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A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy

Identifieur interne : 001B69 ( Istex/Corpus ); précédent : 001B68; suivant : 001B70

A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy

Auteurs : M. D. Green ; H. Koelbl ; J. Baselga ; A. Galid ; V. Guillem ; P. Gascon ; S. Siena ; R. I. Lalisang ; H. Samonigg ; M. R. Clemens ; V. Zani ; B. C. Liang ; J. Renwick ; M. J. Piccart

Source :

RBID : ISTEX:D2832EDCEECA5DCA87D30B88EE6391EE180BAB5B

English descriptors

Abstract

Background: We evaluated the efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support. Patients and methods: Patients (n = 157) were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after doxorubicin and docetaxel chemotherapy (60 mg/m2 and 75 mg/m2, respectively). Duration of grade 4 neutropenia, depth of neutrophil nadir, incidence of febrile neutropenia, time to neutrophil recovery and safety information were recorded. Results: A single 6 mg injection of pegfilgrastim was as effective as daily injections of filgrastim for all efficacy measures for all cycles. The mean duration of grade 4 neutropenia in cycle 1 was 1.8 and 1.6 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2–4 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (13% versus 20%, respectively). A single fixed dose of pegfilgrastim was as safe and well tolerated as standard daily filgrastim. Conclusions: A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim in safely providing neutrophil support during myelosuppressive chemotherapy. Pegfilgrastim may have utility in other clinical settings of neutropenia.

