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dc.contributor.authorGrünwald, Ven_US
dc.contributor.authorLitière, Sen_US
dc.contributor.authorYoung, Ren_US
dc.contributor.authorMessiou, Cen_US
dc.contributor.authorLia, Men_US
dc.contributor.authorWardelmann, Een_US
dc.contributor.authorvan der Graaf, Wen_US
dc.contributor.authorGronchi, Aen_US
dc.contributor.authorJudson, Ien_US
dc.contributor.authorEORTC STBSGen_US
dc.date.accessioned2017-04-26T09:57:34Z
dc.date.issued2016-09en_US
dc.identifier.citationEuropean journal of cancer (Oxford, England : 1990), 2016, 64 pp. 44 - 51en_US
dc.identifier.issn0959-8049en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/621
dc.identifier.eissn1879-0852en_US
dc.identifier.doi10.1016/j.ejca.2016.05.023en_US
dc.description.abstract<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.en_US
dc.formatPrint-Electronicen_US
dc.format.extent44 - 51en_US
dc.languageengen_US
dc.language.isoengen_US
dc.subjectEORTC STBSGen_US
dc.subjectHumansen_US
dc.subjectSarcomaen_US
dc.subjectSoft Tissue Neoplasmsen_US
dc.subjectDisease Progressionen_US
dc.subjectAnthracyclinesen_US
dc.subjectAntineoplastic Combined Chemotherapy Protocolsen_US
dc.subjectPrognosisen_US
dc.subjectTumor Burdenen_US
dc.subjectProportional Hazards Modelsen_US
dc.subjectPredictive Value of Testsen_US
dc.subjectAdulten_US
dc.subjectMiddle Ageden_US
dc.subjectFemaleen_US
dc.subjectMaleen_US
dc.subjectYoung Adulten_US
dc.subjectKaplan-Meier Estimateen_US
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.en_US
dc.typeJournal Article
dcterms.dateAccepted2016-05-17en_US
rioxxterms.versionofrecord10.1016/j.ejca.2016.05.023en_US
rioxxterms.licenseref.startdate2016-09en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfEuropean journal of cancer (Oxford, England : 1990)en_US
pubs.notesNot knownen_US
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-statusPublisheden_US
pubs.volume64en_US
pubs.embargo.termsNot knownen_US
icr.researchteamClinical and Translational Sarcomaen_US
icr.researchteamSarcoma Clinical Trialsen_US
dc.contributor.icrauthorvan der Graaf, Wilhelminaen_US
dc.contributor.icrauthorJudson, Ianen_US
dc.contributor.icrauthorMessiou, Christinaen_US


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