Individual Life Expectancy Estimation Using Validated Prognostic Scores for Patients with Cancer of Unknown Primary

Ferté, Charles; Penel, Nicolas; Bonneterre, Jacques; Adenis, Antoine

doi:10.1159/000306137

Cited by 11 publications

(3 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hence, it is not surprising that the rate of early death was lower in trials with more stringent eligibility criteria. We have observed that the rate of early death in this population is lower than the reported one among patients entering in phase 1 trials (∼16%) or in patients with carcinoma of unknown primary (30%) ( Geraci et al , 2006 ; Kelly et al , 2007 ; Arkenau et al , 2008 ; Penel et al , 2008 , 2009 ; Ferté et al , 2010 ). The present analysis shows that PS is the most powerful PF for early death among patients with advanced STS treated with first-line systemic therapy.…”

Section: Discussionmentioning

confidence: 60%

Performance status is the most powerful risk factor for early death among patients with advanced soft tissue sarcoma

et al. 2011

View full text Add to dashboard Cite

Background:We investigated prognostic factors (PFs) for 90-day mortality in a large cohort of advanced/metastatic soft tissue sarcoma (STS) patients treated with first-line chemotherapy.Methods:The PFs were identified by both logistic regression analysis and probability tree analysis in patients captured in the Soft Tissue and Bone Sarcoma Group (STBSG) database (3002 patients). Scores derived from the logistic regression analysis and algorithms derived from probability tree analysis were subsequently validated in an independent study cohort from the French Sarcoma Group (FSG) database (404 patients).Results:The 90-day mortality rate was 8.6 and 4.5% in both cohorts. The logistic regression analysis retained performance status (PS; odds ratio (OR)=3.83 if PS=1, OR=12.00 if PS ⩾2), presence of liver metastasis (OR=2.37) and rare site metastasis (OR=2.00) as PFs for early death. The CHAID analysis retained PS as a major discriminator followed by histological grade (only for patients with PS ⩾2). In both models, PS was the most powerful PF for 90-day mortality.Conclusion:Performance status has to be taken into account in the design of further clinical trials and is one of the most important parameters to guide patient management. For those patients with poor PS, expected benefits from therapy should be weighed up carefully against the anticipated toxicities.

show abstract

Section: Discussionmentioning

confidence: 60%

Performance status is the most powerful risk factor for early death among patients with advanced soft tissue sarcoma

et al. 2011

View full text Add to dashboard Cite

show abstract

“…We assumed that any severe AE will result in hospitalization. Hospital costs, based on the Ontario Case Costing Initiative [21] , were applied to the corresponding severe AEs using the International Classification of Diseases, tenth revision diagnostic code [22] . All costs are expressed in 2011 CAD.…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of Adding Cetuximab to Platinum-Based Chemotherapy for First-Line Treatment of Recurrent or Metastatic Head and Neck Cancer

et al. 2012

View full text Add to dashboard Cite

Purpose To assess the cost effectiveness of adding cetuximab to platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) from the perspective of the Canadian public healthcare system. Methods We developed a Markov state transition model to project the lifetime clinical and economic consequences of recurrent or metastatic HNSCC. Transition probabilities were derived from a phase III trial of cetuximab in patients with recurrent or metastatic HNSCC. Cost estimates were obtained from London Health Sciences Centre and the Ontario Case Costing Initiative, and expressed in 2011 CAD. A three year time horizon was used. Future costs and health benefits were discounted at 5%. Results In the base case, cetuximab plus platinum-based chemotherapy compared to platinum-based chemotherapy alone led to an increase of 0.093 QALY and an increase in cost of $36,000 per person, resulting in an incremental cost effectiveness ratio (ICER) of $386,000 per QALY gained. The cost effectiveness ratio was most sensitive to the cost per mg of cetuximab and the absolute risk of progression among patients receiving cetuximab. Conclusion The addition of cetuximab to standard platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic HNSCC has an ICER that exceeds $100,000 per QALY gained. Cetuximab can only be economically attractive in this patient population if the cost of cetuximab is substantially reduced or if future research can identify predictive markers to select patients most likely to benefit from the addition of cetuximab to chemotherapy.

show abstract

“…Currently, most prognostic markers used in a routine clinical setting are based on clinical parameters such as performance status and stage and vary between cancer types [ 84 ]. In addition, molecular markers such as the expression of HER2/NEU have been established to further stratify patients according to their relapse risk and their need for additional therapies [ 85 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic and Diagnostic Value of Spontaneous Tumor‐Related Antibodies

Kobold

Luetkens

Cao

et al. 2010

Journal of Immunology Research

View full text Add to dashboard Cite

There is an urgent need for earlier diagnosis of malignancies and more stringent monitoring of relapses after antitumor therapy. In addition, new prognostic markers are needed for risk stratification and design of individualized cancer therapies. New diagnostic and prognostic parameters should overcome the impairments of current standards in a cost-effective manner. Serological approaches measuring spontaneous antibody responses against tumor-associated antigens could be of use as diagnostic and prognostic markers and could also be employed to evaluate response to therapy in cancer patients. Autoantibodies have been suggested to be of frequent and specific occurrence in patients with malignancies and to correlate with clinical parameters. Screening the relevant literature on this topic, we suggest that the analysis of single antibody specificities is unlikely to provide sufficient diagnostic and prognostic accuracy. The combined analysis of autoantibodies targeting different antigens, however, may reach high sensitivity and specificity. In addition, screening cancer patients for autoantibodies might identify subgroups with high relapse risk and a worse prognosis. Larger prospective trials should be initiated to identify sets of tumor-associated autoantibodies suited for the use in diagnostic algorithms for cancer detection and followup.

show abstract

Individual Life Expectancy Estimation Using Validated Prognostic Scores for Patients with Cancer of Unknown Primary

Cited by 11 publications

References 49 publications

Performance status is the most powerful risk factor for early death among patients with advanced soft tissue sarcoma

Performance status is the most powerful risk factor for early death among patients with advanced soft tissue sarcoma

Cost-Effectiveness of Adding Cetuximab to Platinum-Based Chemotherapy for First-Line Treatment of Recurrent or Metastatic Head and Neck Cancer

Prognostic and Diagnostic Value of Spontaneous Tumor‐Related Antibodies

Contact Info

Product

Resources

About