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Fairooz F. Kabbinavar - One of the best experts on this subject based on the ideXlab platform.
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Bevacizumab combined with standard fluoropyrimidine-based Chemotherapy Regimens to treat colorectal cancer
Oncology, 2005Co-Authors: Herbert Hurwitz, Fairooz F. KabbinavarAbstract:For several decades, 5-fluorouracil (5-FU) with or without leucovorin defined the standard of care for the treatment of metastatic colorectal cancer (CRC). The addition of other Chemotherapy Regimens
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Bevacizumab combined with standard fluoropyrimidine-based Chemotherapy Regimens to treat colorectal cancer.
Oncology, 2005Co-Authors: Herbert Hurwitz, Fairooz F. KabbinavarAbstract:For several decades, 5-fluorouracil (5-FU) with or without leucovorin defined the standard of care for the treatment of metastatic colorectal cancer (CRC). The addition of other Chemotherapy Regimens to 5-FU has improved survival, but often at the expense of increased toxicity. Recent advances in our understanding of the molecular basis of CRC have led to the production of novel targeted agents, such as bevacizumab (Avastin). Bevacizumab is currently approved for the first-line treatment of metastatic CRC and is currently being tested in combination with standard therapies for a range of indications. Phase II/III trials have demonstrated that the addition of bevacizumab to 5-FU-based first-line Chemotherapy improves survival, progression-free survival and response rate compared with Chemotherapy alone. Combination therapy does not appear to exacerbate side effects known to be associated with the Chemotherapy regimen. The most common side effects attributable to bevacizumab therapy include hypertension, proteinuria and bleeding. Although uncommon, gastrointestinal perforation and arterial thromobembolic events are the most serious side effects reported to date. Bevacizumab is currently being evaluated in combination with oxaliplatin (Eloxatin)-based therapies and preliminary data are encouraging. Ongoing trials of bevacizumab in combination with standard first-line Chemotherapy Regimens will evaluate bevacizumab's potential in a range of cancer types. .
John P A Ioannidis - One of the best experts on this subject based on the ideXlab platform.
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comparative survival with diverse Chemotherapy Regimens for cancer of unknown primary site multiple treatments meta analysis
Cancer Treatment Reviews, 2009Co-Authors: Vassilis Golfinopoulos, Georgia Salanti, John P A Ioannidis, George Pentheroudakis, Andreas D Nearchou, Nicholas PavlidisAbstract:Summary Objectives To synthesize the evidence from randomized controlled trials concerning systemic treatment Regimens for patients with cancer of unknown primary site (CUP). Data sources PubMed and the Cochrane Library Central Registry of Controlled Trials. Review methods We retrieved all randomized controlled trials comparing at least two arms of different systemic treatment Regimens or a systemic regimen to no treatment in patients with CUP, excluding data on favorable subset CUP, whenever these could be separated. Treatments were categorized according to whether they involved platinum, taxane, both, or neither; non-platinum/non-taxane Regimens were also categorized in monotherapy and combination Regimens. We extracted or estimated the logarithm of the hazard ratio and its variance for death for each randomized comparison. Multiple-treatments meta-analysis with a hierarchical Bayesian model obtained summary hazard ratios with 95% credibility intervals. Results Ten articles were eligible for the meta-analysis. No trials compared systemic treatment to best supportive care and all arms referred to Chemotherapy Regimens. Overall 683 subjects were randomly assigned and eight randomized comparisons were used for the multiple-treatments meta-analysis of survival (543 patients). Multiple-treatments meta-analysis showed no significant benefit for any treatment group over others, with wide credibility intervals. Point estimates of hazard ratios favored platinum, taxane, or both (hazard ratios 0.69, 0.66, and 0.81, respectively, as compared with monotherapy with an agent other than platinum or taxane). Conclusion No type of Chemotherapy has been solidly proven to prolong survival in patients with CUP. Regimens using either platinum or taxanes or both need further testing.
