Median Overall Survival Research Articles

The association between additional radiotherapy after systemic chemotherapy and the prognosis of stage FIGO 2018 IVB cervical cancer.

The association between additional radiotherapy after systemic chemotherapy and the prognosis of stage FIGO 2018 IVB cervical cancer.

Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre

ObjectivesMost patients with small cell lung cancer present with extensive-stage (ES-SCLC) disease. An international randomised trial demonstrated a survival benefit in patients treated with consolidative thoracic radiotherapy (cTRT). We report...

Recurrence-Free Survival as a Surrogate for Overall Survival Among Patients with Intrahepatic Cholangiocarcinoma Following Upfront Surgery: An International Multi-institutional Analysis.

The role of recurrence-free survival (RFS) as a validated surrogate endpoint for overall survival (OS) among patients undergoing upfront surgery for intrahepatic cholangiocarcinoma (ICC) has not been defined. We sought to evaluate the correlation between RFS and OS after surgical resection for ICC. We hypothesized that RFS was a reliable surrogate endpoint for OS among patients with ICC. Patients who underwent upfront curative-intent surgery for ICC between 2000 and 2023 were identified from an international, multi-institutional database. The correlation between RFS and OS was assessed using rank correlation. Landmark analysis evaluated concordance between survival at 5 years and recurrence status at 6, 12, 24, 36, 48, and 54 months postoperatively. Among 1541 patients who underwent curative-intent hepatic resection, the median RFS and OS were 22.6 months and 41.5 months, respectively. A moderately strong correlation between RFS and OS was identified (ρ = 0.79, 95% CI 0.76 to 0.82). In the landmark analysis, the concordance between 5-year OS after surgery and recurrence status at different time points (6, 12, 24, 36, 48, and 54 months) was 60.7%, 72.0%, 81.4%, 83.1%, 83.0%, and 82.5%, respectively. Restricted cubic spline analysis indicated that the prediction of OS based on RFS increased with time and plateaued 3 years after surgery. Among patients undergoing curative-intent resection of ICC, there was a moderately strong correlation between RFS and OS. Three-year RFS may be a reliable surrogate endpoint to predict 5-year OS and should be considered in future trial design.

5-year survival rate over 20% in pancreatic ductal adenocarcinoma: A retrospective study from a Chinese high-volume center.

5-year survival rate over 20% in pancreatic ductal adenocarcinoma: A retrospective study from a Chinese high-volume center.

Cemiplimab Monotherapy for First-Line Treatment of Patients with Advanced NSCLC with PD-L1 Expression ≥50%: 5-Year Outcomes of EMPOWER-Lung 1.

Cemiplimab Monotherapy for First-Line Treatment of Patients with Advanced NSCLC with PD-L1 Expression ≥50%: 5-Year Outcomes of EMPOWER-Lung 1.

Analysis of the effectiveness and safety of lenvatinib/bevacizumab combined with PD-1/PD-L1 inhibitors and GEMOX in the first-line treatment of advanced biliary tract carcinoma