Url:
DOI: 10.1093/annonc/mdg019

Links to Exploration step

ISTEX:D2832EDCEECA5DCA87D30B88EE6391EE180BAB5B

Le document en format XML

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<div type="abstract" xml:lang="en">Background: We evaluated the efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support. Patients and methods: Patients (n = 157) were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after doxorubicin and docetaxel chemotherapy (60 mg/m2 and 75 mg/m2, respectively). Duration of grade 4 neutropenia, depth of neutrophil nadir, incidence of febrile neutropenia, time to neutrophil recovery and safety information were recorded. Results: A single 6 mg injection of pegfilgrastim was as effective as daily injections of filgrastim for all efficacy measures for all cycles. The mean duration of grade 4 neutropenia in cycle 1 was 1.8 and 1.6 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2–4 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (13% versus 20%, respectively). A single fixed dose of pegfilgrastim was as safe and well tolerated as standard daily filgrastim. Conclusions: A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim in safely providing neutrophil support during myelosuppressive chemotherapy. Pegfilgrastim may have utility in other clinical settings of neutropenia.</div>
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<forename type="first">M. D.</forename>
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<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">H.</forename>
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<affiliation>Martin Luther University, Halle-Wittenberg, Germany;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">J.</forename>
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<affiliation>Universitaetsklinik fuer Frauenheilkunde, Vienna, Austria;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<persName>
<forename type="first">V.</forename>
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<affiliation>Instituto Valenciano de Oncologia, Valencia, Spain;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">P.</forename>
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<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">S.</forename>
<surname>Siena</surname>
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<affiliation>Ospedale Niguarda Ca’ Granda, Milan, Italy;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">R. I.</forename>
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<affiliation>Academisch Ziekenhuis Maastricht, Maastricht, The Netherlands;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">H.</forename>
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<affiliation>Medizinische Universitaetsklinik, Graz, Austria;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<persName>
<forename type="first">M. R.</forename>
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<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">B. C.</forename>
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<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<forename type="first">J.</forename>
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<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<persName>
<forename type="first">M. J.</forename>
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<title level="j">Annals of Oncology</title>
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<p>Background: We evaluated the efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support. Patients and methods: Patients (n = 157) were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after doxorubicin and docetaxel chemotherapy (60 mg/m2 and 75 mg/m2, respectively). Duration of grade 4 neutropenia, depth of neutrophil nadir, incidence of febrile neutropenia, time to neutrophil recovery and safety information were recorded. Results: A single 6 mg injection of pegfilgrastim was as effective as daily injections of filgrastim for all efficacy measures for all cycles. The mean duration of grade 4 neutropenia in cycle 1 was 1.8 and 1.6 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2–4 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (13% versus 20%, respectively). A single fixed dose of pegfilgrastim was as safe and well tolerated as standard daily filgrastim. Conclusions: A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim in safely providing neutrophil support during myelosuppressive chemotherapy. Pegfilgrastim may have utility in other clinical settings of neutropenia.</p>
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<term>Key words: breast cancer, clinical trial, hemopoietic growth factor, multicenter study, neutropenia</term>
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<article-title>A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy</article-title>
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<name>
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<name>
<surname>Siena</surname>
<given-names>S.</given-names>
</name>
<xref rid="CHDEDIDD">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lalisang</surname>
<given-names>R. I.</given-names>
</name>
<xref rid="CHDGHCAA">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Samonigg</surname>
<given-names>H.</given-names>
</name>
<xref rid="CHDDJBGD">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Clemens</surname>
<given-names>M. R.</given-names>
</name>
<xref rid="CHDJDEJH">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zani</surname>
<given-names>V.</given-names>
</name>
<xref rid="CHDJIDHA">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Liang</surname>
<given-names>B. C.</given-names>
</name>
<xref rid="CHDJIDHA">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Renwick</surname>
<given-names>J.</given-names>
</name>
<xref rid="CHDJIDHA">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Piccart</surname>
<given-names>M. J.</given-names>
</name>
</contrib>
<contrib contrib-type="group-author">
<on-behalf-of> On behalf of the International Pegfilgrastim 749 Study Group</on-behalf-of>
<xref rid="CHDDFABF">12</xref>
<xref rid="FN2">§</xref>
</contrib>
<aff>
<target target-type="aff" id="CHDBJEDC"></target>
<label>1</label>
Royal Melbourne and Western Hospitals, Melbourne, Australia;
<target target-type="aff" id="CHDGBHHG"></target>
<label>2</label>
Martin Luther University, Halle-Wittenberg, Germany;
<target target-type="aff" id="CHDIEIBF"></target>
<label>3</label>
Hospital Vall d’Hebron, Barcelona, Spain;
<target target-type="aff" id="CHDIEBFJ"></target>
<label>4</label>
Universitaetsklinik fuer Frauenheilkunde, Vienna, Austria;
<target target-type="aff" id="CHDBIAFG"></target>
<label>5</label>
Instituto Valenciano de Oncologia, Valencia, Spain;
<target target-type="aff" id="CHDHGHGE"></target>
<label>6</label>
Hospital Clinic, Barcelona, Spain;
<target target-type="aff" id="CHDEDIDD"></target>
<label>7</label>
Ospedale Niguarda Ca’ Granda, Milan, Italy;
<target target-type="aff" id="CHDGHCAA"></target>
<label>8</label>
Academisch Ziekenhuis Maastricht, Maastricht, The Netherlands;
<target target-type="aff" id="CHDDJBGD"></target>
<label>9</label>