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effects of different Chemotherapy Regimens on survival for advanced cervical cancer systematic review and meta analysis
Cancer Treatment Reviews, 2007Co-Authors: Spyridon Tzioras, Nicholas Pavlidis, Evangelos Paraskevaidis, John P A IoannidisAbstract:Summary Background A large number of trials have assessed various Chemotherapy Regimens for the treatment of advanced cervical cancer, but there is uncertainty about the magnitude of survival benefits. Methods We searched (last update January 2006) for trials in women with locally advanced or disseminated cervical cancer that compared neo-adjuvant or concurrent Chemotherapy plus radiotherapy versus radiotherapy alone; or different Chemotherapy Regimens among themselves (with or without background radiotherapy in both arms). Sixty-five trials were identified with survival data on 11,180 women. Results for survival were combined with fixed and random effects models and between-study heterogeneity was estimated. Separate results were obtained for different Regimens, cycle length, and type of Chemotherapy (neo-adjuvant, concurrent, without radiotherapy). Results Twenty two comparisons had survival data on 3837 women randomized to receive Chemotherapy plus radiotherapy versus radiotherapy alone; the summary relative hazard for mortality was 0.95, 95% CI, 0.83–1.08. Modest between-study heterogeneity ( I 2 = 38%) seemed to be due to contradictory results in early trials; trials published in the last decade had a summary relative hazard 0.89 (95% CI, 0.78–1.02) and no between-study heterogeneity ( I 2 = 0%). Results were similar for neo-adjuvant Chemotherapy and for concurrent chemo-radiotherapy. Cisplatin or cisplatin-based combinations had no significant benefit overall, but a potential benefit was seen with short-length cycles (⩽14 days) and a marginally significant harm with longer-length cycles (summary relative hazards 0.80, 95% CI, 0.66–0.99 and 1.18, 95% CI, 1.02–1.38, respectively). The summary relative hazard was 1.02, (95% CI, 0.84–1.24) for trials using neo-adjuvant Chemotherapy and 0.85 (95% CI, 0.73–1.00) for trials using concurrent Chemotherapy. Conclusions Evidence on Chemotherapy in women with advanced cervical cancer is not encouraging for major survival benefits. However, small benefits have been observed in some trials, especially with short-length cycles of cisplatin-based Regimens and concurrent Chemotherapy and radiotherapy.
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survival benefits with diverse Chemotherapy Regimens for ovarian cancer meta analysis of multiple treatments
Journal of the National Cancer Institute, 2006Co-Authors: Maria Kyrgiou, Georgia Salanti, Nicholas Pavlidis, Evangelos Paraskevaidis, John P A IoannidisAbstract:Background: Numerous randomized trials have compared different Chemotherapy Regimens in women with ovarian cancer. Although ovarian cancer survival has improved in recent years, the magnitude of these incremental benefi ts across diverse Regimens is unclear. Methods: We used multipletreatment meta-analysis methodology to combine information from direct and indirect comparisons of all Chemotherapy Regimens used in randomized trials of ovarian cancer in the last 40 years. Chemotherapy was categorized by the use or not of platinum and/or taxanes, combinations of agents, and intraperitoneal administration. Monte Carlo simulations were used to determine which regimen most improved survival. Analyses of trials that examined fi rst- and second-line treatments were also performed separately. Results: We found 198 trials (N = 38 440 women) involving 120 different Chemotherapy Regimens published in 1971 – 2006. Eighty-two trials compared different types of Chemotherapy, among which 60 had usable survival information (N = 15 609 women). Monte Carlo simulations showed a 92% probability that the regimen that best prolonged survival is a platinum and taxane combination with intraperitoneal administration; this regimen resulted in a 55% relative risk reduction (95% confi dence interval [CI] = 39% to 67%) for mortality as compared with nonintraperitoneal monotherapy using neither platinum nor taxane. Against that same monotherapy comparator, platinum-based combinations with and without intraperitoneal administration achieved 40% (95% CI = 21% to 54%) and 30% (95% CI = 20% to 38%) relative risk reductions for mortality, respectively, and combinations involving platinum and taxane without intraperitoneal administration achieved a 42% (95% CI = 31% to 51%) relative risk reduction. Results were similar when analyses were limited to fi rst-line treatment. Data on second-line treatment were consistent with the superiority of platinum and taxane combinations. Conclusions: Distinct in cre mental improvements in survival have been achieved for ovarian cancer Chemotherapy over time, with the possibility to achieve a doubling or more of time to mortality with platinum and taxane combinations, especially when intraperitoneal administration is used. [J Natl Cancer Inst 2006;98: 1655 – 63 ]
Herbert Hurwitz - One of the best experts on this subject based on the ideXlab platform.
