164 patients with HCC and treated with LEN (median age 73 years, Barcelona Clinic Liver Cancer (BCLC) stage B/C 93/71). Factors associated with overall survival (OS) were evaluated using multivariate and decision tree analyses. OS was calculated using the Kaplan–Meier method and analyzed using the log–rank test. Independent factors for OS were albumin–bilirubin grade 1, BCLC stage B, and CONUT score <5 (hazard ratio (HR) 2.9, 95% confidence interval (CI) 1.58–5.31, p < 0.001). The CONUT score was the most important variable for OS, with OS rates of 70.0% and 29.0% in the low and high CONUT groups, respectively. Additionally, the median survival time was longer in the low CONUT group than in the high CONUT group (median survival time not reached vs. 11.3 months, p < 0.001). The CONUT score was the most important prognostic variable, rather than albumin–bilirubin grade and BCLC stage, in patients with HCC treated with LEN. Accordingly, immuno-nutritional status may be an important factor in the management of patients with HCC treated with LEN.

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Evaluation of chemotherapy response between Paclitaxel-Cisplatin, Paclitaxel -Gemcitabine and Gemcitabine - Cisplatin among non - resectable lung cancer patients, A retrospective study in tertiary care hospital.

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v38i4.48977 ◽

2020 ◽

Vol 38 (4) ◽

pp. 172-175

Author(s):

Md Harun Or Rashid ◽

Quadrat E Elahi ◽

Md Ashraful Alam ◽

Fatima Sarker

Keyword(s):

Lung Cancer ◽

Survival Rate ◽

Survival Time ◽

Cancer Patients ◽

Median Survival ◽

Median Survival Time ◽

Chemotherapy Response ◽

Care Hospital ◽

Lung Cancer Patients ◽

Significant Difference

Background: To compare the survival rate of paclitaxel plus cisplatin (PC arm), paclitaxel plus gemcitabine (PG arm) and gemcitabine plus cisplatin (GC arm) in chemotherapy patients with non resectable lung cancer. Methods: This was a retrospective observational study to evaluate chemotherapy response among non resectable lung cancer patients with their survival at cancer center CMH, Dhaka since 01 July 2013 to 31 March 2015. One hundred fifty-four (154) non resectable lung cancer patients were randomly divided into three groups, 50 patients in PC arm, 51 patients in PG arm and 53 patients in GC arm. In PC arm paclitaxel 175 mg/m2 (day 1) with cisplatin 75mg/m2 (day 1), in PG arm Paclitaxel 175 mg/m2 (day 1) with gemcitabine 1000 mg/m2 (days 1 and 8) and in GC arm gemcitabine 1000 mg/m2 (days 1 and 8) with cisplatin 100mg/m2 (day 1). Results: Patients characteristics were similar between the three groups. The overall response rate was 40% in the PC arm,43.1% in the PG arm, 43.4% in the GC arm. The median survival time in PC arm was 8.5 months, in PG arm was 8.8 months, in GC arm was 9.2 months. The major side effect was myelosuppression which accounts 71% patients. The average treatment costs were 57% and 30% lower in PC arm as compared with GC and PG arm respectively. Conclusion: The median survival time, disease free survival time and 1-year survival rate in PC, PG, GC arms without significant difference. Treatment were well tolerable; quality of life parameter was mostly similar but paclitaxel with cisplatin was most cost effective than others chemotherapy regimen. J Bangladesh Coll Phys Surg 2020; 38(4): 172-175

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Hypercalcemia- Leukocytosis Syndrome: A Rare Ominous Indicator in Lung Cancer

Blood ◽

10.1182/blood-2018-99-112705 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4966-4966

Author(s):

Taylor Hanson ◽

Ravi Patel ◽

Nitasa Sahu ◽

Zain Ayaz ◽

Julie Caler ◽

...

Keyword(s):

