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dc.contributor.authorMcNamara, MGen_US
dc.contributor.authorBridgewater, Jen_US
dc.contributor.authorLopes, Aen_US
dc.contributor.authorWasan, Hen_US
dc.contributor.authorMalka, Den_US
dc.contributor.authorJensen, LHen_US
dc.contributor.authorOkusaka, Ten_US
dc.contributor.authorKnox, JJen_US
dc.contributor.authorWagner, Den_US
dc.contributor.authorCunningham, Den_US
dc.contributor.authorShannon, Jen_US
dc.contributor.authorGoldstein, Den_US
dc.contributor.authorMoehler, Men_US
dc.contributor.authorBekaii-Saab, Ten_US
dc.contributor.authorValle, JWen_US
dc.coverage.spatialEnglanden_US
dc.date.accessioned2017-07-19T11:56:45Z
dc.date.issued2017-04-12en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/28403829en_US
dc.identifier10.1186/s12885-017-3266-9en_US
dc.identifier.citationBMC Cancer, 2017, 17 (1), pp. 262 - ?en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/712
dc.identifier.eissn1471-2407en_US
dc.identifier.doi10.1186/s12885-017-3266-9en_US
dc.description.abstractBACKGROUND: 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. METHODS: 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. RESULTS: 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 (P = 0.12), and OS was 10.8 and 9.7 months, respectively (P = 0.55). Median PFS for those <70 and ≥70 years was 6.0 and 5.0 months (P = 0.53), and OS was 10.2 and 8.8 months, respectively (P = 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, P < 0.0001 and HR-0.72, 95%-CI 0.63-0.82, P < 0.0001, respectively; and in patients ≥70 years: HR-0.54 (95%-CI 0.38-0.77, P = 0.001) and HR-0.60 (95%-CI 0.43-0.85, P = 0.004), respectively. There was no evidence of interaction between age and treatment for PFS (P = 0.58, P = 0.66) or OS (P = 0.18, P = 0.75). CONCLUSIONS: 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.en_US
dc.format.extent262 - ?en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectBiliary canceren_US
dc.subjectElderlyen_US
dc.subjectProspective trialsen_US
dc.subjectSystemic therapyen_US
dc.subjectYounger patientsen_US
dc.subjectAdulten_US
dc.subjectAgeden_US
dc.subjectAged, 80 and overen_US
dc.subjectAntineoplastic Combined Chemotherapy Protocolsen_US
dc.subjectBiliary Tract Neoplasmsen_US
dc.subjectCarboplatinen_US
dc.subjectCisplatinen_US
dc.subjectDisease-Free Survivalen_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectProspective Studiesen_US
dc.subjectSurvival Analysisen_US
dc.subjectTreatment Outcomeen_US
dc.subjectYoung Adulten_US
dc.titleSystemic therapy in younger and elderly patients with advanced biliary cancer: sub-analysis of ABC-02 and twelve other prospective trials.en_US
dc.typeJournal Article
dcterms.dateAccepted2017-04-05en_US
rioxxterms.versionofrecord10.1186/s12885-017-3266-9en_US
rioxxterms.licenseref.startdate2017-04-12en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfBMC Canceren_US
pubs.issue1en_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/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished onlineen_US
pubs.volume17en_US
pubs.embargo.termsNot knownen_US
icr.researchteamMedicine (RMH Smith Cunningham)en_US
dc.contributor.icrauthorCunningham, Daviden_US
dc.contributor.icrauthorMarsden,en_US


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