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Addition of bevacizumab to first-line palliative chemotherapy in patients with metastatic small bowel adenocarcinoma - a population-based study

LEGUE, Laura M. ; VAN ERNING, Felice N. ; BERNARDS, Nienke ; LEMMENS, Valery E. P. P. ; DE HINGH, Ignace H. J. T. ; CREEMERS, Geert-Jan
Targeted oncology, 17/10/2019, p. 1-7

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Thème : Médecine.

CHIMIOTHERAPIE ; CANCER DIGESTIF ; PAYS-BAS

Background: Data about the use and effectiveness of targeted therapy in metastatic small bowel adenocarcinoma (SBA) are scarce.
Objective: The aim of this population-based study was to obtain insights into the use and effectiveness of targeted therapy in patients with synchronous metastases of SBA.
Patients and methods: Data were retrieved from the Netherlands Cancer Registry. Patients treated with palliative chemotherapy and/or targeted therapy for synchronous metastatic SBA between 2007 and 2016 were included (n = 187). Differences in treatment and the subsequent effects on overall survival (OS) were evaluated.
Results: In first-line treatment, 25 patients (13%) received additional targeted therapy, exclusively bevacizumab, and mostly in combination with CAPOX/FOLFOX (n = 24). A primary ileal tumour was predictive for receiving bevacizumab in first-line treatment (odds ratio 3.2, 95% confidence interval (CI) 1.06–9.93). Median OS for patients in whom bevacizumab was added to first-line chemotherapy was 9.3 months, compared to 9.1 months with chemotherapy only (p = 0.85). Median OS for patients receiving first-line treatment only was 8.5 months with and 6.4 months without the addition of bevacizumab, respectively (p = 0.54). In multivariable survival analyses, the addition of bevacizumab was no prognostic factor (hazard ratio 1.01, 95% CI 0.65–1.59).
Conclusions: Bevacizumab was the only prescribed targeted therapy in first-line treatment. Considering the limited number of patients receiving first-line bevacizumab and the unknown reasons to prescribe additional targeted therapy, the corresponding survival rates of patients treated with and without additional bevacizumab in first-line treatment might suggest a limited clinical effect of bevacizumab in addition to first-line palliative chemotherapy on OS. Future research should focus on identifying the subgroup of patients who might benefit from anti-VEGF therapy in metastatic SBA.

Origine : PubMed

Clinical effectiveness and safety of self-expanding metal stent placement following palliative chemotherapy in patients with advanced esophageal cancer

BAKHEET, Nader ; HU, Hong-Tao ; PARK, Jung-Hoon ; JEON, Jae Yong ; YOON, Sung Hwan ; KIM, Kun Yung ; ZHE, Wang ; KIM, Sung-Bae ; SONG, Ho-Young
Abdominal radiology, 05/10/2019, p. 1-8

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Thème : Médecine.