To assess the efficacy and safety of lenvatinib/bevacizumab combined with programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors and gemcitabine/oxaliplatin (GEMOX) as first-line treatments in patients with advanced biliary tract cancer (BTC). Patients with advanced BTC who received lenvatinib/bevacizumab combined with PD-1/PD-L1 inhibitors plus gemcitabine/oxaliplatin (GEMOX) chemotherapy were retrospectively screened. The primary endpoints were overall survival (OS) and progression-free survival (PFS), whereas the secondary endpoints were objective response rate (ORR), disease control rate (DCR), and safety. Prognostic factors for survival were analyzed. A total of 172 individuals were enrolled and categorized into four groups: Group A received GEMOX plus PD-1 antibody (sintilimab or camrelizumab) and lenvatinib; group B received GEMOX and PD-1 antibody (sintilimab or camrelizumab) and bevacizumab; group C received GEMOX and PD-1 antibody (sintilimab or camrelizumab); and group D received GEMOX alone. The median OS was 13.63 months (95% confidence interval [CI]: 12.37–14.89), 12.41 months (95% CI: 10.67–12.32), 11.23 months (95% CI: 9.39–13.07), and 8.86 months (95% CI: 7.28–10.44) in groups A, B, C, and D, respectively (P = 0.312). In groups A, B, C, and D, the median PFS was 12.42 months, 11.05 months, 8.89 months, and 6.02 months. A statistically significant difference was observed (t = 2, 95% CI: 11.31–13.53, P < 0.01). The ORR was 45.00% (17/40) in group A, 34.78% (16/46) in group B, 16.67% (5/30) in group C, and 17.86% (10/56) in group D. The DCR was 87.50% (35/40), 78.26% (36/46), 76.67% (23/30), and 58.93% (33/56) in groups A, B, C, and D, respectively. In addition, regression analysis showed that patients’ metastasis site, whether the neutrophil–lymphocyte ratio was < 2.3, and whether chemotherapy was administered through hepatic artery embolization and was independent prognostic factors influencing median OS and PFS. Almost all patients included in the study experienced treatment-related adverse events (TRAEs) of varying degrees of severity, with grade 1–2 adverse events predominating. Lenvatinib/bevacizumab combined with programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors and gemcitabine/oxaliplatin (GEMOX) represent an effective and tolerable regimen for advanced BTC in a multicenter retrospective real-world study.

Olaparib Plus Abiraterone in Asian Patients With Metastatic Castration-Resistant Prostate Cancer: PROpel Subset Analysis.

In the phase 3 PROpel trial (NCT03732820) patients with metastatic castration-resistant prostate cancer (mCRPC) treated with olaparib plus abiraterone in the first-line setting showed significantly prolonged radiographic progression-free survival (rPFS; primary data cutoff [DCO]: 30 July 2021; hazard ratio [HR] 0.66, 95% confidence interval [CI], 0.54-0.81; p < 0.001), and at prespecified final OS analysis DCO (12 October 2022) numerically prolonged overall survival (OS; HR 0.81, 95% CI, 0.67-1.00; p = 0.054), versus placebo plus abiraterone for the global population. Here, we report efficacy, safety, and patient-reported outcome data for the Asian subset in PROpel. Eligible patients were randomly assigned (1:1) to either olaparib (300 mg twice daily) or placebo in combination with abiraterone (1000 mg once daily). The primary endpoint was investigator-assessed rPFS, and a key secondary endpoint was OS. In the Asian subset (n = 133) at primary analysis, median rPFS was 27.6 months in the olaparib plus abiraterone arm (n = 63), compared with 19.3 months in the placebo plus abiraterone arm (n = 70; HR 0.55, 95% CI, 0.32-0.95). Median OS at the final analysis was not reached in the olaparib plus abiraterone arm versus 43.7 months in the placebo plus abiraterone arm (HR 0.59, 95% CI, 0.32-1.06). The safety profile was generally similar in the Asian subset and the global population. Efficacy and safety results for olaparib plus abiraterone in the Asian subset were generally consistent with the global PROpel population supporting the combination of olaparib plus abiraterone as an important first-line treatment for consideration in Asian patients with mCRPC. Trial Registration: Clinicaltrials.gov identifier: NCT03732820.

Efficacy and safety of hepatic arterial infusion chemotherapy followed by transarterial embolization for hepatocellular carcinoma.

To compare the safety and efficacy of hepatic arterial infusion chemotherapy followed by transarterial embolization (HAIC+TAE) to transarterial chemoembolization (TACE) for the treatment of unresectable hepatocellular carcinoma (uHCC). The clinical data of patients who received HAIC+TAE or TACE between April 2020 and April 2022 was collected. Propensity score-matching was used to balance the baseline characteristics of the two groups. Tumor response according to mRECIST, median time to progression (TTP) and overall survival (OS) were investigated. ALBI score was applied to evaluate the changes of liver function and other relative adverse reactions were recorded. A total of 98 patients with uHCC were enrolled in the study, including 71 in the TACE group and 27 in the HAIC+TAE group. After propensity score matching, 23 pairs of patients were investigated. The HAIC+TAE group showed a longer median TTP and OS than TACE group (mTTP 316 vs. 235 days, P=0.023; mOS 580 vs. 493 days, P=0.020). Objective response rates in HAIC+TAE group and TACE group were 65.2% and 47.8% (P=0.234). Disease-control rates were 87.0% and 82.6% (P=1.000). No significant difference was found in the incidence of adverse events between the two groups (P>0.05). The combination treatment strategy of HAIC+TAE in patients with uHCC appears to be a safe regimen, with the potential to prolong mTTP and mOS relative to TACE. The sequential application of this therapy merits consideration as an innovative treatment strategy for individuals with uHCC.

