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dc.contributor.authorGrünwald, V
dc.contributor.authorLitière, S
dc.contributor.authorYoung, R
dc.contributor.authorMessiou, C
dc.contributor.authorLia, M
dc.contributor.authorWardelmann, E
dc.contributor.authorvan der Graaf, W
dc.contributor.authorGronchi, A
dc.contributor.authorJudson, I
dc.contributor.authorEORTC STBSG
dc.date.accessioned2017-04-26T09:57:34Z
dc.date.issued2016-09
dc.identifier.citationEuropean journal of cancer (Oxford, England : 1990), 2016, 64 pp. 44 - 51
dc.identifier.issn0959-8049
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/621
dc.identifier.eissn1879-0852
dc.identifier.doi10.1016/j.ejca.2016.05.023
dc.description.abstractBackground Anthracycline-based chemotherapy remains the mainstay of first-line treatment in metastatic or advanced soft-tissue sarcoma (STS). Age, performance status, tumour histology and tumour grade are recognised prognostic factors; however, the prognostic value of tumour response and tumour shrinkage is ill-defined.Methods Patients recruited to the European Organisation for Research and Treatment of Cancer 62012 trial with advanced intermediate or high-grade STS, who received at least one cycle of chemotherapy and one tumour assessment of response, were eligible for this study. Kaplan-Meier estimates of overall survival (OS) by tumour response were computed using a landmark approach after two, four, and six cycles of chemotherapy. The prognostic role of the kinetics of tumour response was analysed by Cox proportional hazards.Results Three hundred eighty-nine patients were included in this study. Compared to stable or responding patients, patients with progressive disease (PD) after two, four and six cycles of chemotherapy achieved a worse OS: hazard ratio [HR] 2.62 (95% confidence interval [CI] 1.72-4.00), p < 0.001; HR 2.23 (95% CI 1.4-3.56), p = 0.0001; and HR 3.16 (95% CI 1.96-5.08), p = 0.0001, respectively. However, patients with stable or responding disease achieved similar OS outcomes. Correspondingly, patients with an increase in tumour size by 10% or more correlated with a worse OS in Cox proportional hazard analysis.Conclusions No association between prognosis and amount of tumour shrinkage was detected. Interestingly, an increase in tumour size by at least 10% correlated with a worse OS, but re-defining PD as a ≥10% increase in tumour size did not translate into a better discrimination of survival outcomes for responders versus stable disease. Disease control rather than tumour response is a valuable end-point in advanced or metastatic STS receiving palliative anthracycline-based chemotherapy, supporting the use of time-to-event end-points in future STS trials.
dc.formatPrint-Electronic
dc.format.extent44 - 51
dc.languageeng
dc.language.isoeng
dc.subjectEORTC STBSG
dc.subjectHumans
dc.subjectSarcoma
dc.subjectSoft Tissue Neoplasms
dc.subjectDisease Progression
dc.subjectAnthracyclines
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectPrognosis
dc.subjectTumor Burden
dc.subjectProportional Hazards Models
dc.subjectPredictive Value of Tests
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.subjectKaplan-Meier Estimate
dc.titleAbsence of progression, not extent of tumour shrinkage, defines prognosis in soft-tissue sarcoma - An analysis of the EORTC 62012 study of the EORTC STBSG.
dc.typeJournal Article
dcterms.dateAccepted2016-05-17
rioxxterms.versionofrecord10.1016/j.ejca.2016.05.023
rioxxterms.licenseref.startdate2016-09
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfEuropean journal of cancer (Oxford, England : 1990)
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical and Translational Sarcoma
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Sarcoma Clinical Trials
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical and Translational Sarcoma
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Sarcoma Clinical Trials
pubs.publication-statusPublished
pubs.volume64
pubs.embargo.termsNot known
icr.researchteamClinical and Translational Sarcomaen_US
icr.researchteamSarcoma Clinical Trialsen_US
dc.contributor.icrauthorvan der Graaf, Wilhelminaen
dc.contributor.icrauthorJudson, Ianen
dc.contributor.icrauthorMessiou, Christinaen


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