CHIMIOTHERAPIE ; CANCER DIGESTIF ; THERAPEUTIQUE ANTI CANCEREUSE

Purpose: To investigate the effect of prior chemotherapy on self-expanding metal stent (SEMS)-related complications in patients with locally advanced primary esophageal cancer.
Materials and methods: Data from patients with locally advanced primary esophageal cancer who received SEMS placement with or without prior chemotherapy were retrospectively reviewed. Patients were grouped according to prior palliative therapy: group A (n = 41) had received SEMS only, and group B (n = 64) had received palliative chemotherapy prior to SEMS placement. Patients’ age, stricture length, tumor location, and dysphagia score prior to SEMS placement were evaluated. The overall patient cohort had a median follow-up period of 129 days (range 11–463). Outcomes after SEMS placement, including technical and clinical success rates, the occurrence of complications, and overall survival, were compared.
Results: There were no significant differences between the two groups regarding patients’ age, stricture length, tumor location, and dysphagia score prior to SEMS placement. SEMS placement was technically successful in all patients, with no procedure-related complications reported. Clinical success was achieved in 95.1% of patients in group A and 96.8% of patients in group B. The duration of stent patency was significantly shorter in group B [162 days; 95% confidence interval (CI) 126.6–198.4 vs. group A (339 days; 95% CI 258.8–419.3], p = 0.001. No significant differences were seen between the two groups regarding dysphagia score improvement [group A (3.15 ± 0.57 to 1.17 ± 0.83; p < 0.001) and group B (3.17 ± 0.80 to 1.14 ± 0.79; p < 0.001); p = 0.66], complications [group A (10/41), and group B (24/64); p = 0.094], or overall survival [the median and mean overall survival periods were 105 (95% CI 30–180) and 132 days (95% CI 97–167), respectively, in group A, and 126 (95% CI 88–164) and 156 days (95% CI 132–180), respectively, in group B; p = 0.592].
Conclusion: Prior chemotherapy did not increase the risk of complications following SEMS placement in patients with locally advanced esophageal cancer. SEMS patency was significantly longer in patients who did not receive chemotherapy prior to SEMS placement.

Origine : PubMed

Rising to the medication's requirements - the experience of elderly cancer patients receiving palliative chemotherapy in the elective oncogeriatrics field

FOLEY, Rose-Anna ; LECHEVALIER HURARD, Lucie ; ANCHISI, Annick ; ANCHISI, Sandro
Social science and medicine, 08/10/2019, vol.242, p. 1-11

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Palliative chemotherapy or radiation and prognostic understanding among advanced cancer patients - the role of perceived treatment intent

GEORGE, Login S. ; PRIGERSON, Holly G. ; EPSTEIN, Andrew S. ; RICHARDS, Kristy L. ; SHEN, Megan J. ; DERRY, Heather M. ; REYNA, Valerie F. ; SHAH, Manish A. ; MACIEJEWSKI, Paul K.
JOURNAL OF PALLIATIVE MEDICINE, 08/10/2019, p. 1-7

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Feasibility of early application of an advance directive at the time of first-line palliative chemotherapy in patients with incurable cancer

PARK, Eun-Ju ; LIM, Yeon Jae ; KIM, Jae-Joon ; OH, Sang-Bo ; OH, So Yeon ; PARK, Kwonoh
American journal of hospice and palliative medicine, 10/2019, vol.36, n°10, p. 893-899

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Does palliative chemotherapy really palliate and are we measuring it correctly? - a mixed methods longitudinal study of health related quality of life in advanced soft tissue sarcoma

GOUGH, Nicholas ; KOFFMAN, Jonathan ; ROSS, Joy R. ; RILEY, Julia ; JUDSON, Ian
Plos one, 2019, vol.14, n°9, p. 1-24

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Thème : Médecine. Cote : eD03.05.01