Clinical validity of repeated circulating tumor cell enumeration as an early treatment monitoring tool for metastatic breast cancer in the PREDICT global pooled analysis.

The aim of PREDICT was to confirm clinical validity and the potential for clinical utility of serial circulating tumor cell (CTC) enumeration in metastatic breast cancer (MBC) patients focusing on its prognostic value in different breast cancer subtypes and clinical settings. In total, 4436 individual patient-level data with CTC results from both baseline and one follow-up (CellSearch®; Menarini Silicon Biosystems) were analyzed to evaluate the association between CTC detection and overall survival (OS) in the full patient cohort and separately for tumor and treatment types. Using the cutoff ≥ 1 CTC for CTC positivity, 913 (20.6%) patients had 0 CTCs at both time points (neg/neg), 325 (7.3%) and 1189 (26.8%) patients converted from CTC negative to CTC positive (neg/pos) or vice versa (pos/neg), while 2009 (45.3%) patients had at least one CTC at both time points (pos/pos). Median OS for the neg/neg, neg/pos, pos/neg and pos/pos group was 45.6, 26.1, 32.3, and 17.3 months, respectively (P < 0.0001, global log-rank test). CTC responders (pos/neg) showed a lower risk of death compared to CTC non-responders (pos/pos) (HR 0.48, 95% CI 0.44 - 0.53). Similar results were obtained in subgroup analyses according to hormone receptor and HER2 subtype, treatment type, and with a ≥ 5 CTC cutoff for CTC positivity. Follow-up CTC assessments strongly predict OS independently from tumor subtype and treatment. New randomized trials to define the clinical utility of CTC monitoring for risk stratification and as an early response marker in MBC are urgently needed.

Long-term real-world outcomes of first-line immunotherapy in non-small cell lung cancer - a population-based cohort study in Sweden.

In a previous study, we explored real-world programmed death-ligand 1 (PD-L1) testing and treatment patterns for patients with advanced non-small cell lung cancer (NSCLC) in the era of immune-oncology. The present study aimed to investigate overall survival (OS) with PD-(L)1 inhibitors with longer-term follow-up in the Swedish setting. Data were extracted from the Swedish National Lung Cancer Registry for patients with NSCLC stage IIIB-IV and ECOG performance status (PS) 0-2 who initiated first-line systemic treatment from 1-April-2017 to 30-June-2021 with data cut-off 30-June-2022. OS and Kaplan-Meier estimates were calculated from start of the PD-(L)1 inhibitor therapy, with subgroups based on nonsquamous/squamous (NSQ/SQ) histology, and further by PS, and PD-L1 status (available from 1-January-2018) provided sufficient sample size. We identified 784 (NSQ:590/SQ:194) patients treated with first-line PD-(L)1 inhibitor monotherapy and 369 (NSQ:305/SQ:64) patients receiving combination regimens. Median OS (95% confidence interval [CI]) was 15.2 (12.4-17.7) and 12.9 (10.6-15.8) months with monotherapy and 17.0 (13.6-23.9) and 18.0 (13.9-NA) months with combination regimens for NSQ/SQ patients. In PS2, median OS with monotherapy was 5.0 (3.7-7.1) and 8.9 (6.2-12.9) months for NSQ/SQ patients (n = 138/59), 5.3 (3.6-13.4) months with combination regimens in NSQ (n = 58) and not evaluable in SQ patients. For PS0-1 patients with tumor cell PD-L1 expression ≥50%, the median OS for NSQ was 23.8 (17.7-29.3) and 27.3 (21.6-NA) months for monotherapy/combination therapy (n = 281/55), while the median OS for combination regimens for PD-L1 <1% and 1-49% was 18.6 (12.1-26.9) and 15.9 (10.8-26.7) months (NSQ; n = 65/87). Real-world OS in Swedish patients receiving first-line PD-(L)1 inhibitor-based regimens was consistent with that observed in clinical trials. Moderate OS rates were observed in PS2, with limited sample sizes. Further research is needed in these patients, as well as in high PD-L1, given the slightly longer OS for combination therapy compared to monotherapy seen for NSQ.