Medizinische Universitaetsklinik, Graz, Austria;
<target target-type="aff" id="CHDJDEJH"></target>
<label>10</label>
Krankenanstalt Mutterhaus der Borromaerinnen, Trier, Germany;
<target target-type="aff" id="CHDJIDHA"></target>
<label>11</label>
Amgen Inc, Thousand Oaks, CA, USA;
<target target-type="aff" id="CHDDFABF"></target>
<label>12</label>
Institut Jules Bordet, Brussels, Belgium</aff>
</contrib-group>
<pub-date pub-type="ppub">
<month>01</month>
<year>2003</year>
</pub-date>
<volume>14</volume>
<issue>1</issue>
<fpage>29</fpage>
<lpage>35</lpage>
<permissions>
<copyright-year>2003</copyright-year>
</permissions>
<abstract xml:lang="en">
<p>
<bold>Background:</bold>
</p>
<p>We evaluated the efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support.</p>
<p>
<bold>Patients and methods:</bold>
</p>
<p>Patients (
<italic>n</italic>
= 157) were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after doxorubicin and docetaxel chemotherapy (60 mg/m
<sup>2</sup>
and 75 mg/m
<sup>2</sup>
, respectively). Duration of grade 4 neutropenia, depth of neutrophil nadir, incidence of febrile neutropenia, time to neutrophil recovery and safety information were recorded.</p>
<p>
<bold>Results:</bold>
</p>
<p>A single 6 mg injection of pegfilgrastim was as effective as daily injections of filgrastim for all efficacy measures for all cycles. The mean duration of grade 4 neutropenia in cycle 1 was 1.8 and 1.6 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2–4 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (13% versus 20%, respectively). A single fixed dose of pegfilgrastim was as safe and well tolerated as standard daily filgrastim.</p>
<p>
<bold>Conclusions:</bold>
</p>
<p>A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim in safely providing neutrophil support during myelosuppressive chemotherapy. Pegfilgrastim may have utility in other clinical settings of neutropenia.</p>
</abstract>
<kwd-group kwd-group-type="KWD" xml:lang="en">
<kwd>
<bold>Key words:</bold>
breast cancer, clinical trial, hemopoietic growth factor, multicenter study, neutropenia</kwd>
</kwd-group>
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<meta-name>hwp-legacy-fpage</meta-name>
<meta-value>29</meta-value>
</custom-meta>
<custom-meta>
<meta-name>hwp-legacy-dochead</meta-name>
<meta-value>Original Paper</meta-value>
</custom-meta>
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</article-meta>
<notes>
<p content-type="arthw-misc">Received 20 March 2002; revised 3 June 2002; accepted 17 July 2002</p>
</notes>
</front>
</article>
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<title>A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy</title>
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<title>A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy</title>
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<name type="personal">
<namePart type="given">M. D.</namePart>
<namePart type="family">Green</namePart>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">H.</namePart>
<namePart type="family">Koelbl</namePart>
<affiliation>Martin Luther University, Halle-Wittenberg, Germany;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">J.</namePart>
<namePart type="family">Baselga</namePart>
<affiliation>Hospital Vall d’Hebron, Barcelona, Spain;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">A.</namePart>
<namePart type="family">Galid</namePart>
<affiliation>Universitaetsklinik fuer Frauenheilkunde, Vienna, Austria;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">V.</namePart>
<namePart type="family">Guillem</namePart>
<affiliation>Instituto Valenciano de Oncologia, Valencia, Spain;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">P.</namePart>
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<affiliation>Hospital Clinic, Barcelona, Spain;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">S.</namePart>
<namePart type="family">Siena</namePart>
<affiliation>Ospedale Niguarda Ca’ Granda, Milan, Italy;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">R. I.</namePart>
<namePart type="family">Lalisang</namePart>
<affiliation>Academisch Ziekenhuis Maastricht, Maastricht, The Netherlands;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">H.</namePart>
<namePart type="family">Samonigg</namePart>
<affiliation>Medizinische Universitaetsklinik, Graz, Austria;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">M. R.</namePart>
<namePart type="family">Clemens</namePart>
<affiliation>Krankenanstalt Mutterhaus der Borromaerinnen, Trier, Germany;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">V.</namePart>
<namePart type="family">Zani</namePart>
<affiliation>Amgen Inc, Thousand Oaks, CA, USA;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">B. C.</namePart>
<namePart type="family">Liang</namePart>
<affiliation>Amgen Inc, Thousand Oaks, CA, USA;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">J.</namePart>
<namePart type="family">Renwick</namePart>
<affiliation>Amgen Inc, Thousand Oaks, CA, USA;</affiliation>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">M. J.</namePart>
<namePart type="family">Piccart</namePart>
<affiliation>Royal Melbourne and Western Hospitals, Melbourne, Australia;</affiliation>
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<abstract lang="en">Background: We evaluated the efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support. Patients and methods: Patients (n = 157) were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after doxorubicin and docetaxel chemotherapy (60 mg/m2 and 75 mg/m2, respectively). Duration of grade 4 neutropenia, depth of neutrophil nadir, incidence of febrile neutropenia, time to neutrophil recovery and safety information were recorded. Results: A single 6 mg injection of pegfilgrastim was as effective as daily injections of filgrastim for all efficacy measures for all cycles. The mean duration of grade 4 neutropenia in cycle 1 was 1.8 and 1.6 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2–4 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (13% versus 20%, respectively). A single fixed dose of pegfilgrastim was as safe and well tolerated as standard daily filgrastim. Conclusions: A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim in safely providing neutrophil support during myelosuppressive chemotherapy. Pegfilgrastim may have utility in other clinical settings of neutropenia.</abstract>
<note>Received 20 March 2002; revised 3 June 2002; accepted 17 July 2002</note>
<subject lang="en">
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<title>Annals of Oncology</title>
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<identifier type="ISSN">0923-7534</identifier>
<identifier type="eISSN">1569-8041</identifier>
<identifier type="PublisherID">annonc</identifier>
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<identifier type="PublisherID-nlm-ta">Ann Oncol</identifier>
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<date>2003</date>
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<caption>vol.</caption>
<number>14</number>
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<detail type="issue">
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