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Kaiser F, Rudloff LV, Vehling-Kaiser U, Hollburg W, Nauck F, Alt-Epping B. Palliative home care for patients with advanced haematological malignancies-a multicenter survey. Ann Hematol 2017. [PMID: 28638954 DOI: 10.1007/s00277-017-3045-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with advanced haematological malignancies in non-curative settings suffer from complex physical symptoms and psychosocial distress, comparable to patients with solid tumour entities. Nevertheless, numerous problems at the interface between haematology and palliative home care have been described. From January 2011 until October 2014, we performed a retrospective, multicenter analysis of all patients with haematological malignancies (ICD 10: C81-C95) being treated by the respective specialized palliative home care (SAPV) team. Three SAPV teams were surveyed. Disease entity, physical symptoms, psychosocial distress, number of hospital admissions, therapeutic interventions and other items were analysed descriptively. Of 3,955 SAPV patients, 1.8% (n = 73) suffered from haematological malignancies. Main problems were deterioration of general condition, pain or psychological problems. Thirty-seven percent developed new symptoms during SAPV, mainly pain, psychological distress or deterioration of general status. In 33%, patients were referred to hospital, mainly due to deterioration of general condition or pain. Seventy percent died within 3 months after beginning SAPV care; 83% died at home or in a nursing home. Patients suffering from advanced haematological malignancies were statistically underrepresented in SAPV, and SAPV was installed rather at the very last days of life. By far, more patients were able to die outside a hospital as compared to reference cohorts of haematological patients not being treated in SAPV. The spectrum of documented problems is comparable to other patient cohorts being treated in SAPV; therefore, the options and benefits of palliative home care should be incorporated in palliative haematological treatment concepts more vigorously and consequently.
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Affiliation(s)
- F Kaiser
- Department of Haematology and Oncology, University Medical Center Göttingen, Göttingen, Germany.
| | - L V Rudloff
- Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany
| | | | - W Hollburg
- PalliativPartner Hamburg, Hamburg, Germany
| | - F Nauck
- Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - B Alt-Epping
- Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany
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Kaifie A, Kirschner M, Wolf D, Maintz C, Hänel M, Gattermann N, Gökkurt E, Platzbecker U, Hollburg W, Göthert JR, Parmentier S, Lang F, Hansen R, Isfort S, Schmitt K, Jost E, Serve H, Ehninger G, Berdel WE, Brümmendorf TH, Koschmieder S. Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry. J Hematol Oncol 2016; 9:18. [PMID: 26944254 PMCID: PMC4779229 DOI: 10.1186/s13045-016-0242-9] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 02/10/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Patients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these events, antiplatelet and/or anticoagulant agents are commonly employed as primary and/or secondary prophylaxis. On the other hand, disease-related bleeding complications (i.e., from esophageal varices) are common in patients with MPN. This analysis was performed to define the frequency of such events, identify risk factors, and assess antiplatelet/anticoagulant therapy in a cohort of patients with MPN. METHODS The MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences as well as contingency tables were used to identify the odds of potential risk factors for vascular events. RESULTS MPN subgroups significantly differed in sex distribution, age at diagnosis, blood counts, LDH levels, JAK2V617F positivity, and spleen size (length). While most thromboembolic events occurred around the time of MPN diagnosis, one third of these events occurred after that date. Splanchnic vein thrombosis was most frequent in post-PV-MF and MPN-U patients. The chance of developing a thromboembolic event was significantly elevated if patients suffered from post-PV-MF (OR 3.43; 95% CI = 1.39-8.48) and splenomegaly (OR 1.76; 95% CI = 1.15-2.71). Significant odds for major bleeding were previous thromboembolic events (OR = 2.71; 95% CI = 1.36-5.40), splenomegaly (OR = 2.22; 95% CI 1.01-4.89), and the administration of heparin (OR = 5.64; 95% CI = 1.84-17.34). Major bleeding episodes were significantly less frequent in ET patients compared to other MPN subgroups. CONCLUSIONS Together, this report on an unselected "real-world" cohort of German MPN patients reveals important data on the prevalence, diagnosis, and treatment of thromboembolic and major bleeding complications of MPN.