Lung Cancer ◽

Squamous Cell Carcinoma ◽

Lactic Acid ◽

Cell Carcinoma ◽

Survival Time ◽

Median Survival ◽

Squamous Cell ◽

Median Survival Time ◽

Poor Prognosis ◽

Conflicts Of Interest

Abstract Introduction: Paraneoplastic syndromes are signs and symptoms that occur in association with malignancy at sites distant from the primary tumor or metastases. They occur in approximately 10% of patients with lung cancer (1). Case: A 59-year-old male with a history of tobacco abuse, COPD, and Stage IV Lung Adenosquamous cancer with brain metastases status post chemotherapy presented with weakness and lethargy. Patient was normotensive and on room air. Clinical exam was significant for confusion with noted chronic cachexia. Labs most prominent were a WBC count of 46.8 (16.3 1mo prior, 44.6 3wks prior) , Cr of 1.9, Ca of 11.9 , and Lactic acid of 3.7. Imaging was consistent with an increase in his RUL cavitary lesion with pleural based lesions and 11 metastatic deposits throughout the brain. He was admitted and started on aggressive intravenous fluids. Furthermore, infectious workup was initiated and empiric antibiotics administered for possible pneumonia. By day 3 of admission his creatinine, calcium, and lactic acid normalized but his wbc continued to trend up to 98.6 despite negative infectious workup. His severe metastatic disease burden along with his failure to thrive carried a poor prognosis. Subsequently, a family meeting was held and he was transitioned to comfort measures. Patient passed away shortly thereafter. Discussion: The case clearly demonstrates poor prognostic indicators with hypercalcemia and severe leukocytosis in the setting of end stage lung adenosquamous carcinoma. Classically, paraneoplastic hypercalcemia is associated with PTHrP production in Squamous Cell carcinoma. Overall incidence of hypercalcemia in lung cancer ranges from to 8%-12% with median survival time (MST) of 3.8 months (1,2).Paraneoplastic Leukocytosis meanwhile is most often associated with adenocarcinoma (42%) and squamous cell carcinoma (36%) with incidence ranging between 16 and 30% and MST of 1.9 months (1,2). Nonetheless, the combination of these two known as Hypercalcemia-Leukocytosis syndrome has been identified an independent clinical entity with an even shorter median survival time in comparison with leukocytosis or hypercalcemia alone of 1.5 months (2). The incidence of this was studied to be 0.5% over a 10 year interval (2). Given this rare occurrence, it is prudent for clinicians to recognize this clinical syndrome and the very poor prognosis it bears . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127595/ G.R. Mundy, K.J. Ibbotson, S.M. D'Souza, E.L.Simpson, J.W. Jacobs, T.J. MartinThe hypercalcemia of cancer. Clinical implications and pathogenic mechanismsN Engl J Med, 310 (1984), pp. 1718-1727 .https://www.sciencedirect.com/science/article/pii/S0169500203004549?via%3Dihub Hypercalcemia-leukocytosis syndrome associated with lung cancer Disclosures No relevant conflicts of interest to declare.

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The Predictive Value of TP53 FISH Analysis for Treatment Response and Survival in Cytogenetic Subgroups of AML Patients.

Blood ◽

10.1182/blood.v114.22.2617.2617 ◽

2009 ◽

Vol 114 (22) ◽

pp. 2617-2617

Author(s):

Sigal Tavor ◽

Rachel Rothman ◽

Tamar Golan ◽

Nadia Voskoboinik ◽

Ruth Shomrat ◽

...

Keyword(s):