Overall survival with maintenance olaparib in platinum-sensitive relapsed ovarian cancer by somatic or germline BRCA and homologous recombination repair mutation status.

The open-label, single-arm, multicentre ORZORA trial (NCT02476968) evaluated maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer (PSR OC) with a germline (g) or somatic (s) BRCA1 and/or BRCA2 mutation (BRCAm) or a non-BRCA homologous recombination repair mutation (non-BRCA HRRm). Patients were in response to platinum-based chemotherapy after ≥2 prior lines of treatment and underwent prospective central screening for tumour BRCA status, then central gBRCAm testing to determine sBRCAm or gBRCAm status. An exploratory cohort evaluated non-BRCA HRRm in 13 predefined genes. Patients received olaparib 400 mg (capsules) twice daily until investigator-assessed disease progression. Secondary endpoints included overall survival (OS) and safety. 177 patients received olaparib. At the final data cutoff (25 June 2021), median OS from study enrolment was 46.8 (95% confidence interval [CI] 37.9-54.4), 43.2 (31.7-NC [not calculated]), 47.4 (37.9-NC) and 44.9 (28.9-NC) months in the BRCAm, sBRCAm, gBRCAm and non-BRCA HRRm cohorts, respectively. No new safety signals were identified. Maintenance olaparib showed consistent clinical activity in the BRCAm and sBRCAm cohorts; exploratory analysis suggested similar activity in the non-BRCA HRRm cohort. These findings highlight that patients with PSR OC, beyond those with gBRCAm, may benefit from maintenance olaparib.

Safety and Efficacy of Unresectable Malignant Cardiac Tumors Treated with Concurrent Chemoradiation Therapy Using a 1.5T MR-Linac (GASTO-1078).

Safety and Efficacy of Unresectable Malignant Cardiac Tumors Treated with Concurrent Chemoradiation Therapy Using a 1.5T MR-Linac (GASTO-1078).

THSD7A as a novel prognostic factor for colorectal carcinoma

BackgroundThrombospondin type 1 domain-containing 7 A (THSD7A) expression, an angiogenesis-related protein, has been implicated in various aspects of cancer progression, reflecting its potential as a prognostic marker for various cancers. Therefore, we investigated the prognostic value of THSD7A expression in colorectal cancer (CRC).MethodsA total of 95 patients with CRC were included. The patients were stratified into two groups according to THSD7A expression status determined by immunohistochemistry [negative (no staining), and positive (expression ≥ 1% of cancer cells)]. The overall survival (OS) of prognostic subgroups was estimated by Kaplan Meier method. The prognostic value of THSD7A expression was evaluated by univariable and multivariable Cox regression models.ResultsTHSD7A was expressed in 42.1% of CRC patients. Patients with no THSD7A expression had inferior OS than patients with THSD7A expression (72.9 months vs. median OS was not reached, p = 0.001, respectively). Our multivariate analyses revealed that the independent predictors of OS were poor differentiation of tumor (HR: 2.603, p = 0.002), advanced stage (HR: 3.210, p < 0.001), and the loss of THSD7A expression (HR: 3.094, p = 0.001).ConclusionsThe present study showed that THSD7A expression could serve as a potential prognostic marker for CRC cancer. Further research is warranted to elucidate the exact underlying THSD7A-mediated cancer progression and to explore its clinical use in improving CRC prognostication and treatment strategies.

Prognostic utility of the CALLY index in metastatic melanoma: building a nomogram for Patients on Anti-PD-1 therapy.

