The relationship between an objective response to chemotherapy and survival in advanced colorectal cancer

Abstract

SmaryThis analysis was conducted to evaluate the independent relationship between survival and response to chemotherapy in advanced colorectal cancer. In order to correct for the guarantee time effect, patients dying before the response evaluation were excKlded from the analyses. A (Moertel, 1975 Material andPatients included in four chemotherapy trials were studied (Gimeius et al., 1986;Nordic Gastrointestinal Tumor Adjuvant Therapy Group, 1989. The following inclusion criteria were applied in all trials: metastatic or locally recurrent/inextirpable colorectal cancer, age 75 or younger, Karnofsky performance status 50 or higher, serum creatinine <125mmoll-1, serum bilirubin <40mmoll-1 and no signs of pleural effusion or ascites. Inclusion criteria differed in two respects between the trials: patients previously treated with chemotherapy were eligible only in the phase II trial (Glimelius et al., 1986) and patients with nonmeasurable disease only in one of the phase HI trials (Nordic Gastrointtinal Tumor Adjuvant Therapy Group, 1992).The following requirements had to be met for inclusion in the present study: no previous chemotherapy, at least one course of chemotherapy ad and measurable diseas. The first population comprised 324 patients treated with either 5-FU alone or sequential methotrexate/5-FU/ leucovorin (MFL), and the second population 198 patients treated with MFL or sequential 5-FU and leucovorin (ELv) ( Table I). We have earlier described prognostic factors in these populations (Graf et al., 1991. Survival time was measured from on-protocol time to death from any cause. At the time of analysis, 22 patients were alive in the first population (median follow-up 18 months, range 10-72) and 15 in the second population (median follow-up 19 months, range 13-31).The evaluation of objective responses followed the UICC recommendations (Hayward & Rubens, 1977

Causal Inference Methods Based on Pseudo-Observations: A Comparative Analysis of Treatment Types for Iranian Gastrointestinal Cancer Patients

“…In our study, although individuals who had not received radiotherapy had a higher risk of death in the first period, this association was no longer significant in later periods. Our study also found that individuals who had not received chemotherapy had a higher risk of death across all time points, similar to Kasuga et al [ 30 ], Graf et al [ 31 ] and Smyth et al [32]. and in contrast to the results of A Hern et al [ 33 ].…”

Causal Inference Methods Based on Pseudo-Observations: A Comparative Analysis of Treatment Types for Iranian Gastrointestinal Cancer Patients

“…In our study, although individuals who had not received radiotherapy had a higher risk of death in the first period, this association was no longer significant in later periods. Our study also found that individuals who had not received chemotherapy had a higher risk of death across all time points, similar to Kasuga et al [ 30 ], Graf et al [ 31 ] and Smyth et al [32]. and in contrast to the results of A Hern et al [ 33 ].…”

A Serum Protein Profile Predictive of the Resistance to Neoadjuvant Chemotherapy in Advanced Breast Cancers

“…See supplemental Table S7 for the cluster memberships of 50 differentially expressed peptides. also able to predict the relapse-free survival rate (p ϭ 0.0172), which is consistent with a high anti-correlation between chemoresistance and survival reported in other studies (47,48). Taken together, all these results indicate that the six selected biomarkers can predict the responses to NACT and further relapse-free survival rate.…”

A phase II study of recombinant interferon-β (r-hIFN-β 1a) in combination with 5-fluorouracil (5-FU) in the treatment of patients with advanced colorectal carcinoma

“…In this study, the response rate was low, and survival for the group as a whole was less than that reported in some other series. Responding patients demonstrated prolonged survival compared with non-responders, as has been demonstrated previously (Graf et al, 1994), but such observations must be interpreted cautiously. Our response rate of 4/27 (15%) patients and 19% (4/21) in evaluable patients is consistent with previously reported response rates for 5-FU alone, but is also similar to that seen in some studies of the Wadler regimen (Kemeny et al, 1990;Kemeny and Younes, 1992) and is similar to our own experience of a 15% response rate to a modified version of that (Pittman et al, 1993).…”

Causal Inference Methods Based on Pseudo-Observations: A Comparative Analysis of Treatment Types for Iranian Gastrointestinal Cancer Patients

“…In our study, although individuals who had not received radiotherapy had a higher risk of death in the first period, this association was no longer significant in later periods. Our study also found that individuals who had not received chemotherapy had a higher risk of death across all time points, similar to Kasuga et al [ 30 ], Graf et al [ 31 ] and Smyth et al [32]. and in contrast to the results of A Hern et al [ 33 ].…”

A Serum Protein Profile Predictive of the Resistance to Neoadjuvant Chemotherapy in Advanced Breast Cancers

“…See supplemental Table S7 for the cluster memberships of 50 differentially expressed peptides. also able to predict the relapse-free survival rate (p ϭ 0.0172), which is consistent with a high anti-correlation between chemoresistance and survival reported in other studies (47,48). Taken together, all these results indicate that the six selected biomarkers can predict the responses to NACT and further relapse-free survival rate.…”

A phase II study of recombinant interferon-β (r-hIFN-β 1a) in combination with 5-fluorouracil (5-FU) in the treatment of patients with advanced colorectal carcinoma

“…In this study, the response rate was low, and survival for the group as a whole was less than that reported in some other series. Responding patients demonstrated prolonged survival compared with non-responders, as has been demonstrated previously (Graf et al, 1994), but such observations must be interpreted cautiously. Our response rate of 4/27 (15%) patients and 19% (4/21) in evaluable patients is consistent with previously reported response rates for 5-FU alone, but is also similar to that seen in some studies of the Wadler regimen (Kemeny et al, 1990;Kemeny and Younes, 1992) and is similar to our own experience of a 15% response rate to a modified version of that (Pittman et al, 1993).…”

Causal Inference Methods Based on Pseudo-Observations: A Comparative Analysis of Treatment Types for Iranian Gastrointestinal Cancer Patients

“…In our study, although individuals who had not received radiotherapy had a higher risk of death in the first period, this association was no longer significant in later periods. Our study also found that individuals who had not received chemotherapy had a higher risk of death across all time points, similar to Kasuga et al [ 30 ], Graf et al [ 31 ] and Smyth et al [32]. and in contrast to the results of A Hern et al [ 33 ].…”

A Serum Protein Profile Predictive of the Resistance to Neoadjuvant Chemotherapy in Advanced Breast Cancers

“…See supplemental Table S7 for the cluster memberships of 50 differentially expressed peptides. also able to predict the relapse-free survival rate (p ϭ 0.0172), which is consistent with a high anti-correlation between chemoresistance and survival reported in other studies (47,48). Taken together, all these results indicate that the six selected biomarkers can predict the responses to NACT and further relapse-free survival rate.…”

A phase II study of recombinant interferon-β (r-hIFN-β 1a) in combination with 5-fluorouracil (5-FU) in the treatment of patients with advanced colorectal carcinoma

“…In this study, the response rate was low, and survival for the group as a whole was less than that reported in some other series. Responding patients demonstrated prolonged survival compared with non-responders, as has been demonstrated previously (Graf et al, 1994), but such observations must be interpreted cautiously. Our response rate of 4/27 (15%) patients and 19% (4/21) in evaluable patients is consistent with previously reported response rates for 5-FU alone, but is also similar to that seen in some studies of the Wadler regimen (Kemeny et al, 1990;Kemeny and Younes, 1992) and is similar to our own experience of a 15% response rate to a modified version of that (Pittman et al, 1993).…”