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 |
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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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