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1.
Eur J Popul ; 40(1): 10, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38446226

RESUMO

The share of young adults living in married-couple family households in the USA has declined in recent decades. Research on alternative living arrangements focuses on cohabitation among unmarried couples and parent-adult child coresidence. Less is known about trends in non-family living arrangements and the characteristics of young adults living with non-relatives. This study documents trends over time in non-family living arrangements among young adults in the USA and examines the sociodemographic profile of those living with non-relatives. Using pooled US Census and American Community Survey microdata from 1990 to 2019, the authors document age patterns in non-family living arrangements over time and use logistic regression to estimate the likelihood of living with non-family based on individual-level characteristics. Results indicate that non-family living among young adults has increased over time, and that the arrangement is associated with markers of both advantage and disadvantage. Differences across age groups explain some of these mixed results. Trends among younger groups are linked to socioeconomic patterns around family formation. Among older groups, the demographic and labor force characteristics of the foreign born and constraints of their kin availability may be driving trends. The exploratory analysis provides relevant evidence around an increasingly common living arrangement in the USA and also identifies several areas for future research on living arrangements among young adults and the implications of these trends.

2.
Sci Data ; 11(1): 145, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38296987

RESUMO

The CORESIDENCE Database (CoDB) represents a significant advancement in the field of family studies, addressing existing data gaps and facilitating comprehensive analysis of households' composition and living arrangements at the national and subnational levels. This article introduces the CoDB, developed for the ERC project Intergenerational Coresidence in Global Perspective: Dimensions of Change. The database draws on global-scale individual microdata from four main repositories and national household surveys, encompassing over 150 million individual records representing more than 98% of the world's population. The CoDB provides datasets at the national, subnational, and subnational-harmonized levels, covering 156 countries, 3950 regions, and 1511 harmonized regions for the period 1964-2021. It includes 146 indicators on household composition and family arrangements, allowing researchers to explore intergenerational co-residence patterns, gender dynamics within households, and longitudinal trends in living arrangements. The CoDB fills an important gap in comparative household studies, enabling researchers to undertake ground breaking research at both macro and micro levels, ultimately fostering a deeper understanding of the complex dynamics of family structures and living arrangements.

3.
Eur J Popul ; 38(5): 1333-1346, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36507242

RESUMO

The Spanish total fertility rate declined from 2.8 to below 1.4 children per woman from 1975 to 2020. Spain is categorized as a "lowest-low fertility" country. Although there have been many attempts to explain the Spanish fertility decline, there has been an insufficient focus been given to religion. This brief report aims to analyse how religious affiliation, particularly being Catholics, associates with fertility behaviours-entering parenthood and the total number of children. Using three nationally representative surveys, we show that, compared with the religiously non-affiliated, Catholic women have a higher likelihood of entering parenthood after controlling for demographic, union status and educational characteristics. After controlling for changes in education and union formation, changes in religious affiliation account for approximately 4% of the cohort variation in the age at first birth, but there is no significant contribution for men nor to the total number of children for both sexes. Supplementary Information: The online version contains supplementary material available at 10.1007/s10680-022-09644-1.

4.
Rev Panam Salud Publica ; 45: e115, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34621303

RESUMO

OBJECTIVE: Analyze cohabitation patterns in the population over 60 years of age living in private households in 23 countries in Latin America and the Caribbean. METHODS: Cross-sectional study based on the most recently available census microdata from the Integrated Public Use Microdata Series (IPUMS, International), corresponding mainly to the 2010 census. Average number of household members, age distribution, and family relationships were calculated and compared for each country and by sex. The average number of household members was compared, by country and by sex, in relation to level of schooling and marital status. RESULTS: The average number of people that older people live with differs between countries, ranging from two or less in countries such as Argentina, Puerto Rico, and Uruguay, to four or more in countries such as Honduras and Nicaragua. This difference depends on a greater or lesser presence of young adults, children, and other family members in the household. The number of household members declines with a higher level of schooling, except in Cuba and Puerto Rico, where no differences are observed. In general, older women live in households with fewer people than men, although this is not the case for unmarried or divorced people. CONCLUSIONS: In the Region, it is common for older persons to live with children and other family members. The differences between countries and by educational level show that the family plays an important role in social protection of the elderly in less developed countries and in the least educated groups.