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Bevacizumab combined with standard fluoropyrimidine-based Chemotherapy Regimens to treat colorectal cancer
Oncology, 2005Co-Authors: Herbert Hurwitz, Fairooz F. KabbinavarAbstract:For several decades, 5-fluorouracil (5-FU) with or without leucovorin defined the standard of care for the treatment of metastatic colorectal cancer (CRC). The addition of other Chemotherapy Regimens
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Bevacizumab combined with standard fluoropyrimidine-based Chemotherapy Regimens to treat colorectal cancer.
Oncology, 2005Co-Authors: Herbert Hurwitz, Fairooz F. KabbinavarAbstract:For several decades, 5-fluorouracil (5-FU) with or without leucovorin defined the standard of care for the treatment of metastatic colorectal cancer (CRC). The addition of other Chemotherapy Regimens to 5-FU has improved survival, but often at the expense of increased toxicity. Recent advances in our understanding of the molecular basis of CRC have led to the production of novel targeted agents, such as bevacizumab (Avastin). Bevacizumab is currently approved for the first-line treatment of metastatic CRC and is currently being tested in combination with standard therapies for a range of indications. Phase II/III trials have demonstrated that the addition of bevacizumab to 5-FU-based first-line Chemotherapy improves survival, progression-free survival and response rate compared with Chemotherapy alone. Combination therapy does not appear to exacerbate side effects known to be associated with the Chemotherapy regimen. The most common side effects attributable to bevacizumab therapy include hypertension, proteinuria and bleeding. Although uncommon, gastrointestinal perforation and arterial thromobembolic events are the most serious side effects reported to date. Bevacizumab is currently being evaluated in combination with oxaliplatin (Eloxatin)-based therapies and preliminary data are encouraging. Ongoing trials of bevacizumab in combination with standard first-line Chemotherapy Regimens will evaluate bevacizumab's potential in a range of cancer types. .
Shu-ping Xie - One of the best experts on this subject based on the ideXlab platform.
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A network meta-analysis of the short-term efficacy of five Chemotherapy Regimens based on cisplatin and fluorouracil for esophagogastric junctional adenocarcinoma.
