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Fehr M, Lang N, Rubio L, Güsewell S, Templeton A, Aeppli S, Tsang R, Hodgson D, Moccia A, Bargetzi M, Caspar C, Brülisauer DMA, Ebnöther M, Fischer N, Prica A, Kukreti V, Ghilardi G, Krasniqi F, Mey UJ, Mingrone W, Novak U, Richter P, Kridel R, Rodin D, Rütti M, Schmidt A, Stenner F, Voegeli M, Zander T, Crump M, Hitz F, Kuruvilla J. PROGNOSTIC FACTORS IN ELDERLY PATIENTS WITH CLASSICAL HODGKIN LYMPHOMA ‐ A JOINT ANALYSIS OF TWO CLINICAL DATABASES. Hematol Oncol 2021. [DOI: 10.1002/hon.113_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M Fehr
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - N Lang
- Hôpitaux Universitaires Genève, Department of Oncology Genève Switzerland
| | - L Rubio
- Manchester Royal Infirmary, Haematology Manchester UK
| | - S Güsewell
- Cantonal Hospital St. Gallen, Clinical Trials Unit St. Gallen Switzerland
| | - A.J. Templeton
- Claraspital Basel, Oncology and Haematology Basel Switzerland
| | - S Aeppli
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - R Tsang
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - D Hodgson
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - A Moccia
- Oncology Institute of Southern Switzerland, Department of Medical Oncology Bellinzona Switzerland
| | - M Bargetzi
- Cantonal Hospital Aarau, Haematology Aarau Switzerland
| | - C Caspar
- Cantonal Hospital Baden, Oncology und Haematology Baden Switzerland
| | | | - M Ebnöther
- Claraspital Basel, Oncology and Haematology Basel Switzerland
| | - N Fischer
- Cantonal Hospital Winterthur, Medical Oncology and Haematology Winterthur Switzerland
| | - A Prica
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - V Kukreti
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - G Ghilardi
- Oncology Institute of Southern Switzerland, Haematology Bellinzona Switzerland
| | - F Krasniqi
- University Hospital Basel, Oncology Basel Switzerland
| | - U. J Mey
- Cantonal Hospital Grisons, Oncology and Haematology Chur Switzerland
| | - W Mingrone
- Cantonal Hospital Olten, Centre for Oncology Olten Switzerland
| | - U Novak
- University Hospital Bern, Medical Oncology Bern Switzerland
| | - P Richter
- Cantonal Hospital Grisons, Oncology and Haematology Chur Switzerland
| | - R Kridel
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - D Rodin
- Princess Margaret Cancer Centre, Radiation Oncology Toronto Switzerland
| | - M Rütti
- Hospital Wil, Medicine Wil Switzerland
| | - A Schmidt
- Stadtspital Triemli, Medical Oncology und Haematology Zürich Switzerland
| | | | - M Voegeli
- Cantonal Hospital Baselland, Oncology and Haematology Liestal Switzerland
| | - T Zander
- Cantonal Hospital Luzern, Medical Oncology Luzern Switzerland
| | - M Crump
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - F Hitz
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - J Kuruvilla
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
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Aeppli S, Schmaus M, Eisen T, Escudier B, Grünwald V, Larkin J, McDermott D, Oldenburg J, Porta C, Rini BI, Schmidinger M, Sternberg CN, Rothermundt C, Putora PM. First-line treatment of metastatic clear cell renal cell carcinoma: a decision-making analysis among experts. ESMO Open 2021; 6:100030. [PMID: 33460963 PMCID: PMC7815472 DOI: 10.1016/j.esmoop.2020.100030] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The treatment landscape of metastatic clear cell renal cell carcinoma (mccRCC) has been transformed by targeted therapies with tyrosine kinase inhibitors (TKI) and more recently by the incorporation of immune checkpoint inhibitors (ICI). Today, a spectrum of single agent TKI to TKI/ICI and ICI/ICI combinations can be considered and the choice of the best regimen is complex. MATERIALS AND METHODS We performed an updated decision-making analysis among 11 international kidney cancer experts. Each expert provided their treatment strategy and relevant decision criteria in the first line treatment of mccRCC. After the collection of all input a list of unified decision criteria was determined and compatible decision trees were created. We used a methodology based on diagnostic nodes, which allows for an automated cross-comparison of decision trees, to determine the most common treatment recommendations as well as deviations. RESULTS Diverse parameters were considered relevant for treatment selection, various drugs and drug combinations were recommended by the experts. The parameters, chosen by the experts, were performance status, International Metastatic renal cell carcinoma Database Consortium (IMDC) risk group, PD-L1 status, zugzwang and contraindication to immunotherapy. The systemic therapies selected for first line treatment were sunitinib, pazopanib, tivozanib, cabozantinib, ipilimumab/nivolumab or pembrolizumab/axitinib. CONCLUSION A wide spectrum of treatment recommendations based on multiple decision criteria was demonstrated. Significant inter-expert variations were observed. This demonstrates how data from randomized trials are implemented differently when transferred into daily practice.
