Evaluation of prognostic factors and treatment in advanced small bowel adenocarcinoma: report of a multi-institutional experience of anatolian Society of medical oncology (ASMO)

WOS: 000388782200027PubMed ID: 27837629Purpose: Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA. Methods: Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC). Results: Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow-up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluoroura-cil/5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 months, respectively, while median OS was 15, 16, 15 and 11 months, respectively. No significant differences between chemotherapy groups were noticed in terms of PFS and OS. Univariate analysis revealed that chemotherapy administration, de novo metastatic disease, ECOG PS 0 and 1, and overall response to therapy were significantly related to improved outcome. Only overall response to treatment was found to be significantly prognostic in multivariate analysis (p = 0.001). Conclusions: In this study, overall response to chemotherapy emerged as the single significant prognostic factor for advanced SBAs. Platin and irinotecan based regimens achieved similar survival outcomes in advanced SBA patients

Third-line Therapy for Metastatic Renal Cell Carcinoma and Its Effect on Quality of Life and Overall Survival: A National, Multicenter, Observational Study

ABSTRACT Objective: The study aimed to evaluate the efficacy of targeted therapies used as the third-line treatment after first-line cytokineand second-line tyrosine kinase inhibitor (TKI) therapies in metastatic renal cell carcinoma (mRCC) patients and assess the quality of life (QoL)of patients. Material and Methods: This national, multicenter, non-interventional study included patients aged ≥18 years with histologicallyconfirmed mRCC, receiving targeted therapies as the third-line treatment for the last one month. Overall survival (OS), progression-free sur-vival (PFS), adverse events (AEs), and QoL were evaluated. Results: The study included 102 mRCC patients (74 males) (median age of 61years). The median disease duration since diagnosis was 27.5 months (ranging 4-201 months). Of all the patients, 75.5% and 24.5% were re-ceiving Axitinib and Everolimus, respectively, as third-line therapy. In all patients, the one-year PFS and OS rates were 62.9% and 79.9%,respectively. Seventy-one AEs (mostly mild) developed in 29 (28.4%) patients, fatigue being the most common (9.8%) AE. As compared tothe baseline, no significant change was observed in the QoL scores of patients in the 12th month. The Axitinib and Everolimus groups did notdiffer significantly as regards to PFS and OS. Of the 11 patients with grade III-IV AEs, four were from the Everolimus group, and seven be-longed to the Axitinib group. The QoL scores did not show a significant difference between the two groups except for that in the 12th month.Conclusion: Third-line therapy in mRCC patients was found to be effective and tolerable. Prolonged survival in mRCC patients receiving anincreasing number of therapy lines requires further evaluation of QoL, considering it to be a part of treatment assessment.Keywords: Clear-cell metastatic renal cell carcinoma; quality of life; survival&nbsp;</div