Landmark survival analysis and impact of anatomic site of origin in prospective clinical trials of biliary tract cancer

Autor: David Cunningham, David Malka, John Bridgewater, Dieter Koeberle, David Goldstein, Lars Henrik Jensen, Markus Moehler, Juan W. Valle, Thierry André, Jenny Shannon, Tanios Bekaii-Saab, Harpreet Wasan, Takuji Okusaka, Mairéad G McNamara, Anna Dorothea Wagner, Andre Lopes, Jennifer J. Knox
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
medicine.medical_specialty
Biliary Tract cancer
Antineoplastic Agents
Anatomic Site
Global Health
Deoxycytidine
Gastroenterology
Cholangiocarcinoma
03 medical and health sciences
0302 clinical medicine
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Overall survival
First-line clinical trials
Humans
Neoplasm Metastasis
Gallbladder cancer
Biliary Tract
Survival analysis
primary site
Neoplasm Staging
Biliary tract cancer
Hepatology
Manchester Cancer Research Centre
business.industry
ResearchInstitutes_Networks_Beacons/mcrc
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Gemcitabine
landmark survival
first-line trials
Clinical trial
030104 developmental biology
Bile Duct Neoplasms
Biliary tract
Female
Gallbladder Neoplasms
030211 gastroenterology & hepatology
Cisplatin
business
medicine.drug
Zdroj: Mcnamara, M, Lopes, A, Wasan, H, Malka, D, Goldstein, D, Shannon, J, Okusaka, T, Knox, J J, Wagner, A D, Andre, T, Cunningham, D, Moehler, M, Jensen, L H, Koeberle, D, Bekaii-Saab, T, Bridgewater, J & Valle, J 2020, ' Landmark survival analysis and impact of anatomic site of origin in prospective clinical trials of biliary tract cancer ', Journal of Hepatology, vol. 73, no. 5, pp. 1109-1117 . https://doi.org/10.1016/j.jhep.2020.05.014
McNamara, M G, Lopes, A, Wasan, H, Malka, D, Goldstein, D, Shannon, J, Okusaka, T, Knox, J J, Wagner, A D, André, T, Cunningham, D, Moehler, M, Jensen, L H, Koeberle, D, Bekaii-Saab, T, Bridgewater, J & Valle, J W 2020, ' Landmark survival analysis and impact of anatomic site of origin in prospective clinical trials of biliary tract cancer ', Journal of Hepatology, vol. 73, no. 5, pp. 1109-1117 . https://doi.org/10.1016/j.jhep.2020.05.014
Popis: BACKGROUND & AIMS: Whether all patients with advanced biliary tract cancer (aBTC) should be included in prospective trials, irrespective of the anatomic site of origin, is debated. Herein, we aimed to assess the survival impact of anatomic site of origin in prospective clinical trials of aBTC using landmark survival analysis.METHODS: Patients enrolled into prospective first-line aBTC clinical trials (Jan 97-Dec 15) were included. Overall survival (OS) was analysed using Cox proportional hazard regression; landmark survival (LS) and 95% CIs were calculated.RESULTS: Overall, 1,333 patients were included: median age 63 years (range 23-85); 46% male; 84% ECOG-PS0/1; 25% with locally advanced disease, 72% with metastatic, 3% not reported (NR). Patients were treated with mono-chemotherapy (23%), cisplatin/gemcitabine (36%), other combinations (39%), or NR (2%). Median OS was 10.2 months (95% CI 9.6-10.9). All sites (treatment-adjusted) had decreased risk of death vs. gallbladder cancer (GBC) (p 0.05, p = 0.08 respectively).CONCLUSIONS: GBC is associated with worse OS than other BTC sites and should be considered as a stratification factor in clinical trials. LS rates enable adjusted prognostication for aBTC survivors.LAY SUMMARY: Patients with gallbladder cancer have worse overall survival compared to those with biliary tract cancers of different primary origin. Thus, gallbladder cancer should be considered as a stratification factor in future clinical trials. Landmark survival rates enable adjusted prognosis prediction for patients with advanced biliary tract cancer who survive for some time.
Databáze: OpenAIRE
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