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Impact of the first tumor response at eight weeks on overall survival in metastatic breast cancer patients treated with first-line combination chemotherapy

Suzuki, Chikako ; Blomqvist, Lennart ; Hatschek, Thomas ; Carlsson, Lena ; Einbeigi, Zakaria ; Linderholm, Barbro ; Lindh, Birgitta ; Loman, Niklas LU ; Malmberg, Martin and Rotstein, Samuel , et al. (2013) In Medical Oncology 30(1). p.415-415
Abstract
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... (More)
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 < 0.001). A decrease by >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 < 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. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Metastatic breast cancer, Treatment response evaluation, Overall, survival, First-line chemotherapy, Computed tomography (CT), RECIST
in
Medical Oncology
volume
30
issue
1
pages
415 - 415
publisher
Humana Press
external identifiers
  • wos:000316800800093
  • scopus:84880608722
  • pmid:23322522
ISSN
1559-131X
DOI
10.1007/s12032-012-0415-5
language
English
LU publication?
yes
id
dc2622b7-4431-4afe-b52d-f230596b8648 (old id 3749170)
date added to LUP
2016-04-01 13:29:29
date last changed
2022-01-27 19:30:53
@article{dc2622b7-4431-4afe-b52d-f230596b8648,
  abstract     = {{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 &lt; 0.001). A decrease by &gt;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 &lt; 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.}},
  author       = {{Suzuki, Chikako and Blomqvist, Lennart and Hatschek, Thomas and Carlsson, Lena and Einbeigi, Zakaria and Linderholm, Barbro and Lindh, Birgitta and Loman, Niklas and Malmberg, Martin and Rotstein, Samuel and Söderberg, Martin and Sundqvist, Marie and Walz, Thomas M. and Astrom, Gunnar and Fujii, Hirofumi and Jacobsson, Hans and Glimelius, Bengt}},
  issn         = {{1559-131X}},
  keywords     = {{Metastatic breast cancer; Treatment response evaluation; Overall; survival; First-line chemotherapy; Computed tomography (CT); RECIST}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{415--415}},
  publisher    = {{Humana Press}},
  series       = {{Medical Oncology}},
  title        = {{Impact of the first tumor response at eight weeks on overall survival in metastatic breast cancer patients treated with first-line combination chemotherapy}},
  url          = {{http://dx.doi.org/10.1007/s12032-012-0415-5}},
  doi          = {{10.1007/s12032-012-0415-5}},
  volume       = {{30}},
  year         = {{2013}},
}