Survival data of patients with breast cancer who were treated in the university hospital of Essen (West German Cancer Center) (First contac 1995-1999)

Mit der hier vorliegenden Untersuchung erfolgte die retrospektive Ermittlung der Überlebenszeiten derjenigen Patientinnen, die sich zwischen 1995 und 1999 mit der Diagnose eines metastasierten Mammakarzinoms in der Spezialambulanz der Inneren Klinik (Tumorforschung) des Universitätsklinikums Essen erstmalig vorstellten und in der Folge behandelt wurden. Dabei wurden – wegen der oben beschriebenen unterschiedlichen Prognose - besonders die Unterschiede bezüglich des Hormonrezeptorstatus und des Metastasierungsmusters (ossär gegen viszeral) herausgearbeitet. Die mediane Überlebenszeit der Gesamtgruppe betrug 25 Monate bei einer 4-, bzw. 5-Jahresüberlebenswahrscheinlichkeit von 24,2 und 19,3%. In Fällen mit Hormonrezeptor-negativer Erkrankung betrug die mediane Überlebenszeit 19,3 Monate, die 4-, bzw. 5-Jahresüberlebenswahrscheinlichkeit lag bei 13,3 und 9,3%. Patientinnen mit initial hepatischer Metastasierung erreichten hingegen nur eine mediane Überlebenszeit von 23,6 Monaten bei einer 4- und 5-Jahresüberlebenswahrscheinlichkeit von 20,9, bzw. 11,9%. Die ermittelten Überlebenszeiten liegen damit geringfügig über denen, die in der neueren Literatur angegeben werden, obwohl etliche der neueren Medikamente (z.B. Trastuzumab bei Erkrankung mit Her2-Überexpression) für viele dieser Patientinnen noch nicht zur Verfügung standen

Improved survival in metastatic breast cancer: results from a 20-year study involving 1033 women treated at a single comprehensive cancer center

Purpose!#!Diagnosis and treatment of breast cancer have changed profoundly over the past 25 years. The outcome improved dramatically and was well quantified for early stage breast cancer (EBC). However, progress in the treatment of metastatic disease has been less convincingly demonstrated. We have studied survival data of patients with metastatic breast cancer (MBC) from a large academic cancer center over a period of 20 years.!##!Methods!#!Data from 1033 consecutive MBC patients who were treated at the Department of Medical Oncology of the West German Cancer Center from January 1990 to December 2009 were retrospectively analyzed for overall survival (OS) and risk factors. Patients were grouped in 5-year cohorts, and survival parameters of each cohort were compared before and after adjustment for risk factors.!##!Results!#!Overall survival of patients with MBC treated at specialized center has significantly improved from 1990 to 2010 (hazard ratio 0.7, 95%CI 0.58-0.84). The increments in OS have become less profound over time (median OS 1990-1994: 24.2 months, 1995-1999: 29.6 months, 2000-2004: 36.5 months, 2005-2009: 37.8 months).!##!Conclusion!#!Survival of patients with MBC has improved between 1990 and 2004, but less from 2005 to 2009. Either this suggests an unnoticed shift in the patient population, or a lesser impact of therapeutic innovations introduced in the most recent period

Six versus eight doses of rituximab in patients with aggressive B cell lymphoma receiving six cycles of CHOP: results from the “Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas” (PETAL) trial

Standard first-line treatment of aggressive B cell lymphoma comprises six or eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus eight doses of rituximab (R). Whether adding two doses of rituximab to six cycles of R-CHOP is of therapeutic benefit has not been systematically investigated. The Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas (PETAL) trial investigated the ability of [F-18]-fluorodesoxyglucose PET scanning to guide treatment in aggressive non-Hodgkin lymphomas. Patients with B cell lymphomas and a negative interim scan received six cycles of R-CHOP with or without two extra doses of rituximab. For reasons related to trial design, only about a third underwent randomization between the two options. Combining randomized and non-randomized patients enabled subgroup analyses for diffuse large B cell lymphoma (DLBCL; n=544), primary mediastinal B cell lymphoma (PMBCL; n=37), and follicular lymphoma (FL) grade 3 (n=35). With a median follow-up of 52months, increasing the number of rituximab administrations failed to improve outcome. A non-significant trend for improved event-free survival was seen in DLBCL high-risk patients, as defined by the International Prognostic Index, while inferior survival was observed in female patients below the age of 60years. Long-term outcome in PMBCL was excellent. Differences between FL grade 3a and FL grade 3b were not apparent. The results were confirmed in a Cox proportional hazard regression model and a propensity score matching analysis. In conclusion, adding two doses of rituximab to six cycles of R-CHOP did not improve outcome in patients with aggressive B cell lymphomas and a fast metabolic treatment response