Systemic therapy in younger and elderly patients with advanced biliary cancer: sub-analysis of ABC-02 and twelve other prospective trials
Identifieur interne : 000312 ( Main/Exploration ); précédent : 000311; suivant : 000313Systemic therapy in younger and elderly patients with advanced biliary cancer: sub-analysis of ABC-02 and twelve other prospective trials
Auteurs : Mairéad Geraldine Mcnamara ; John Bridgewater ; Andre Lopes ; Harpreet Wasan ; David Malka [France] ; Lars Henrik Jensen [Danemark] ; Takuji Okusaka [Japon] ; Jennifer J. Knox ; Dorothea Wagner [Suisse] ; David Cunningham [Royaume-Uni] ; Jenny Shannon ; David Goldstein ; Markus Moehler [Allemagne] ; Tanios Bekaii-Saab [États-Unis] ; Juan W. ValleSource :
- BMC Cancer [ 1471-2407 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Analyse de survie, Carboplatine (administration et posologie), Carboplatine (usage thérapeutique), Cisplatine (administration et posologie), Cisplatine (usage thérapeutique), Femelle, Humains, Jeune adulte, Mâle, Protocoles de polychimiothérapie antinéoplasique (administration et posologie), Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique), Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Survie sans rechute, Tumeurs des voies biliaires (anatomopathologie), Tumeurs des voies biliaires (traitement médicamenteux), Études prospectives.
- MESH :
- administration et posologie : Carboplatine, Cisplatine, Protocoles de polychimiothérapie antinéoplasique.
- anatomopathologie : Tumeurs des voies biliaires.
- traitement médicamenteux : Tumeurs des voies biliaires.
- usage thérapeutique : Carboplatine, Cisplatine, Protocoles de polychimiothérapie antinéoplasique.
- Adulte, Adulte d'âge moyen, Analyse de survie, Femelle, Humains, Jeune adulte, Mâle, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Survie sans rechute, Études prospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols (administration & dosage), Antineoplastic Combined Chemotherapy Protocols (therapeutic use), Biliary Tract Neoplasms (drug therapy), Biliary Tract Neoplasms (pathology), Carboplatin (administration & dosage), Carboplatin (therapeutic use), Cisplatin (administration & dosage), Cisplatin (therapeutic use), Disease-Free Survival, Female, Humans, Male, Middle Aged, Prospective Studies, Survival Analysis, Treatment Outcome, Young Adult.
- MESH :
- chemical , administration & dosage : Carboplatin, Cisplatin.
- administration & dosage : Antineoplastic Combined Chemotherapy Protocols.
- drug therapy : Biliary Tract Neoplasms.
- pathology : Biliary Tract Neoplasms.
- therapeutic use : Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Cisplatin.
- Adult, Aged, Aged, 80 and over, Disease-Free Survival, Female, Humans, Male, Middle Aged, Prospective Studies, Survival Analysis, Treatment Outcome, Young Adult.
Abstract
Outcomes in younger (<40 years) and elderly (≥70 years) patients with advanced biliary cancer (ABC) receiving palliative chemotherapy are unclear. This study assessed outcomes in those receiving monotherapy or combination therapy in thirteen prospective systemic-therapy trials.
Multivariable analysis explored the impact of therapy on progression-free (PFS) and overall survival (OS) in two separate age cohort groups: <70 years and ≥70 years, and <40 years and ≥40 years.
Overall, 1163 patients were recruited (Jan 1997-Dec 2013). Median age of entire cohort: 63 years (range 23–85); 36 (3%) were <40, 260 (22%); ≥70. Combination therapy was platinum-based in nine studies. Among patients <40 and ≥70 years, 23 (64%) and 182 (70%) received combination therapy, respectively. Median follow-up was 42 months (95%-CI 37–51). Median PFS for patients <40 and ≥40 years was 3.5 and 5.9 months (
In ABC, younger patients are rare, and survival in elderly patients in receipt of systemic therapy for advanced disease, whether monotherapy or combination therapy, is similar to that of non-elderly patients, therefore age alone should not influence decisions regarding treatment.