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Affiliation(s)
- A. Kaifie
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - M. Kirschner
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - D. Wolf
- Internal Medicine 3, Oncology, Hematology and Rheumatology, University Clinic Bonn (UKB), Bonn, Germany
| | - C. Maintz
- Practice for Hematology and Oncology, Wuerselen, Germany
| | - M. Hänel
- Department for Hematology, Oncology, Stem Cell Transplantation, Hospital Chemnitz, Chemnitz, Germany
| | - N. Gattermann
- Department for Hematology, Oncology and Clinical Immunology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - E. Gökkurt
- Practice for Hematology-Oncology Eppendorf, Hamburg, Germany
| | - U. Platzbecker
- Department for Hematology, University Hospital Dresden, Dresden, Germany
| | - W. Hollburg
- Practice for Hematology and Oncology Altona, Hamburg, Germany
| | - J. R. Göthert
- Department for Hematology, University Hospital Essen, Essen, Germany
| | - S. Parmentier
- Department for Hematology, Oncology and Palliative Care, Rems-Murr-Hospitals, Winnenden, Germany
| | - F. Lang
- Department for Hematology and Oncology, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | - R. Hansen
- Practice for Hematology and Oncology, Kaiserslautern, Germany
| | - S. Isfort
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - K. Schmitt
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - E. Jost
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - H. Serve
- Department for Hematology and Oncology, University Hospital Frankfurt/Main, Frankfurt/Main, Germany
| | - G. Ehninger
- Department for Hematology, University Hospital Dresden, Dresden, Germany
| | - W. E. Berdel
- Department of Medicine A, University Hospital Münster, Münster, Germany
| | - T. H. Brümmendorf
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - S. Koschmieder
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
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Schmidt M, Schneeweiss A, Förster F, Geberth M, Schumacher C, Hollburg W, Söling U, Aktas B, Kümmel S. Abstract P2-16-03: Mature results on metastatic breast cancer patients with prolonged (≥1 year) exposure to first-line bevacizumab combined with paclitaxel from a large observation study. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-16-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Bevacizumab (BEV) combined with chemotherapy (CT) significantly improves progression-free survival (PFS) and response rate (RR) vs CT alone in the 1st-line treatment of HER2-negative metastatic breast cancer (mBC). BEV was continued for ≥1 year in 20% of patients (pts) in the global ATHENA safety study. We examined a similar subgroup of pts with long-term antibody treatment in a large German observation study. Meanwhile, long-term follow-up of up to 4.5 years allows to present the final results, including mature data on overall survival.
Methods: Pts who had received no prior CT for their mBC received BEV-PAC per the European label. Efficacy and safety were documented in detail for up to 1 year (or until progression, death, or BEV discontinuation if earlier), with subsequent retrieval of long-term follow-up.
Results: By April 2013, final data were available for 865 pts, of whom 167 (20%) were recorded to have received BEV for ≥1 year. Baseline characteristics of this subset relative to the overall population are summarized in the table.
CharacteristicOverall population (n = 865)Subgroup treated with BEV for ≥1 year (n = 167)Median age, years (range)58(26-87)57(28-79)Age ≥65 years,%3230Metastatic at diagnosis,%2018Disease-free inreval <12 months,%24*14#Liver metastasis,%4235≥3 metastatic sites,%3329Triple-negative disease,%1812ECOG performance status >1,%98Prior (neo)adjuvant chemotherapy,%6661*n = 591, initially M0. #n = 113
Dose reductions of long-term BEV occurred in only 3% of cycles and (at least once) in 17% of pts. In the majority of pts treated for ≥1 year, BEV was continued as a single agent after discontinuation of CT. The overall best RR in pts treated for ≥1 year was 80% (complete response in 19%). Median PFS, based on observed events in 83% of all pts, was 18.4 months compared to 9.6 months in the overall population. Overall survival data, based on 524 deaths (61%), show a median of 21.6 months. In the subgroup with prolonged therapy, median OS amounts to 35.7 months with 40% of pts still alive after 4 years. Safety of long-term BEV is as previously reported with only a slightly increased hypertension rate (35%, grade ≥3: 11%), and no cases of gastrointestinal perforation, arterial thromboembolic event, or reversible posterior leukoencephalopathy syndrome.
