Histology classification is not a predictor of clinical outcomes in advanced non-small cell lung cancer (NSCLC) treated with vinorelbine or gemcitabine combinations

Trani, Leonardo; Myerson, James S.; Ashley, S.; Young, Kate; Sheri, Amna; Hübner, Ralf-Harto; Puglisi, Martina; Popat, Sanjay; O’Brien, Mary

doi:10.1016/j.lungcan.2010.02.003

Cited by 5 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, despite the fact that the authors of a randomized controlled trial showed that patients with adenocarcinoma had the greatest profit in terms of five-year survival with resected stage stage IB, II and IIIA NSCLC, they simultaneously concluded that the efficacy of adjuvant treatment was not dependent on histology type [ 54 ]. This is supported by another study in 2011 suggesting that histology subtype may not be predictive for outcome in advanced NSCLC treated with CTx [ 50 ]. It remains elusive and may be subject of future debates as to whether histology types serve as survival predictors.…”

Section: Discussionmentioning

confidence: 55%

Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis

Schad¹,

Thronicke²,

Steele³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

BackgroundStage IV non-small cell lung cancer (NSCLC) is associated with a five-year survival rate of around 1%. Treatment with Viscum album L. (VA) extracts has been shown to reduce chemotherapy (CTx)-related adverse events, decrease CTx dose reductions and improve quality of life in a number of cancers. Recent data suggest a beneficial effect of add-on treatment with Viscum album L. (VA, European mistletoe) on survival in cancer patients. The objective of this study was to evaluate the effect of VA in addition to chemotherapy on survival in stage IV NSCLC patients.MethodsThe observational study was conducted using data from the Network Oncology clinical registry which is an accredited conjoint clinical registry of German oncological hospitals, practitioners and out-patient centers.Patients were included if they had stage IV NSCLC at diagnosis, lived at least for four weeks post-diagnosis and received chemotherapeutic treatment. Patients with EGFR mutations as well as patients receiving tyrosine kinase inhibitors or immune checkpoint inhibitors were not included. Overall survival and impact on hazard in patients with chemotherapy (CTx) to patients receiving CTx plus VA were compared. To identify factors associated with survival and to address potential sources of bias a multivariate analyses using Cox proportional hazard model was performed.ResultsThe median age of the population was 64.1 years with 55.7% male patients. The highest proportion of patients had adenocarcinoma (72.2%) and most of the patients were current or past smokers (70.9%). Of 158 stage IV NSCLC patients, 108 received CTx only and 50 additional VA. Median survival was 17.0 months in the CTx plus VA group (95%CI: 11.0–40.0) and was 8.0 months (95%CI: 7.0–11.0) in the CTx only group (χ2 = 7.2, p = .007). Overall survival was significantly prolonged in the VA group (HR 0.44, 95%CI: 0.26–0.74, p = .002). One-year and three-year overall survival rates were greater with CTx plus VA compared to CTX alone (1y: 60.2% vs. 35.5%; 3y: 25.7% vs. 14.2%).ConclusionOur findings suggest that concomitant VA is positively associated with survival in stage IV NSCLC patients treated with standard CTx. These findings complement pre-existing knowldedge of add-on VA’s clinical impact, however, results should be interpreted with caution in light of the study’s observational character.

show abstract

Section: Discussionmentioning

confidence: 55%

Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis

Schad¹,

Thronicke²,

Steele³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Another randomized study also showed that gemcitabine and carboplatin combination therapy, compared with a mitomycin, ifosfamide and cisplatin combination regimen, tended to improve OS in patients with ADC than patients with SqCC [27]. On the other hand, Trani et al [28] suggested that histology may not be considered as a predictor of clinical outcome in a retrospective study of 420 patients treated with gemcitabine/platinum, vinorelbine/platinum, or single gemcitabine or vinorelbine. Therefore, given the conflicting results noted above and the small sample sizes in our report, the role of histology in patients treated with a GV regimen needs to be determined in a large, prospective study.…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine Plus Vinorelbine as the Second-Line Treatment and Beyond in Elderly Patients with Platinum-Pretreated Advanced Non-Small Cell Lung Cancer

Go¹,

Lee²,

Lee³

et al. 2014

Chemotherapy

View full text Add to dashboard Cite

Background: The efficacy and tolerance of a gemcitabine and vinorelbine (GV) combination as salvage therapy have not been reported in elderly patients with advanced non-small cell lung cancer (NSCLC). Methods: We reviewed elderly patients with advanced NSCLC who had disease progression after one or more chemotherapy regimens, at least one including platinum, and then who were treated with GV as the salvage therapy. Results: In total 40 patients were analyzed. GV was at least the third-line chemotherapy in 24 patients (60.0%). Only 2 patients (5.0%) experienced grade 3 febrile neutropenia. Nonhematologic toxicities were generally mild and there was no treatment-related mortality. Among 29 patients evaluable for treatment response, 10 (34.5%) and 9 (31.0%) achieved a partial response and stable disease, respectively. The median overall survival was 10.3 months and the median progression-free survival was 3.1 months. Conclusions: GV in combination is an effective and tolerable salvage regimen in elderly and heavily pretreated patients with advanced NSCLC.

show abstract

“…Similarly, an analysis of Southwest Oncology Group studies failed to show a predictive role of histology for any treatment [26]. In an analysis of 420 patients treated with vinorelbine or gemcitabine combinations, histology was not an important predictor of outcome [19]. It is possible that histology may not be predictive of sensitivity to most commonly used chemotherapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

“…While the relevance of histology as a prognostic factor has been also recently denied [18,19], it is still an open question if histology may be predictive of sensitivity to specific chemotherapeutic agents. The comparability of commonly used chemotherapy regimens when selected by histologic subtype is also uncertain.…”

Section: Introductionmentioning

confidence: 99%

Comparison of pemetrexed plus cisplatin with other first-line doublets in advanced non-small cell lung cancer (NSCLC): A combined analysis of three phase 3 trials

et al. 2012

View full text Add to dashboard Cite

Histology classification is not a predictor of clinical outcomes in advanced non-small cell lung cancer (NSCLC) treated with vinorelbine or gemcitabine combinations

Cited by 5 publications

References 31 publications

Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis

Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis

Gemcitabine Plus Vinorelbine as the Second-Line Treatment and Beyond in Elderly Patients with Platinum-Pretreated Advanced Non-Small Cell Lung Cancer

Comparison of pemetrexed plus cisplatin with other first-line doublets in advanced non-small cell lung cancer (NSCLC): A combined analysis of three phase 3 trials

Contact Info

Product

Resources

About