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1.
Transplant Cell Ther ; 30(2): 207.e1-207.e7, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37931801

RESUMEN

POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome is a rare form of plasma cell dyscrasia often treated with high-dose chemotherapy and autologous stem cell transplantation (ASCT). ASCT has resulted in satisfactory and sustained therapeutic outcomes. However, a substantial number of patients eventually experience disease progression, requiring second-line treatment. Therefore, it would be of further benefit to identify patients who will acquire the best long-term survival after ASCT. The aim of this study was to fully reveal the outcomes of patients undergoing ASCT in a large series with long-term follow-up. Long-term outcomes of 239 patients with newly diagnosed POEMS syndrome undergoing ASCT at a single center were evaluated retrospectively. Rates of hematologic complete response (CRH) and vascular endothelial growth factor (VEGF) complete response (CRV) were 57.3% and 68.6%, respectively, with 90.5% of patients achieving an overall clinical response. At a median follow-up of 94 months, the 5-year overall survival (OS) rate was 92.8%, and the 5-year time to next-line treatment (TTNT) rate was 72.2% (median TTNT, 96 months). Patients achieving CRH (5-year TTNT rate, 82.5% versus 60.7%; P < .0001) or CRV (5-year TTNT rate 83.7% versus 54.2%; P < .0001) had better survival outcomes compared to non-CR group patients. Dual hematologic and VEGF complete responses carry further benefit for survival (median TTNT, 129 months versus 68 months; P < .0001). Seven cases of second primary malignancy were recorded, all of which were solid tumors. Front-line ASCT resulted in excellent long-term survival in patients with POEMS syndrome, with the best survival observed in those achieving dual hematologic and VEGF CRs.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Síndrome POEMS , Humanos , Trasplante de Células Madre Hematopoyéticas/métodos , Síndrome POEMS/terapia , Síndrome POEMS/tratamiento farmacológico , Factor A de Crecimiento Endotelial Vascular/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento , Trasplante Autólogo/métodos
2.
Future Oncol ; 19(23): 1627-1639, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37589145

RESUMEN

Aim: Time to subsequent therapy (TST) is an end point that may complement progression-free survival (PFS) and overall survival (OS) in determining the treatment effect of anticancer drugs and may be a potential surrogate for PFS and OS. We systematically reviewed the correlation between TST and both PFS and OS in published phase 2/3 studies in advanced solid tumors. Materials & methods: Trial-level correlational analyses were performed for TST versus PFS (by investigator and/or central review) and TST versus OS. Results: Of 21 included studies, nine (43%) used 'time to first subsequent therapy or death' (TFST) as the TST end point; 11 (57%) used different definitions ('other TST end points'). There was a strong correlation between TFST and PFS by investigator (medians: R2 = 0.88; hazard ratio [HR]: R2 = 0.91) and TFST versus PFS by central review (medians: R2 = 0.86; HRs: R2 = 0.84). For TFST versus OS there was medium/poor correlation for medians (R2 = 0.64) and HRs (R2 = 0.02). Conclusion: TFST strongly correlates with PFS, but not with OS.


In a recent study, researchers investigated how we can measure the effectiveness of cancer drugs. They focused on a specific measure called 'time to next therapy', which is the duration between two treatments patients receive. By analyzing the relationship between time to next therapy and disease progression, they discovered a strong correlation. This suggests that in the future, time to next therapy could potentially help to measure how well a cancer treatment works. However, when it comes to predicting patient survival, the relationship was not as strong. This implies that time to next therapy is not a reliable indicator of patient survival. To fully understand whether time to next therapy can effectively measure the effectiveness of anticancer drugs, further research is necessary.


Asunto(s)
Neoplasias , Humanos , Neoplasias/terapia , Supervivencia sin Progresión , Investigadores
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