Overall Survival ◽

Survival Time ◽

Median Survival ◽

Predictive Value ◽

Cytogenetic Analysis ◽

Median Survival Time ◽

Allogeneic Transplantation ◽

Fish Analysis ◽

Chromosomal Deletions ◽

Tp53 Status

Abstract Abstract 2617 Poster Board II-593 In recent years, a number of studies emphasized AML with complex aberrant karyotype as a distinct biological entity which is characterized by a unique gene expression pattern, with very frequent alteration in TP53 and a median overall survival (OS) of less than 6 months. However, the definition of a complex karyotype (CK) or whether monosomal karyotype (MK) provides a better prognostic prediction than CK is not well established. In the present study, we examined whether a prompt and simple Fluorescence in situ hybridization (FISH) test for TP53 deletion (presence or absence of 17p13) at diagnosis, has a predictive value for response to therapy and overall survival in AML patients (pts) with CK or chromosomal deletions (either complete or partial of any other chromosome). Between 2000 and 2009 we analyzed 38 patients with newly diagnosed AML, with age ranged from 18 to 82 years (median 52 years). On cytogenetic analysis from bone marrow at diagnosis, 16 (42%) pts had a CK (≥3 chromosome abnormalities), 16 pts (42%) had a normal karyotype (NK) and 6 (16%) pts had other monosomy or deletion of any chromosomal region. Seven patients had a post myelodysplastic syndrome AML and 1 post therapy for a prior malignancy. For induction treatment patients received idarubicine, 12 mg/m2/d (age 18– 55y) or mitoxantron 10 mg/m2/d intravenous (IV) on days 1-3 (age 55–68y) and cytarabine, 100mg/m2/d by continuous IV infusion on days 1 through 7. Pts entering complete remission (CR) received three courses of consolidation with high dose cytarabine. Patients with a histocompatibale donor, which did not received CR or relapsed, were allografted. Elderly patients, 69–82 years old, were treated with one induction chemotherapy which included Mylotarg (3mg/m2/2h on day 1) plus cytarabine (100 mg/m2/24h on days 2-8). Patients at this group of age did not received consolidation therapy. Of the16 pts with CK AML, 14 were treated with chemotherapy but only 3 pts (21%) achieved CR, 4 pts died during induction therapy. By comparison, of the 16 pts with NK AML, 15 pts were treated with chemotherapy, 11 pts achieved CR (73%), 3 pts died during induction therapy. Of the 6 AML pts with monosomy or deletion in cytogenetic analysis, 3 pts (50%) achieved CR (p =0.0067). In all NK AML patients examined the TP53 FISH was normal (mean 4% of cells examined), where as in patient with CK 75% of pts had TP53 deletion (mean 51%), and in the group with chromosomal deletion 50% of pts showed a loss of one TP53 (mean 18%) p=0.0016. Of note, in 13 pts (34%) with TP53 deletion by FISH analysis, cytogenetic analysis found no anomaly of 17p chromosome. In a stepwise logistic regression model FISH groups significantly entered the model in first step, and no other variable did (p=0.0056, C=0.833). In pts in which two copies of TP53 were found in FISH analysis ('10%) the median survival time is 440 days, whereas in pts with TP53 deletion was detected the median survival time was 189 days. The OS in pts with deletion of TP53 was significantly shorter as compared to pts that TP53 deletion was not found (p=0.025). However, a multivariate analysis including age, karyotype, deletion of TP53 and allogeneic transplantation showed that only CK and allogeneic transplantation are independent prognostic factors in this analysis. In conclusion, TP53 status by FISH at diagnosis is important due to the following findings: The test is sensitive, rapid and simple. 2. TP53 deletions are frequent in AML with CK and tend to segregate with additional chromosomal deletions. TP53 status at diagnosis has a predictive value with respect to chemotherapy response and OS in AML pts with CK and chromosomal deletions. Disclosures: No relevant conflicts of interest to declare.

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Mitomycin, Ifosfamide, and Cisplatin in Unresectable Non–Small-Cell Lung Cancer: Effects on Survival and Quality of Life

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.10.3188 ◽

1999 ◽

Vol 17 (10) ◽

pp. 3188-3194 ◽

Cited By ~ 350

Author(s):

M. H. Cullen ◽

L. J. Billingham ◽

C. M. Woodroffe ◽

A. D. Chetiyawardana ◽

N. H. Gower ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Palliative Care ◽

Small Cell Lung Cancer ◽

Survival Time ◽

Median Survival ◽

Median Survival Time ◽

Small Cell ◽

Small Cell Lung

PURPOSE: Chemotherapy for non–small-cell lung cancer (NSCLC) remains controversial. We describe the two largest reported, randomized, parallel trials designed to determine whether the addition of chemotherapy influences duration and quality of life in localized, unresectable (mitomycin, ifosfamide, cisplatin [MIC]1 trial) and extensive (MIC2 trial) disease. PATIENTS AND METHODS: Ambulatory patients with NSCLC, aged 75 years or younger, with localized disease, were randomized in MIC1 to receive up to four cycles of chemotherapy (CT: mitomycin 6 mg/m2, ifosfamide 3 g/m2, and cisplatin 50 mg/m2) every 21 days, followed by radical radiotherapy (CT + RT) or radiotherapy (RT) alone. Extensive-stage patients were randomized in MIC2 to identical chemotherapy plus palliative care (CT + PC) or palliative care (PC) alone. Short-term change in quality of life (QOL) was assessed in a subgroup of patients. Data from the two trials were combined to allow multivariate and stratified survival analyses. RESULTS: Seven hundred ninety-seven eligible patients were randomized, 446 in MIC1 and 351 in MIC2. MIC CT improved survival in both trials (significantly in MIC2). The median survival time in MIC1 was 11.7 months (CT + RT) versus 9.7 months (RT alone) (P = .14); whereas in MIC2, median survival time was 6.7 months (CT + PC) compared with 4.8 months (PC alone) (P = .03). QOL, assessed in 134 patients from start of trial to week 6, showed improvement with chemotherapy and deterioration with standard treatment. In the combined analysis of 797 randomized patients, the positive effect of MIC on survival was significant overall (P = .01) and after adjusting for prognostic factors (P = .01). CONCLUSION: MIC chemotherapy prolongs survival in unresectable NSCLC without compromising QOL.

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