Url:
DOI: 10.1186/s12885-017-3266-9
PubMed: 28403829
PubMed Central: 5389161
Affiliations:
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Le document en format XML
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institution-id-type="GRID">grid.417271.6</institution-id><institution></institution><institution>Vejle Hospital,</institution></institution-wrap>7100 Vejle, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>7100 Vejle</wicri:regionArea></affiliation></author><author><name sortKey="Okusaka, Takuji" sort="Okusaka, Takuji" uniqKey="Okusaka T" first="Takuji" last="Okusaka">Takuji Okusaka</name><affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="GRID">grid.272242.3</institution-id><institution></institution><institution>National Cancer Center Hospital,</institution></institution-wrap>Tokyo, 104-0045 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Tokyo</wicri:regionArea></affiliation></author><author><name sortKey="Knox, Jennifer J" sort="Knox, Jennifer J" uniqKey="Knox J" first="Jennifer J." last="Knox">Jennifer J. Knox</name><affiliation><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="GRID">grid.415224.4</institution-id><institution></institution><institution>Princess Margaret Cancer Centre,</institution></institution-wrap>Toronto, M5G 2M9 Canada</nlm:aff><wicri:noCountry code="subfield">M5G 2M9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Wagner, Dorothea" sort="Wagner, Dorothea" uniqKey="Wagner D" first="Dorothea" last="Wagner">Dorothea Wagner</name><affiliation wicri:level="1"><nlm:aff id="Aff9"><institution-wrap><institution-id institution-id-type="GRID">grid.8515.9</institution-id><institution></institution><institution>Centre Hospitalier Universitaire Vaudois,</institution></institution-wrap>CH-1011 Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>CH-1011 Lausanne</wicri:regionArea></affiliation></author><author><name sortKey="Cunningham, David" sort="Cunningham, David" uniqKey="Cunningham D" first="David" last="Cunningham">David Cunningham</name><affiliation wicri:level="1"><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="GRID">grid.424926.f</institution-id><institution></institution><institution>Royal Marsden Hospital,</institution></institution-wrap>London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London</wicri:regionArea></affiliation></author><author><name sortKey="Shannon, Jenny" sort="Shannon, Jenny" uniqKey="Shannon J" first="Jenny" last="Shannon">Jenny Shannon</name><affiliation><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="GRID">grid.1013.3</institution-id><institution></institution><institution>University of Sydney,</institution></institution-wrap>Sydney, NSW 2006 Australia</nlm:aff><wicri:noCountry code="subfield">NSW 2006 Australia</wicri:noCountry></affiliation></author><author><name sortKey="Goldstein, David" sort="Goldstein, David" uniqKey="Goldstein D" first="David" last="Goldstein">David Goldstein</name><affiliation><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="GRID">grid.1005.4</institution-id><institution>Prince of Wales Clinical School,</institution><institution>University of New South Wales,</institution></institution-wrap>Sydney, NSW 2052 Australia</nlm:aff><wicri:noCountry code="subfield">NSW 2052 Australia</wicri:noCountry></affiliation></author><author><name sortKey="Moehler, Markus" sort="Moehler, Markus" uniqKey="Moehler M" first="Markus" last="Moehler">Markus Moehler</name><affiliation wicri:level="1"><nlm:aff id="Aff13"><institution-wrap><institution-id institution-id-type="GRID">grid.410607.4</institution-id><institution></institution><institution>Universitätsmedizin Mainz,</institution></institution-wrap>55122 Mainz, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>55122 Mainz</wicri:regionArea></affiliation></author><author><name sortKey="Bekaii Saab, Tanios" sort="Bekaii Saab, Tanios" uniqKey="Bekaii Saab T" first="Tanios" last="Bekaii-Saab">Tanios Bekaii-Saab</name><affiliation wicri:level="2"><nlm:aff id="Aff14"><institution-wrap><institution-id institution-id-type="GRID">grid.417468.8</institution-id><institution></institution><institution>Mayo Clinic,</institution></institution-wrap>Phoenix, AZ 85054 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Phoenix</wicri:cityArea></affiliation></author><author><name sortKey="Valle, Juan W" sort="Valle, Juan W" uniqKey="Valle J" first="Juan W." last="Valle">Juan W. Valle</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.412917.8</institution-id><institution>Division of Molecular & Clinical Cancer Sciences,</institution><institution>Institute of Cancer Sciences, The University of Manchester and The Christie NHS Foundation Trust,</institution></institution-wrap>Manchester, M20 4BX UK</nlm:aff><wicri:noCountry code="subfield">M20 4BX UK</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Cancer</title><idno type="eISSN">1471-2407</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Antineoplastic Combined Chemotherapy