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Affiliation(s)
- S Aeppli
- Division of Oncology and Haematology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
| | - M Schmaus
- Department of Radiotherapy and Radiation Oncology, University Medical Centre Hamburg Eppendorf, Hamburg, Germany
| | - T Eisen
- Department of Oncology, Cambridge University Hospitals National Health Service Foundation, Cambridge, UK
| | | | - V Grünwald
- Interdisciplinary GU Oncology, Clinic for Urology and Clinic for Tumour Research, University Hospital Essen, Essen, Germany
| | - J Larkin
- The Royal Marsden Hospital, London, UK
| | - D McDermott
- Beth Israel Deaconess Medical Centre, Boston, USA
| | - J Oldenburg
- Department of Oncology, Akershus University Hospital and Medical Faculty of University of Oslo, Oslo, Norway
| | - C Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari 'A. Moro', Bari, Italy
| | - B I Rini
- Division of Hematology and Oncology, Vanderbilt University Medical Centre, Nashville, USA
| | - M Schmidinger
- Department of Medicine I, Clinical Division of Oncology and Comprehensive Cancer Centre, Medical University of Vienna, Austria
| | - C N Sternberg
- Division of Hematology and Oncology, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, USA
| | - C Rothermundt
- Division of Oncology and Haematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - P M Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Department of Radiation Oncology, University of Bern, Bern, Switzerland
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Moccia AA, Aeppli S, Güsewell S, Bargetzi M, Caspar C, Brülisauer D, Ebnöther M, Fehr M, Fischer N, Ghilardi G, Krasniqi F, Lang N, Mey U, Mingrone W, Novak U, Pfleger C, Richter P, Rütti M, Schmidt A, Stenner F, Voegeli M, Zander T, Zucca E, Hitz F. Clinical characteristics and outcome of patients over 60 years with Hodgkin lymphoma treated in Switzerland. Hematol Oncol 2020; 39:196-204. [PMID: 33300135 DOI: 10.1002/hon.2830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/06/2020] [Indexed: 11/09/2022]
Abstract
Hodgkin lymphoma (HL) in older patients appears to be a different disease compared with younger patients with historically lower survival rates. This is related to a variety of factors, including increased treatment-related toxicity, the presence of comorbidities, and biologic differences. In order to better assess the clinical characteristics, treatment strategies, and outcome of this particular population, we conducted a population-based, retrospective analysis including 269 patients with HL older than 60 years (median age 71 years, range 60-94), treated between 2000 and 2017 in 15 referral centers across Switzerland. Primary endpoints were overall survival (OS), progression-free survival (PFS), and cause-specific survival (CSS). The vast majority of patients were treated with curative intent, either with a combined modality approach (chemotherapy followed by radiation therapy) or with systemic therapy. At a median follow-up of 6.6 years (95% confidence interval [CI], 6.0-7.6), 5-year PFS was 52.2% (95% CI, 46.0-59.2), 5-year OS was 62.5% (95% CI, 56.4-69.2), and 5-year CSS was 85.1.8% (95% CI, 80.3-90.1) for the entire cohort. A significant difference in terms of CSS was observed for patients older than 71 years in comparison to patients aged 60-70 years (hazard ratio 2.6, 1.3-5.0, p = 0.005). Bleomycin-induced lung toxicity (BLT) was documented in 26 patients (17.7%) out of the 147 patients exposed to this compound and was more frequent in patients older than 71 years (15/60, 25%). Outcome of HL pts older than 71 years appeared to decrease substantially in comparison to the younger counterpart. Treatment-related toxicities appeared to be relevant, in particular, BLT. New, potentially less toxic strategies need to be investigated in prospective clinical trials in this particular frail population.
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Affiliation(s)
- A A Moccia
- Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - S Aeppli
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - S Güsewell
- Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - M Bargetzi
- Hematology, Kantonsspital Aarau, Aarau, Switzerland
| | - C Caspar
- Medical Oncology and Hematology, Kantonsspital Baden, Baden, Switzerland
| | - D Brülisauer
- Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - M Ebnöther
- Medical Oncology and Hematology, Claraspital, Basel, Switzerland
| | - M Fehr
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - N Fischer
- Medical Oncology and Hematology Clinic, Kantonsspital Winterthur, Winterthur, Switzerland
| | - G Ghilardi
- Hematology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F Krasniqi
- Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland
| | - N Lang
- Medical Oncology Clinic, University Hospital of Geneva, Genève, Switzerland
| | - U Mey
- Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - W Mingrone
- Medical Oncology Clinic, Kantonsspital Olten, Olten, Switzerland
| | - U Novak
- Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - C Pfleger
- Medical Oncology and Hematology, Claraspital, Basel, Switzerland
| | - P Richter
- Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - M Rütti
- Internal Medicine Clinic, Spital Wil, Wil, Switzerland
| | - A Schmidt
- Medical Oncology and Hematology Clinic, Stadtspital Triemli, Zürich, Switzerland
| | - F Stenner
- Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland
| | - M Voegeli
- Medical Oncology and Hematology Clinic, Kantonsspital Baselland, Liestal, Switzerland
| | - T Zander
- Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | - E Zucca
- Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F Hitz
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Schmid S, Klingbiel D, Aeppli S, Britschgi C, Gautschi O, Pless M, Rothschild S, Wannesson L, Janthur W, Foerbs D, Demmer I, Jochum W, Früh M. Patterns of progression on osimertinib in EGFR T790M positive NSCLC: A Swiss cohort study. Lung Cancer 2019; 130:149-155. [DOI: 10.1016/j.lungcan.2019.02.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/10/2019] [Accepted: 02/19/2019] [Indexed: 02/08/2023]
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Schmid S, Klingbiel D, Aeppli S, Britschgi C, Gautschi O, Pless M, Rothschild S, Wannesson De Nicola L, Janthur WD, Foerbs D, Demmer I, Jochum W, Früh M. Patterns of recurrence to Osimertinib in T790m positive NSCLC: A Swiss cohort study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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