Despite the success of immune checkpoint inhibitors (ICIs) in metastatic melanoma, many patients fail to derive meaningful benefit, underscoring the urgent need for accessible prognostic biomarkers. The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index, an immunonutritional index, has shown prognostic value in various cancers. Previous studies indicate that systemic inflammation and nutritional status influence ICI efficacy, suggesting the potential relevance of the CALLY index in metastatic melanoma. This study evaluates the CALLY index's role in metastatic melanoma patients treated with anti-PD-1 therapy. This retrospective study analysed 92 patients with metastatic melanoma who were treated with anti-PD-1 monotherapy at Ege University's Faculty of Medicine between 2015 and 2023. The CALLY index was calculated using the pre-treatment CRP, albumin and lymphocyte levels. Kaplan-Meier analysis was used to estimate survival outcomes, and univariate and multivariate Cox regression models were employed to identify independent prognostic factors. A predictive nomogram incorporating the CALLY index and other significant variables was then developed. The optimal CALLY index cutoff was determined to be 2. Patients with a low CALLY index (≤ 2) had worse median overall survival (OS) and progression-free survival (PFS) when compared with those who had a high CALLY index (> 2) (median OS: 9.6 vs 31.3months, p < 0.001; median PFS: 3.8 vs 10.6months, p = 0.001). Multivariate analysis identified the CALLY index, lactate dehydrogenase above the upper limit of normal, Eastern Cooperative Oncology Group score ≥ 2, M1c/M1d staging and acral/mucosal melanoma subtypes to be independent predictors of OS. A nomogram was then constructed based on these factors, yielding a concordance index of 0.705 (95% confidence interval: 0.634-0.776). This model stratified patients into low-, intermediate- and high-risk groups, with the high-risk group showing significantly worse OS than the intermediate- and the low-risk groups (p < 0.001). The CALLY index is a cost-effective and independent prognostic biomarker that can aid in risk stratification and guide treatment decisions in patients with metastatic melanoma receiving anti-PD-1 therapy.

A Post Hoc Analysis of Older Patients with Metastatic Colorectal Cancer Receiving Oxaliplatin-Based Chemotherapy Plus Bevacizumab: The Randomized Obelics Study.

Phase II trials and subgroup analyses of clinical studies suggest that bevacizumab plus an oxaliplatin-based chemotherapy doublet is effective and tolerable in fit older patients with metastatic colorectal cancer (mCRC). To evaluate the influence of age on the incidence of side effects and efficacy of this combination in patients with mCRC randomized in the prospective phase III OBELICS study. In total, 230 patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 out of 1 were retrieved on the basis of age (190 < 70 years and 40 ≥ 70 years). They received bevacizumab 5 mg/kg administered either on the same day as chemotherapy (standard arm) or 4 days before chemotherapy (experimental arm) and oxaliplatin 85 mg/m2 on day 1, plus capecitabine 1000 mg/m2 twice a day (bid) orally on days 1-10 or levofolinic acid, 200 mg/m2, bolus 5-fluorouracil (5-FU) 400 mg/m2, and a 46-h intravenous infusion of 5-FU 2400 mg/m2, every 14 days; oxaliplatin was discontinued after 12 cycles. The primary end point was the overall response rate (ORR). Efficacy and toxicity analyses are reported in aggregate form because there were no statistically significant differences between the two arms. Patient characteristics are well balanced between older and younger patients. No difference in ORR was observed between the two groups (50% for the older patients versus 57.9% for the younger ones; p = 0.36). The median PFS was 10.8 (95% confidence interval [CI], 9.9-12.2) and 11.3 (95% CI 8.3-13.0) months, respectively, for subjects younger than 70 years and those aged ≥ 70 years, with an adjusted hazard ratio (HR) of 1.16 (95% CI 0.80-1.68; p = 0.43). The median OS was 26.2 (95% CI 23.3-32.7) for the former and 23.2 (95% CI 17.3-35.3) months for the latter, respectively, with an adjusted HR of 1.60 (95% CI 1.08-2.37; p = 0.027). Considering all forms of toxicity, the most severe ones were not statistically different between the two groups (65% for the older patients and 60.6% for the younger ones, p = 0.61). Bevacizumab plus an oxaliplatin-based chemotherapy doublet were effective in older patients randomized in the OBELICS trial, and the adverse event profile was not dissimilar from that of younger patients; no new safety concerns were identified. This post hoc analysis confirms that fit older patients with mCRC should be considered for treatment with this regimen.