Conclusions: According to the mature data of this study, including those on OS, a notable proportion of pts appear to derive benefit from prolonged exposure to first-line BEV-containing therapy. Although baseline characteristics exhibited only moderate indicators for an a priori more favorable prognostic profile in the subset of pts treated for ≥1 year, of course one has to keep in mind, that time-related efficacy data are biased towards improved outcome in those able to continue BEV for ≥1 year. However, the median survival of almost 3 years suggests that in a considerable number of pts continued first-line BEV-PAC correlates to favorable outcomes with limited adverse effects.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-16-03.
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Affiliation(s)
- M Schmidt
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - A Schneeweiss
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - F Förster
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - M Geberth
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - C Schumacher
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - W Hollburg
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - U Söling
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - B Aktas
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - S Kümmel
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
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Kuemmel S, Schneeweiss A, Foerster FG, Geberth M, Tesch H, Klare P, Schumacher C, Hollburg W, Soeling U, Schmidt M. P1-14-04: Prolonged (≥1 Year) Exposure to First-Line Bevacizumab Combined with Paclitaxel in Patients with HER2−Negative Metastatic Breast Cancer Treated in a Routine Oncology Practice Study. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: First-line bevacizumab (BEV) combined with weekly paclitaxel (PAC) significantly improves progression-free survival (PFS) and response rate (RR) vs PAC alone in HER2−negative metastatic breast cancer (mBC), as shown in E2100. The benefit of BEV combined with other chemotherapy (CT) agents was demonstrated in AVADO and RIBBON-1. BEV was continued for ≥1 year in 21% of patients in the global ATHENA safety study and in 42% of patients in the JO19901 single-arm Japanese study of BEV-PAC. We analyzed data from the subgroup of patients treated for ≥1 year in a German routine oncology practice study to provide insight into the safety and efficacy of prolonged first-line BEV-PAC.
Methods: Patients who had received no prior CT for their mBC received BEV-PAC per the European label. Efficacy and safety were documented for up to 1 year (or until progression, death, or BEV discontinuation if earlier) with additional long-term follow-up. Data from patients treated with BEV for ≥1 year were extracted for this analysis.
Results: By Jan 2011, data were available for 818 patients, of whom 157 (19%) had already received BEV for ≥1 year. Baseline characteristics of this subset relative to the overall population are summarized in the table.
In 79% of those treated for ≥1 year, BEV was continued as a single agent after discontinuation of CT. The overall RR in patients treated for ≥1 year was 81% (complete response in 20%). Median PFS was 17.9 months (events in 44% of patients) vs 9.4 months in the overall population (events in 68%). Overall survival data are immature, as 81% of those treated for ≥1 year are still alive. The most common grade 3/4 adverse events in patients treated with BEV for ≥1 year were hypertension (11% of patients), pain (10%), and leukopenia (7%). There were no cases of gastrointestinal perforation, arterial thromboembolic event, or reversible posterior leukoencephalopathy syndrome in those treated for≥1 year. Analysis of adverse events according to time of onset is ongoing.
Conclusions: A notable proportion of patients appear to derive benefit from prolonged exposure to first-line BEV-containing therapy. In the present analysis, baseline characteristics appeared more favorable in the subset of patients treated for ≥1 year than in the overall population. Efficacy data clearly have a bias towards improved outcome in those able to continue BEV for ≥1 year, as these patients had sustained disease control for ≥1 year. However, the efficacy of prolonged BEV-containing therapy is of interest and suggests that some patients achieve sustained disease control with continued first-line BEV-PAC with limited side effects.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-14-04.
