Reintroduction of Oxaliplatin Is Associated With Improved Survival in Advanced Colorectal Cancer
Autor: | Pierre-Luc Etienne, Elisabeth Carola, Thierry André, Aimery de Gramont, Andrés Cervantes, Arie Figer, N. Perez-Staub, Isabelle Tabah-Fisch, Laurent Mineur, Fernando Rivera, Marc Buyse, Tomasz Burzykowski, Christophe Louvet, E. Quinaux, Christophe Tournigand, Gérard Lledo, M. Flesch, Isabel Chirivella, José Cortiñas Abrahantes |
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Rok vydání: | 2007 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Organoplatinum Compounds Colorectal cancer medicine.medical_treatment Leucovorin Irinotecan Gastroenterology Drug Administration Schedule Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Neoplasm Metastasis Survival rate Aged Proportional Hazards Models Chemotherapy business.industry Proportional hazards model Hazard ratio Middle Aged Prognosis medicine.disease Oxaliplatin Survival Rate Treatment Outcome Oncology Fluorouracil Disease Progression Camptothecin Female Colorectal Neoplasms business medicine.drug |
Zdroj: | Journal of Clinical Oncology. 25:3224-3229 |
ISSN: | 1527-7755 0732-183X |
Popis: | Purpose In the OPTIMOX1 trial, previously untreated patients with advanced colorectal cancer were randomly assigned to two different schedules of leucovorin, fluorouracil, and oxaliplatin that were administered until progression in the control arm or in a stop-and-go fashion in the experimental arm. The randomly assigned treatment groups did not differ significantly in terms of response rate, progression-free survival, and overall survival (OS). However, the impact of oxaliplatin reintroduction on OS was potentially masked by the fact that a large number of patients did not receive the planned oxaliplatin reintroduction or received oxaliplatin after second-line therapy in both treatment groups. Patients and Methods A Cox model was fitted with all significant baseline factors plus time-dependent variables reflecting tumor progression, reintroduction of oxaliplatin, and use of second-line irinotecan. A shared frailty model was fitted with all significant baseline factors plus the number of lines of chemotherapy received by the patient and the percentage of patients with oxaliplatin reintroduction in the center. An adjusted hazard ratio (HR) was calculated for three reintroduction classes (1% to 20%, 21% to 40%, and > 40%), using centers with no reintroduction (0%) as the reference group. Results Oxaliplatin reintroduction had an independent and significant impact on OS (HR = 0.56, P = .009). The percentage of patients with oxaliplatin reintroductions also had a significant impact on OS. Centers in which more than 40% of the patients were reintroduced had an adjusted HR for OS of 0.59 compared with centers in which no patient was reintroduced. Conclusion Oxaliplatin reintroduction is associated with improved survival in patients with advanced colorectal cancer. |
Databáze: | OpenAIRE |
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