CHIMIOTHERAPIE ; QUALITE VIE ; ETUDE LONGITUDINALE

OBJECTIVE: Soft tissue sarcoma (STS) is a rare cancer type that when locally advanced or metastatic, is predominantly treated with palliative chemotherapy with the aim of improving both quantity and quality of life. Given modest survival data after commencing first line chemotherapy, this study examines (i) what constitutes health related quality of life (HRQoL), (ii) whether the most commonly used HRQoL assessment tool measures this and (iii) to what extent HRQoL, and its components, change during and after treatment.
DESIGN: Mixed-methods longitudinal study of 66 sarcoma patients living with STS (42 commencing chemotherapy, 24 under surveillance after completing chemotherapy) involving serial EORTC QLQ-C30 questionnaires and nested-qualitative semi-structured interviews with a sub-sample of participants. EORTC QLQ-C30 score change from baseline to primary evaluation point was examined using a paired t-test. Interviews were analysed using the framework approach before both datasets were integrated.
RESULTS: Five main factors, including control of pain, were identified by study participants as important components of HRQoL; these are examined within the EORTC QLQ-C30. However, others e.g. independence loss and common causes of anxiety, are not. Whilst social and psychological domains are addressed by the EORTC QLQ-C30, the quantitative change over time did reflect qualitative descriptions of decline. The mean overall EORTC QLQ-C30 HRQoL score deteriorated from baseline (60.4) to the primary evaluation point (50.2) [change of -10.2, t-test: -2.70, p = 0.01] for those receiving chemotherapy; this was in concordance with patients' qualitative accounts. Baseline overall HRQoL scores were higher in the surveillance group suggesting a correlation with chemotherapy response and longer-term improvement in HRQoL. The evidence from both HRQoL scores and qualitative accounts indicated that the presence and control of physical symptoms were particularly important in maintaining HRQoL. Whilst fatigue deteriorated on chemotherapy (baseline 41.7 to 52.8; change of +11.1, t-test +2.51, p<0.05), pain (baseline 41.5 to 32.1; change -9.4, t-test -2.06 p<0.05) and sleep disturbance (43.1 to 28.5; change -14.6, t-test -3.05, p<0.05) both improved.
CONCLUSION: A key finding was that the EORTC QLQ-C30 assesses some but not all of the patient-reported components of HRQoL in sarcoma patients highlighting the need for either STS specific modules within the EORTC QLQ-C30 or a completely new STS specific HRQoL tool. First line palliative chemotherapy improves specific symptoms known to be prevalent and to influence HRQoL in this patient group which in some patients may translate to sustained improvement in HRQoL: further exploration and validation of these findings in larger prospective studies are warranted.

Origine : PubMed

Management and intensity of medical end-of-life care in people with colorectal cancer during the year before their death in 2015 - a French national observational study

TANGUY-MELAC, Audrey ; AGUADE, Anne-Sophie ; FAGOT-CAMPAGNA, Anne ; GASTALDI-MÉNAGER, Christelle ; SABATE, Jean-Marc ; TUPPIN, Philippe
Cancer medicine, 25/09/2019, p. 1-13

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Outcome and feasibility of palliative chemotherapy in very elderly patients with metastatic breast cancer

OVERGAAUW, Audrey J. C. ; SPEIJERS-VAN DER PLAS, Linda M. ; HENDRIKS, Mathijs P. ; SMORENBURG, Carolien H.
The breast journal, 20/09/2019, Pagination inconnue

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Phase I/II study of palliative triple metronomic chemotherapy in platinum-refractory/early-failure oral cancer

PATIL, Vijay M. ; NORONHA, Vanita ; JOSHI, Amit ; DHUMAL, Sachin ; MAHIMKAR, Manoj ; BHATTACHARJEE, Atanu ; GOTA, Vikram ; PANDEY, Manish ; MENON, Nandini ; MAHAJAN, Abhishek ; SABLE, Nilesh ; KUMAR, Suman ; NAWALE, Kavita ; MUKADAM, Sadaf ; SOLANKI, Bhavin ; DAS, Sudeep ; SIMHA, Vijai ; ABRAHAM, George ; CHANDRASEKHARAN, Arun ; TALREJA, Vikas ; DSOUZA, Hollis ; SRINIVAS, Sujay ; KASHYAP, Lakhan ; BANAVALI, Shripad ; PRABHASH, Kumar
Journal of clinical oncology, 20/09/2019, Pagination inconnue

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Quality of life in patients with advanced non-small-cell lung cancer receiving palliative chemotherapy

DAROSZEWSKI, Cyryl ; STASIEWICZ, Malgorzata ; JAZWINSKA-TARNAWSKA, Ewa ; RACHWALIK, Anna ; MURA, Ewa ; LUBOCH-KOWAL, Joanna ; DRYS, Andrzej ; BOGUCKI, Zdzislaw A. ; BRZECKA, Anna
Advances in experimental medicine and biology, 2019, vol.1160, p. 11-18

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Palliative chemotherapy in carcinoma nasopharynx