Protocols (administration & dosage)</term><term>Antineoplastic Combined Chemotherapy Protocols (therapeutic use)</term><term>Biliary Tract Neoplasms (drug therapy)</term><term>Biliary Tract Neoplasms (pathology)</term><term>Carboplatin (administration & dosage)</term><term>Carboplatin (therapeutic use)</term><term>Cisplatin (administration & dosage)</term><term>Cisplatin (therapeutic use)</term><term>Disease-Free Survival</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Survival Analysis</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Carboplatine (administration et posologie)</term><term>Carboplatine (usage thérapeutique)</term><term>Cisplatine (administration et posologie)</term><term>Cisplatine (usage thérapeutique)</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Protocoles de polychimiothérapie antinéoplasique (administration et posologie)</term><term>Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique)</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Survie sans rechute</term><term>Tumeurs des voies biliaires (anatomopathologie)</term><term>Tumeurs des voies biliaires (traitement médicamenteux)</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Carboplatin</term><term>Cisplatin</term></keywords><keywords scheme="MESH" qualifier="administration & dosage" xml:lang="en"><term>Antineoplastic Combined Chemotherapy Protocols</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Carboplatine</term><term>Cisplatine</term><term>Protocoles de polychimiothérapie antinéoplasique</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs des voies biliaires</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Biliary Tract Neoplasms</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Biliary Tract Neoplasms</term></keywords><keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Antineoplastic Combined Chemotherapy Protocols</term><term>Carboplatin</term><term>Cisplatin</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Tumeurs des voies biliaires</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Carboplatine</term><term>Cisplatine</term><term>Protocoles de polychimiothérapie antinéoplasique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Disease-Free Survival</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Survival Analysis</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Survie sans rechute</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Outcomes in younger (<40 years) and elderly (≥70 years) patients with advanced biliary cancer (ABC) receiving palliative chemotherapy are unclear. This study assessed outcomes in those receiving monotherapy or combination therapy in thirteen prospective systemic-therapy trials.</p></sec><sec><title>Methods</title><p>Multivariable analysis explored the impact of therapy on progression-free (PFS) and overall survival (OS) in two separate age cohort groups: <70 years and ≥70 years, and <40 years and ≥40 years.</p></sec><sec><title>Results</title><p>Overall, 1163 patients were recruited (Jan 1997-Dec 2013). Median age of entire cohort: 63 years (range 23–85); 36 (3%) were <40, 260 (22%); ≥70. Combination therapy was platinum-based in nine studies. Among patients <40 and ≥70 years, 23 (64%) and 182 (70%) received combination therapy, respectively. Median follow-up was 42 months (95%-CI 37–51). Median PFS for patients <40 and ≥40 years was 3.5 and 5.9 months (<italic>P</italic> = 0.12), and OS was 10.8 and 9.7 months, respectively (<italic>P</italic> = 0.55). Median PFS for those <70 and ≥70 years was 6.0 and 5.0 months (<italic>P</italic> = 0.53), and OS was 10.2 and 8.8 months, respectively (<italic>P</italic> = 0.08). For the entire cohort, PFS and OS were significantly better in those receiving combination therapy: Hazard Ratio [HR]-0.66, 95%-CI 0.58–0.76, <italic>P</italic> < 0.0001 and HR-0.72, 95%-CI 0.63–0.82, <italic>P</italic> < 0.0001, respectively; and in patients ≥70 years: HR-0.54 (95%-CI 0.38–0.77, <italic>P</italic> = 0.001) and HR-0.60 (95%-CI 0.43–0.85, <italic>P</italic> = 0.004), respectively. There was no evidence of interaction between age and treatment for PFS (<italic>P</italic> = 0.58, <italic>P</italic> = 0.66) or OS (<italic>P</italic> = 0.18, <italic>P</italic> = 0.75).</p></sec><sec><title>Conclusions</title><p>In ABC, younger patients are rare, and survival in elderly patients in receipt of systemic therapy for advanced disease, whether monotherapy or combination therapy, is similar to that of non-elderly patients, therefore age alone should not influence decisions regarding treatment.