- MeSH
- ATP-Binding Cassette Transporters analysis MeSH
- Survival Analysis MeSH
- Drug Resistance, Neoplasm MeSH
- Adult MeSH
- Risk Assessment statistics & numerical data MeSH
- Carcinoma epidemiology etiology drug therapy physiopathology MeSH
- Drug Resistance MeSH
- Middle Aged MeSH
- Humans MeSH
- Drug Resistance, Multiple MeSH
- Ovarian Neoplasms * epidemiology etiology drug therapy physiopathology MeSH
- ATP Binding Cassette Transporter, Subfamily B, Member 1 analysis MeSH
- Disease-Free Survival * MeSH
- ATP-Binding Cassette, Sub-Family C Proteins * analysis MeSH
- Vault Ribonucleoprotein Particles analysis MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Východiska: Malignity C56 jsou významná onemocnění. V ČR byla za r. 2018 hlášena incidence 956 případů a mortalita 637 (data Ústavu zdravotnických informací a statistiky). Dominantní sku pinu zde představují karcinomy. Páteří 1. linie léčby je dostatečně radikální chirurgický výkon, v naprosté většině případů s chemoterapií s karboplatinou (paklitaxel/karboplatina). Analýzy výsledků léčby center ČR jsou prezentovány ojediněle. Soubor pacientů a metody: Pacientky s nově diagnostikovaným a morfologicky verifikovaným tuboovariálním karcinomem v období 2010–2019 a v aktivní péči Komplexního onkologického centra FN Plzeň. Byly sledovány základní faktory s možným vlivem na dobu od diagnózy do progrese (progression free survival – PFS) nebo úmrtí (overall survival – OS): stav dosažení kompletní remise (complete remission – CR) v 1. linii léčby (ano vs. ne), grade (low = 1–2 vs. high = 3–4), stadium (1 vs. 2 vs. 3 vs. 4), typ (serózní vs. neserózní, nespecifikovaný), věk (< 65 let vs. ≥ 65 let), rok diagnózy (2010–2012 vs. 2017–2019). Pro analýzu PFS a OS byl využit Kaplan-Meierův odhad funkce přežití, log-rank test a byly stano veny mediány přežití. Výsledky: Registrováno bylo n = 510 pacientek, z toho pro PFS validních n = 498 a pro OS n = 507. Byl prokázán statisticky významný rozdíl v křivkách přežití (p ≤ 0,001) u PFS dle stadia: I (medián přežití t. č. nedosažen), II (49 měsíců), III (16 měsíců), IV (14 měsíců); dle gradingu: low (36 měsíců) vs. high (19 měsíců); dle dosažení CR: ano (33 měsíců) vs. ne (11 mě síců); dle věku: < 65 let (23 měsíců) vs. ≥ 65 let (15 měsíců). Statisticky významné rozdíly v OS (p ≤ 0,019) byly zaznamenány rovněž dle stadia: I (medián t. č. nedosažen), II (medián t. č. ne dosažen), III (36 měsíců), IV (27 měsíců); dle gradingu: low (87 měsíců) vs. high (46 měsíců); dle dosažení CR: ano (91 měsíců) vs. ne (18 měsíců); dle věku: < 65 let (66 měsíců) vs. ≥ 65 let (32 mě síců). Statisticky významný rozdíl PFS a OS dle typu malignity a roku diagnózy nebyl prokázán. Závěr: Uváděný soubor lze považovat za reprezentativní a neselektovaný. Potvrzujeme obecně očekávané výsledky, které jsou výstupem komplexní multioborové spolupráce se zásadní pozicí chirurgických resekcí (pozn. u neresekabilních případů byl stav CR při chemoterapii s příp. bevacizumabem jen 9 %). Srovnání výsledků podle období léčby (2010–2012 vs. 2017–2019) neukázalo rozdíly a pro zhodnocení efektu bevacizumabu nebo nověji udržovací léčby PARPi či koncentrace operativy do komplexních onkologických center by bylo nutné další sledování nebo multicent- rická spolupráce. Soubor dat z reálné praxe může být cenný zdroj pro další analýzy a výzkum.