PATIL, Vijay M. ; JOSHI, Amit ; NORONHA, Vanita ; TALREJA, Vikas ; SIMHA, Vijai ; DHUMAL, Sachin ; BANDEKAR, Bhavesh ; CHANDRASEKHARAN, Arun ; PRABHASH, Kumar
South Asian journal of cancer, 09/2019, vol.8, n°3, p. 173-177

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Patient perceptions of their decision to undergo palliative chemotherapy in the Edinburgh cancer centre

BOWDEN, Joanna ; GWYTHER, Beth ; PRICE, Allan ; SWAN, Amanda ; NUSSEY, Fiona ; HACKING, Belinda ; SHEARER, Morven ; LLOYD, Anna
The journal of the Royal College of Physicians of Edinburgh, 09/2019, vol.49, n°3, p. 199-203

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Changes of end of life practices for cancer patients and their association with hospice palliative care referral over 2009-2014 - a single institution study

JHO, Hyun Jung ; NAM, Eun Jung ; SHIN, Il Won ; KIM, Sun Young
Cancer research and treatment, 03/09/2019, Pagination inconnue

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Treatment of syncope in tongue cancer with palliative chemotherapy in the intensive care unit - a case report

FANG, Chongkai ; YANG, Liting ; ZENG, Guangbi ; HUANG, Ruilin ; FANG, Wei ; CHEN, Yao ; GUAN, Jieshan ; LI, Peng ; HUANG, Xuewu ; LIN, Lizhu
Medicine, 08/2019, vol.98, n°35, p. 1-4

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Validation and application of a prognostic model for patients with advanced pancreatic cancer receiving palliative chemotherapy

HUANG, Pei-Wei ; CHANG, Ching-Fu ; HUNG, Chia-Yen ; HSUEH, Shun-Wen ; CHANG, Pei-Hung ; YEH, Kun-Yun ; CHEN, Jen-Shi ; CHEN, Yen-Yang ; LU, Chang-Hsien ; HUNG, Yu-Shin ; CHOU, Wen-Chi
Cancer medicine, 06/08/2019, p. 1-10

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Older adults' preferred and perceived roles in decision-making about palliative chemotherapy, decision priorities and information preferences

MOTH, Erin B. ; KIELY, Belinda E. ; MARTIN, Andrew ; NAGANATHAN, Vasi ; DELLA-FIORENTINA, Stephen ; HONEYBALL, Florian ; ZIELINSKI, Rob ; STEER, Christopher ; MANDALIYA, Hiren ; RAGUNATHAN, Abiramy ; BLINMAN, Prunella
Journal of geriatric oncology, 19/08/2019, Pagination inconnue

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Survival benefit of palliative gastrectomy followed by chemotherapy in stage IV gastric signet ring cell carcinoma patients - a large population-based study

SHI, Tao ; SONG, Xueru ; LIU, Qin ; YANG, Yang ; YU, Lixia ; LIU, Baorui ; WEI, Jia
Cancer medicine, 25/08/2019, p. 1-11

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Is in-hospital mortality higher in patients with metastatic lung cancer who received treatment in the last month of life? - a retrospective cohort study

MIERAS, Adinda ; PASMAN, H. Roeline W. ; ONWUTEAKA-PHILIPSEN PROF, Bregje D. ; DINGEMANS, Anne-Marie M. C. ; KOK, Edith V. ; CORNELISSEN, Robin ; JACOBS, Wouter ; VAN DEN BERG, Jan-Willem ; WELLING, Alle ; BOGAARTS, Brigitte A. H. A. ; PRONK, Lemke ; BECKER-COMMISSARIS, Annemarie
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 05/07/2019, Pagination inconnue

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Role of palliative resection in patients with incurable advanced gastric cancer who are unfit for chemotherapy

OMORI, Hayato ; TANIZAWA, Yutaka ; MAKUUCHI, Rie ; IRINO, Tomoyuki ; BANDO, Etsuro ; KAWAMURA, Taiichi ; TERASHIMA, Masanori
World journal of surgery, 02/2019, vol.43, n°2, p. 571-579

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