Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma

Blayney, Jaine K., Ceresoli, Giovanni L., Castagneto, Bruno, O'Brien, Mary E. R., Hasan, Baktar, Sylvester, Richard, Rudd, Robin, Steele, Jeremy, Busacca, Sara, Porta, Camillo, Mutti, Luciano, O'Byrne, Kenneth J., Scullin, Paula, Gaafar, Rabab, Baas, Paul, Van Meerbeeck, Jan, & Fennell, Dean A. (2012) Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma. European Journal of Cancer, 48(16), pp. 2983-2992.

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Background: There is currently no early predictive marker of survival for patients receiving chemotherapy for malignant pleural mesothelioma (MPM). Tumour response may be predictive for overall survival (OS), though this has not been explored. We have thus undertaken a combined-analysis of OS, from a 42 day landmark, of 526 patients receiving systemic therapy for MPM. We also validate published progression-free survival rates (PFSRs) and a progression-free survival (PFS) prognostic-index model.

Methods: Analyses included nine MPM clinical trials incorporating six European Organisation for Research and Treatment of Cancer (EORTC) studies. Analysis of OS from landmark (from day 42 post-treatment) was considered regarding tumour response. PFSR analysis data included six non-EORTC MPM clinical trials. Prognostic index validation was performed on one non-EORTC data-set, with available survival data.

Results: Median OS, from landmark, of patients with partial response (PR) was 12·8 months, stable disease (SD), 9·4 months and progressive disease (PD), 3·4 months. Both PR and SD were associated with longer OS from landmark compared with disease progression (both p < 0·0001). PFSRs for platinum-based combination therapies were consistent with published significant clinical activity ranges. Effective separation between PFS and OS curves provided a validation of the EORTC prognostic model, based on histology, stage and performance status.

Conclusion: Response to chemotherapy is associated with significantly longer OS from landmark in patients with MPM. © 2012 Elsevier Ltd. All rights reserved.

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ID Code: 64814
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Landmark analysis, Mesothelioma, Prognosis, Survival, carboplatin, cisplatin, doxorubicin, mitomycin C, navelbine, oxaliplatin, pemetrexed, raltitrexed, temozolomide, vinblastine, adult, aged, article, cancer chemotherapy, cancer combination chemotherapy, cancer growth, cancer patient, cancer prognosis, cancer staging, clinical trial (topic), controlled study, data analysis, female, human, major clinical study, male, overall survival, performance, pleura mesothelioma, prediction, priority journal, progression free survival, treatment response, validation process, Antineoplastic Combined Chemotherapy Protocols, Clinical Trials as Topic, Disease-Free Survival, Humans, Kaplan-Meier Estimate, Middle Aged, Pleural Neoplasms, Proportional Hazards Models, Reproducibility of Results, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome
DOI: 10.1016/j.ejca.2012.05.018
ISSN: 0959-8049
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2012 Pergamon
Deposited On: 26 Nov 2013 04:26
Last Modified: 18 Dec 2013 03:01

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