Ruxolitinib combined with dexamethasone for adult patients with newly diagnosed hemophagocytic lymphohistiocytosis in China.

Ruxolitinib combined with dexamethasone for adult patients with newly diagnosed hemophagocytic lymphohistiocytosis in China.

Lymphocyte/monocyte to lactate dehydrogenase ratio prior to lymphodepletion impact the outcomes of patients with diffused large B cell lymphoma undergoing CAR-T cell therapy

Factors associated with outcomes of chimeric antigen receptor (CAR)-T cell therapy in patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) have not been fully elucidated. We explored the impact of the prelymphodepletion (pre-LD) lymphocyte to monocyte ratio (LMR) and its ratio to lactate dehydrogenase (LDH) (LMR/LDH) on the efficacy and prognosis of 60 patients with R/R DLBCL undergoing CAR-T cell therapy. The optimal cutoff values for pre-LD LMR and LMR/LDH were 3.583 and 0.0103, respectively. The overall response rate (ORR)s were higher in patients with high pre-LD LMR or LMR/LDH than those with low pre-LD LMR or LMR/LDH (ORR, 100% vs. 65.79%, P = 0.006 and 96.15% vs. 38.24%, P < 0.0001, respectively). Pre-LD LMR/LDH was an independent factor associated with ORR (P = 0.010, odds ratio = 18.757; 95% confidence interval [CI] 2.046–171.975) by multivariate logistic regression analysis. Patients with high pre-LD LMR/LDH had significantly longer progression-free survival (PFS) (median PFS, 29.73 vs. 2.47 months, P < 0.0001) and overall survival (OS) (median OS, not reached vs. 7.4 months, P = 0.0002) than those with low pre-LD LMR/LDH. Multivariate Cox regression analysis showed that pre-LD LMR/LDH and ORR were independent factors affecting PFS (P = 0.030, hazard ratio [HR] = 2.561; 95% CI 1.093–5.999 and P = 0.024, HR = 2.202; 95% CI 1.22–4.369, respectively); pre-LD LMR/LDH was an independent factor affecting OS (P = 0.029, HR = 3.331; 95% CI 1.131–9.807). In conclusion, the pre-LD LMR/LDH was an independent factor associated with ORR and an independent prognostic factor in patients with R/R DLBCL undergoing CAR-T cell therapy.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy outcomes in peritoneal carcinomatosis: 11-year tertiary-center experience

BackgroundCytoreductive Surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are techniques developed for curative treatment of peritoneal carcinomatosis (PC). Studies have shown that CRS + HIPEC provides a survival advantage in PC, and long-term survival can be achieved in selected cases. This study aimed to evaluate CRS + HIPEC cases performed for curative purposes and to examine the prognostic factors.MethodsPC patients who underwent CRS + HIPEC with curative intent between January 2011 and September 2022 were included. Demographic, clinical, and pathological findings, procedure-specific parameters, complications, mortality, progression-free survival (PFS), and overall survival (OS) were analyzed.ResultsOptimal cytoreduction was achieved in 70% of the patients. The median PFS for the entire series was 9.2 months, while the median OS was 20.5 months, with a 3-year OS rate of 36%. Appendiceal origin, cytoreduction score, absence of lymph node metastasis, and absence of complications were factors associated with a positive impact on both PFS and OS. In multivariate analysis, cytoreduction score emerged as the sole independent factor influencing both PFS and OS.ConclusionsConsidering the results in our series, cases of PC in which complete cytoreduction can be achieved should be evaluated for CRS + HIPEC.

Eribulin efficacy in long responder patients with metastatic breast cancer: A multicentric observational study.

Eribulin efficacy in long responder patients with metastatic breast cancer: A multicentric observational study.

The impact of brain MRI screening on stage IV NSCLC patients: A real world look at guidelines based care.

The impact of brain MRI screening on stage IV NSCLC patients: A real world look at guidelines based care.