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Affiliation(s)
- S Kuemmel
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - A Schneeweiss
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - FG Foerster
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - M Geberth
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - H Tesch
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - P Klare
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - C Schumacher
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - W Hollburg
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - U Soeling
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
| | - M Schmidt
- 1Kliniken Essen-Mitte, Essen, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Zwickau, Germany; SPGO-Mannheim, Mannheim, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Oncology Practice Krebsheilkunde für Frauen, Berlin, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Hospital Mainz, Mainz, Germany
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Schneeweiss A, Foerster F, Hollburg W, Tesch H, Klare P, Wuelfing P, Distelrath A, Schumacher C, Steffens C, Schmidt M. 5073 POSTER Bevacizumab (Bev) Combined With Paclitaxel (Pac) as First-line Therapy for Metastatic Triple-negative Breast Cancer (TNBC) -Analysis of 147 Patients (pts) Treated in Routine Oncology Practice in Germany. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71515-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Klare P, Foerster FG, Geberth M, Schneeweiss A, Tesch H, Kuemmel S, Schumacher C, Hollburg W, Soeling U, Schmidt M. Efficacy and safety of first-line bevacizumab (Bev) combined with paclitaxel (Pac): An observational study in 786 patients (pts) with HER2-negative metastatic breast cancer (mBC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Schneeweiss A, Foerster FG, Hollburg W, Tesch H, Klare P, Wuelfing P, Distelrath A, Schumacher C, Steffens CC, Schubert R, Widing A, Kasper C, Schmidt M. Abstract P2-16-12: First-Line Bevacizumab Combined with Paclitaxel in Triple-Negative Locally Recurrent/Metastatic Breast Cancer: Subpopulation Analysis of 115 Patients Treated in Routine Oncology Practice in Germany. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p2-16-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Both progression-free survival (PFS) and response rate (RR) are significantly improved when bevacizumab (Bev) is combined with first-line chemotherapy for locally recurrent/metastatic breast cancer (LR/mBC), as demonstrated in three randomized, phase III trials (E2100, AVADO, RIBBON-1). The benefit derived from Bev appears to be similar in triple-negative (TN) and non-TN LR/mBC according to subanalyses of the randomized trials. We conducted a subpopulation analysis of TN patients treated with first-line Bev-paclitaxel (Pac) in a large German observational study in the context of routine oncology practice. Methods: Patients with HER2-negative LR/mBC received first-line Bev-Pac according to the European label at the time of study design. Safety and efficacy data were collected for up to 1 year (or until progression, death, or Bev discontinuation if earlier). The endpoints were safety and efficacy (PFS and RR). We conducted an exploratory analysis of the subset of patients with TN disease.
Results: Of the 567 patients for whom data are currently available, 115 (20%) had TN disease. Baseline characteristics and efficacy are summarized below. Overall survival data are immature and follow-up is continuing.
Conclusions: In this ongoing study, first-line Bev-Pac demonstrated a 51% RR and median PFS of 7.7 months in patients with TN LR/mBC. These data are consistent with findings from retrospective analyses of randomized phase III trials and a subpopulation analysis of the ATHENA study. Prospective trials evaluating Bev combination regimens in TN breast cancer are ongoing.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-16-12.
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Affiliation(s)
- A Schneeweiss
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - FG Foerster
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - W Hollburg
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - H Tesch
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - P Klare
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - P Wuelfing
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - A Distelrath
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - C Schumacher
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - C-C Steffens
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - R Schubert
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - A Widing
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - C Kasper
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
| | - M. Schmidt
- University of Heidelberg, Germany; Medical Care Center Flemmingstrasse, Chemnitz, Germany; Hämatologisch-onkologische Praxis Altona (HOPA), Hamburg, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Praxisklinik Krebsheilkunde für Frauen, Berlin, Germany; University of Münster, Germany; MVZ Ostehessen Onkologie, Fulda, Germany; St. Elisabeth-Hospital, Cologne, Germany; Klinik Dr. Hancken, Stade, Germany; Gynäkologisch-onkologische Schwerpunktpraxis Schubert, Scheibenberg, Germany; Oncologische Praxisgemeinschaft, Berlin, Germany; Onkologische Schwerpunktpraxis Hof, Hof, Germany; University Hospital, Mainz, Germany
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