Experimental & molecular medicine, 2017Co-Authors: Cong Wang, Dong-jian Song, Shu-ping XieAbstract:The primary purpose of this study was to explore the short-term efficacy of different cisplatin and fluorouracil-based Chemotherapy Regimens in the treatment of patients with esophagogastric junctional adenocarcinoma (EGJA) using a network meta-analysis (NMA). Randomized controlled trials (RCTs) related to Chemotherapy Regimens based on cisplatin and fluorouracil for EGJA were included from the PubMed, EMBASE and Cochrane Library electronic databases (from inception to June 2016). Direct and indirect evidence were combined to calculate the pooled odds ratio (OR) and its 95% confidence interval (95% CI) as well as to draw the surface under the cumulative ranking (SUCRA) curves. This NMA finally enrolled ten eligible RCTs with the following five Regimens: cisplatin plus fluorouracil (cisplatin+fluorouracil), cisplatin+fluorouracil-based Chemotherapy (cisplatin+fluorouracil+docetaxel/epirubicin/irinotecan), fluorouracil-based Chemotherapy (fluorouracil+docetaxel/doxorubicin/methotrexate/irinotecan), cisplatin-based Chemotherapy (cisplatin+docetaxel/epirubicin/irinotecan/capecitabine/s-1) and other drug-based Chemotherapy (docetaxel/irinotecan/capecitabine). These results revealed that compared with a cisplatin+ fluorouracil-based Chemotherapy regimen, the fluorouracil-based Chemotherapy regimen had a lower overall response rate (ORR) and partial response (PR) for EGJA patients (ORR: OR=0.43, 95% CI=0.22-0.86; PR: OR=0.46, 95% CI=0.23-0.91). Cluster analyses suggested that the cisplatin+fluorouracil-based Chemotherapy regimen had the best short-term efficacy for EGJA in terms of the complete response (CR), PR, ORR, stable disease (SD) and progression disease (PD). Our results indicated that cisplatin+fluorouracil-based Chemotherapy Regimens may have the best short-term efficacy in the treatment of EGJA.
Karen Mclean - One of the best experts on this subject based on the ideXlab platform.
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Comparison of first-line Chemotherapy Regimens for ovarian carcinosarcoma: a single institution case series and review of the literature.
BMC cancer, 2018Co-Authors: Melissa Brackmann, Marina Stasenko, Shitanshu Uppal, Jake Erba, R. Kevin Reynolds, Karen McleanAbstract:The optimal first-line Chemotherapy for ovarian carcinosarcoma has not yet been determined. We therefore sought to determine the progression-free survival (PFS) and overall survival (OS) for patients with ovarian carcinosarcoma treated at our institution with different first-line Chemotherapy Regimens. This single-institution, retrospective analysis included all patients with ovarian or primary peritoneal carcinosarcoma diagnosed from September 1996 to July 2017. Kaplan Meier analysis with a log-rank Mantel-Cox test was used to compare PFS and OS between treatment groups, and a p-value of
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comparison of first line Chemotherapy Regimens for ovarian carcinosarcoma a single institution case series and review of the literature
BMC Cancer, 2018Co-Authors: Melissa Brackmann, Marina Stasenko, Shitanshu Uppal, Jake Erba, Kevin R Reynolds, Karen McleanAbstract:The optimal first-line Chemotherapy for ovarian carcinosarcoma has not yet been determined. We therefore sought to determine the progression-free survival (PFS) and overall survival (OS) for patients with ovarian carcinosarcoma treated at our institution with different first-line Chemotherapy Regimens. This single-institution, retrospective analysis included all patients with ovarian or primary peritoneal carcinosarcoma diagnosed from September 1996 to July 2017. Kaplan Meier analysis with a log-rank Mantel-Cox test was used to compare PFS and OS between treatment groups, and a p-value of < 0.05 was considered statistically significant. Thirty-one patients met inclusion criteria: two patients were stage IC, 5 were stage II, 21 were stage III, and 3 were stage IV. The median PFS and OS for all stages was 9.3 and 19.7 months respectively. Fifteen patients (48%) received carboplatin/paclitaxel as first therapy, 7 (23%) received ifosfamide/paclitaxel, 6 (19%) received a different regimen, and 3 (10%) did not receive Chemotherapy. Patients treated with carboplatin/paclitaxel had a statistically significant longer PFS when compared to those receiving ifosfamide/paclitaxel (17.8 vs. 8.0 months, p = 0.025). OS was similar between all comparisons. In summary, in our cohort of ovarian carcinosarcoma patients, median PFS is longer in patients treated with carboplatin/paclitaxel compared to ifosfamide/paclitaxel. Overall survival was similar for all treatment groups, potentially due to subsequent treatment crossover. Given the rarity and aggressive nature of this tumor, further study into optimal first-line Chemotherapy is warranted.