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Siegel, R" uniqKey="Siegel R">R Siegel</name></author><author><name sortKey="Naishadham, D" uniqKey="Naishadham D">D Naishadham</name></author><author><name sortKey="Jemal, A" uniqKey="Jemal A">A Jemal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Valle, J" uniqKey="Valle J">J Valle</name></author><author><name sortKey="Wasan, H" 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A" uniqKey="Hurria A">A Hurria</name></author><author><name sortKey="Togawa, K" uniqKey="Togawa K">K Togawa</name></author><author><name sortKey="Mohile, Sg" uniqKey="Mohile S">SG Mohile</name></author><author><name sortKey="Owusu, C" uniqKey="Owusu C">C Owusu</name></author><author><name sortKey="Klepin, Hd" uniqKey="Klepin H">HD Klepin</name></author><author><name sortKey="Gross, Cp" uniqKey="Gross C">CP Gross</name></author><author><name sortKey="Lichtman, Sm" uniqKey="Lichtman S">SM Lichtman</name></author><author><name sortKey="Gajra, A" uniqKey="Gajra A">A Gajra</name></author><author><name sortKey="Bhatia, S" uniqKey="Bhatia S">S Bhatia</name></author><author><name sortKey="Katheria, V" uniqKey="Katheria V">V Katheria</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hurria, A" uniqKey="Hurria A">A Hurria</name></author><author><name sortKey="Mohile, S" uniqKey="Mohile S">S Mohile</name></author><author><name sortKey="Gajra, A" uniqKey="Gajra A">A Gajra</name></author><author><name sortKey="Klepin, H" uniqKey="Klepin H">H Klepin</name></author><author><name sortKey="Muss, H" uniqKey="Muss H">H Muss</name></author><author><name sortKey="Chapman, A" uniqKey="Chapman A">A Chapman</name></author><author><name sortKey="Feng, T" uniqKey="Feng T">T Feng</name></author><author><name sortKey="Smith, D" uniqKey="Smith D">D Smith</name></author><author><name sortKey="Sun, Cl" uniqKey="Sun C">CL Sun</name></author><author><name sortKey="De Glas, N" uniqKey="De Glas N">N De Glas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Extermann, M" uniqKey="Extermann M">M Extermann</name></author><author><name sortKey="Boler, I" uniqKey="Boler I">I Boler</name></author><author><name sortKey="Reich, Rr" uniqKey="Reich R">RR Reich</name></author><author><name sortKey="Lyman, Gh" uniqKey="Lyman G">GH Lyman</name></author><author><name sortKey="Brown, Rh" uniqKey="Brown R">RH Brown</name></author><author><name sortKey="Defelice, J" uniqKey="Defelice J">J DeFelice</name></author><author><name sortKey="Levine, Rm" uniqKey="Levine R">RM Levine</name></author><author><name sortKey="Lubiner, Et" uniqKey="Lubiner E">ET Lubiner</name></author><author><name sortKey="Reyes, P" uniqKey="Reyes P">P Reyes</name></author><author><name sortKey="Schreiber, Fj" uniqKey="Schreiber F">FJ Schreiber</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Danemark</li><li>France</li><li>Japon</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Arizona</li></region></list><tree><noCountry><name sortKey="Bridgewater, John" sort="Bridgewater, John" uniqKey="Bridgewater J" first="John" last="Bridgewater">John Bridgewater</name><name sortKey="Goldstein, David" sort="Goldstein, David" uniqKey="Goldstein D" first="David" last="Goldstein">David Goldstein</name><name sortKey="Knox, Jennifer J" sort="Knox, Jennifer J" uniqKey="Knox J" first="Jennifer J." last="Knox">Jennifer J. Knox</name><name sortKey="Lopes, Andre" sort="Lopes, Andre" uniqKey="Lopes A" first="Andre" last="Lopes">Andre Lopes</name><name sortKey="Mcnamara, Mairead Geraldine" sort="Mcnamara, Mairead Geraldine" uniqKey="Mcnamara M" first="Mairéad Geraldine" last="Mcnamara">Mairéad Geraldine Mcnamara</name><name sortKey="Shannon, Jenny" sort="Shannon, Jenny" uniqKey="Shannon J" first="Jenny" last="Shannon">Jenny Shannon</name><name sortKey="Valle, Juan W" sort="Valle, Juan W" uniqKey="Valle J" first="Juan W." last="Valle">Juan W. Valle</name><name sortKey="Wasan, Harpreet" sort="Wasan, Harpreet" uniqKey="Wasan H" first="Harpreet" last="Wasan">Harpreet Wasan</name></noCountry><country name="France"><noRegion><name sortKey="Malka, David" sort="Malka, David" uniqKey="Malka D" first="David" last="Malka">David Malka</name></noRegion></country><country name="Danemark"><noRegion><name sortKey="Jensen, Lars Henrik" sort="Jensen, Lars Henrik" uniqKey="Jensen L" first="Lars Henrik" last="Jensen">Lars Henrik Jensen</name></noRegion></country><country name="Japon"><noRegion><name sortKey="Okusaka, Takuji" sort="Okusaka, Takuji" uniqKey="Okusaka T" first="Takuji" last="Okusaka">Takuji Okusaka</name></noRegion></country><country name="Suisse"><noRegion><name sortKey="Wagner, Dorothea" sort="Wagner, Dorothea" uniqKey="Wagner D" first="Dorothea" last="Wagner">Dorothea Wagner</name></noRegion></country><country name="Royaume-Uni"><noRegion><name sortKey="Cunningham, David" sort="Cunningham, David" uniqKey="Cunningham D" first="David" last="Cunningham">David Cunningham</name></noRegion></country><country name="Allemagne"><noRegion><name sortKey="Moehler, Markus" sort="Moehler, Markus" uniqKey="Moehler M" first="Markus" last="Moehler">Markus Moehler</name></noRegion></country><country name="États-Unis"><region name="Arizona"><name sortKey="Bekaii Saab, Tanios" sort="Bekaii Saab, Tanios" uniqKey="Bekaii Saab T" first="Tanios" last="Bekaii-Saab">Tanios Bekaii-Saab</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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