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Impact of the first...
Impact of the first tumor response at eight weeks on overall survival in metastatic breast cancer patients treated with first-line combination chemotherapy
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- Suzuki, Chikako (author)
- Karolinska Institutet
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- Blomqvist, Lennart (author)
- Karolinska Institutet
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- Hatschek, Thomas (author)
- Karolinska Institutet
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- Carlsson, Lena (author)
- Sundsvall Gen Hospital, Sweden
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- Einbeigi, Zakaria (author)
- Sahlgrens University Hospital, Sweden
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- Linderholm, Barbro (author)
- Karolinska Institutet
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- Lindh, Birgitta (author)
- Umeå universitet,Onkologi,University of Umeå Hospital, Sweden
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- Loman, Niklas (author)
- Skåne University Hospital, Sweden
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- Malmberg, Martin (author)
- Helsingborg Gen Hospital, Sweden
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- Rotstein, Samuel (author)
- Karolinska University Hospital, Sweden
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- Soderberg, Martin (author)
- Skåne University Hospital, Sweden
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- Sundqvist, Marie (author)
- Kalmar Gen Hospital, Sweden
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- Walz, Thomas (author)
- Östergötlands Läns Landsting,Linköpings universitet,Onkologi,Hälsouniversitetet,Onkologiska kliniken US
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- Åström, Gunnar (author)
- Uppsala universitet,Enheten för radiologi,Uppsala University, Sweden
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- Fujii, Hirofumi (author)
- National Cancer Centre Hospital East, Japan
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- Jacobsson, Hans (author)
- Karolinska Institutet
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- Glimelius, Bengt (author)
- Uppsala universitet,Enheten för onkologi,Karolinska Institute, Sweden
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(creator_code:org_t)
- 2013-01-16
- 2013
- English.
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In: Medical Oncology. - : Humana Press. - 1357-0560 .- 1559-131X. ; 30:1
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https://doi.org/10.1...
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Abstract
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- The aim of this was to determine whether the change of size observed at the first response evaluation after initiation of first-line combination chemotherapy correlates with overall survival (OS) in patients with metastatic breast cancer (MBC). The change in size of tumors derived from measurements according to Response Evaluation Criteria In Solid Tumors (RECIST) at the first evaluation on computed tomography (CT) was obtained from a multicenter, randomized phase III trial ("TEX trial," n = 287) comparing treatment with a combination of epirubicin and paclitaxel alone or with capecitabine (TEX). Cox regression and Kaplan-Meier analyses were performed to evaluate the correlations between the first change in tumor size, response according to RECIST and OS. Data from CT evaluations of 233 patients were available. Appearance of new lesions or progression of non-target lesions (new/non-target) indicated short OS by univariable regression analysis (HR 3.76, 95 % CI 1.90-7.42, p andlt; 0.001). A decrease by andgt;30 % at this early time point was prognostic favorable (HR 0.69, 95 % CI 0.49-0.98, p = 0.04) and not significantly less than the best overall response according to RECIST. After adjustment for previous adjuvant treatment and the treatment given within the frame of the randomized trial, OS was still significantly shorter in patients with new/non-target lesions after a median 8 weeks of treatment (HR 4.41, 95 % CI 2.74-7.11, p andlt; 0.001). Disease progression at the first evaluation correlates with OS in patients with MBC treated with first-line combination chemotherapy. The main reason for early disease progression was the appearance of new lesions or progression of non-target lesions. These patients had poor OS even though more lines of treatment were available. Thus, these factors should be focused on in the response evaluations besides tumor size changes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Metastatic breast cancer
- Treatment response evaluation
- Overall survival
- First-line chemotherapy
- Computed tomography (CT)
- RECIST
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Suzuki, Chikako
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Blomqvist, Lenna ...
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Hatschek, Thomas
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Carlsson, Lena
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Einbeigi, Zakari ...
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Linderholm, Barb ...
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show more...
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Lindh, Birgitta
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Loman, Niklas
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Malmberg, Martin
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Rotstein, Samuel
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Soderberg, Marti ...
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Sundqvist, Marie
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Walz, Thomas
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Åström, Gunnar
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Fujii, Hirofumi
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Jacobsson, Hans
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Glimelius, Bengt
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Medical Oncology
- By the university
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Linköping University
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Umeå University
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Uppsala University
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Karolinska Institutet