Background: C56 malignancies are significant diseases. In the Czech Republic, the incidence of 956 and mortality of 637 cases were reported in 2018 (data from the registry of the Institute of Health Information and Statistics of the Czech Republic). Carciomas are a dominant group. The backbone of first-line treatment is a sufficiently radical surgery and chemotherapy with carboplatin (paclitaxel/carboplatin) in the vast majority of cases. Analyses of treatment outcomes in CZ centers are presented infrequently. Patients and methods: Patients with a new diagnosis and morphologically verified tubo-ovarian cancer in the period 2010–2019 and active care within comprehensive oncology centre FN Plzen. Basic factors with possible influence on time from diagnosis to progression (progression-free survival – PFS) or death (overall survival – OS) were moni- tored: the state of complete remission (CR) in the first line of treatment (yes vs. no), grade (low = 1–2 vs. high = 3–4), stage (1 vs. 2 vs. 3 vs. 4), type (serous vs. non-serous, unspecified), age (< 65 years vs. ≥ 65 years), year of dia gnosis (2010–2012 vs. 2017–2019). The Kaplan-Meier estimate of survival function, log-rank test and median survival were used for PFS and OS analysis. Results: Registered n = 510 patients, of which n = 498 valid for PFS and n = 507 for OS. A statistically significant difference in survival curves (P ≤ 0.001) was demonstrated for PFS according to the stage: I (median survival not reached), II (49 months), III (16 months), and IV (14 months); by grading: low (36 months) vs. high (19 months); according to CR achievement: yes (33 months) vs. no (11 months); by age: < 65 years (23 months) vs . ≥ 65 years (15 months) . Statistically significant differences in OS (P ≤ 0.019) were also recorded according to the stage: I (median not reached), II (median not reached), III (36 months), IV (27 months); by grading: low (87 months) vs. high (46 months); according to CR achievement: yes (91 months) vs. no (18 months); by age: < 65 years (66 mon- ths) vs. ≥ 65 years (32 months). A statistically significant difference between PFS and OS according to the type of malignancy and the year of diagnosis was not proven. Conclusion: The presented set can be considered representative and unselected. We confirm the generally expected results, which are the result of a comprehensive multidisciplinary cooperation with the crucial position of surgical resections (note: in unresec- table cases, the state of CR during chemotherapy with potentially bevacizumab was only 9%). Comparison of the results by treatment period (2010–2012 vs. 2017–2019) did not show differences and further monitoring or multicentre cooperation would be needed to evaluate the effect of bevacizumab, or more recently PARPi maintenance treatment, or the concentration of surgery in complex cancer centers. The real world data file can be a source for further analysis and research.
GOYA was a randomized phase 3 study comparing obinutuzumab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) vs standard-of-care rituximab plus CHOP in patients with previously untreated diffuse large B-cell lymphoma (DLBCL). This retrospective analysis of GOYA aimed to assess the association between progression-free survival (PFS) and overall survival (OS) with positron emission tomography (PET)-based complete response (CR) status. Overall, 1418 patients were randomly assigned to receive 8 21-day cycles of obinutuzumab (n = 706) or rituximab (n = 712) plus 6 or 8 cycles of CHOP. Patients received a mandatory fluoro-2-deoxy-d-glucose-PET/computed tomography scan at baseline and end of treatment. After a median follow-up of 29 months, the numbers of independent review committee-assessed PFS and OS events in the entire cohort were 416 (29.3%) and 252 (17.8%), respectively. End-of-treatment PET CR was highly prognostic for PFS and OS according to Lugano 2014 criteria (PFS: hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.19-0.38; P < .0001; OS: HR, 0.12; 95% CI, 0.08-0.17; P < .0001), irrespective of international prognostic index score and cell of origin. In conclusion, the results from this prospectively acquired large cohort corroborated previously published data from smaller sample sizes showing that end-of-treatment PET CR is an independent predictor of PFS and OS and a promising prognostic marker in DLBCL. Long-term survival analysis confirmed the robustness of these data over time. Additional meta-analyses including other prospective studies are necessary to support the substitution of PET CR for PFS as an effective and practical surrogate end point. This trial was registered at www.clinicaltrials.gov as #NCT01287741.
- MeSH
- Lymphoma, Large B-Cell, Diffuse * diagnostic imaging drug therapy MeSH
- Progression-Free Survival MeSH
- Humans MeSH
- Positron Emission Tomography Computed Tomography * MeSH
- Positron-Emission Tomography MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase III MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Keywords
- ribociclib,
- MeSH
- Aminopyridines * therapeutic use MeSH
- Cyclin-Dependent Kinase 4 antagonists & inhibitors MeSH
- Cyclin-Dependent Kinase 6 antagonists & inhibitors MeSH
- Progression-Free Survival MeSH
- Clinical Trials, Phase III as Topic MeSH
- Drug Therapy, Combination MeSH
- Letrozole therapeutic use MeSH
- Humans MeSH
- Breast Neoplasms * drug therapy MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Comparative Study MeSH