OBJETIVO: Analisar os padrões de convivência da população de 60 anos ou mais que reside em moradias particulares em 23 países da América Latina e do Caribe. MÉTODOS: Estudo transversal realizado com base nos microdados censitários mais recentes disponíveis no Integrated Public Use Microdata Series (IPUMS)-International, na maior parte correspondente à etapa censitária de 2010. O número médio de coabitantes, sua distribuição por idade e as relações de parentesco estabelecidas entre eles foram calculados e comparados para cada país e por sexo. A média de coabitantes em função do nível de escolaridade e do estado civil foi comparada por país e por sexo. RESULTADOS: A média do número de pessoas com quem os idosos convivem difere entre países. Oscila entre 2 pessoas em países como Argentina, Porto Rico e Uruguai e 4 ou mais pessoas em países como Honduras e Nicarágua. Essa diferença resulta da maior ou menor presença de jovens, filhos e outros familiares em casa. Quanto maior o nível de escolaridade, menor o número de coabitantes, exceto em Cuba e em Porto Rico, onde não são observadas diferenças. Em geral, as mulheres idosas vivem em moradias com menos pessoas que os homens, embora não seja o caso das pessoas solteiras ou divorciadas. CONCLUSÕES: A convivência com filhos e outros familiares é habitual na Região. As diferenças entre países e por nível educacional mostram que a família desempenha um papel importante na proteção social da velhice nos países menos desenvolvidos e nos grupos menos escolarizados.

5.
Artigo em Espanhol | PAHO-IRIS | ID: phr-54915

RESUMO

[RESUMEN]. Objetivo. Analizar las pautas de convivencia de la población de 60 años o más que reside en hogares priva-dos en 23 países de América Latina y el Caribe. Métodos. Estudio transversal realizado con base en los microdatos censales más recientes disponibles en Integrated Public Use Microdata Series (IPUMS)-International, la mayoría de ellos correspondientes a la ronda censal de 2010. Se calcularon y se compararon, para cada país y por sexo, el número medio de convivientes, su distribución por edad y las relaciones de parentesco que se establecen entre ellos. Se compararon, por país y por sexo, el promedio de convivientes en función del nivel de escolaridad y del estado civil. Resultados. El promedio del número de personas con las que convive la gente mayor difiere entre países. Oscila entre dos personas en países como Argentina, Puerto Rico y Uruguay, y cuatro o más personas en países como Honduras y Nicaragua. Esta diferencia resulta de la mayor o menor presencia de personas jóvenes, hijos y otros familiares en el hogar. El número de convivientes disminuye con el mayor nivel de escolaridad, salvo en Cuba y en Puerto Rico, donde no se observan diferencias. En general, las mujeres mayores viven en hogares con menos personas que los hombres, aunque no es el caso de las personas solteras o divorciadas. Conclusiones. La convivencia con hijos y otros familiares es habitual en la Región. Las diferencias entre países y por nivel educativo muestran que la familia juega un papel importante en la protección social de la vejez en los países menos desarrollados y en los grupos menos escolarizados.


[ABSTRACT]. Objective. Analyze cohabitation patterns in the population over 60 years of age living in private households in 23 countries in Latin America and the Caribbean. Methods. Cross-sectional study based on the most recently available census microdata from the Integrated Public Use Microdata Series (IPUMS, International), corresponding mainly to the 2010 census. Average number of household members, age distribution, and family relationships were calculated and compared for each country and by sex. The average number of household members was compared, by country and by sex, in relation to level of schooling and marital status. Results. The average number of people that older people live with differs between countries, ranging from two or less in countries such as Argentina, Puerto Rico, and Uruguay, to four or more in countries such as Honduras and Nicaragua. This difference depends on a greater or lesser presence of young adults, children, and other family members in the household. The number of household members declines with a higher level of schooling, except in Cuba and Puerto Rico, where no differences are observed. In general, older women live in households with fewer people than men, although this is not the case for unmarried or divorced people. Conclusions. In the Region, it is common for older persons to live with children and other family members. The differences between countries and by educational level show that the family plays an important role in social protection of the elderly in less developed countries and in the least educated groups.


[RESUMO]. Objetivo. Analisar os padrões de convivência da população de 60 anos ou mais que reside em moradias particulares em 23 países da América Latina e do Caribe. Métodos. Estudo transversal realizado com base nos microdados censitários mais recentes disponíveis no Integrated Public Use Microdata Series (IPUMS)-International, na maior parte correspondente à etapa cen-sitária de 2010. O número médio de coabitantes, sua distribuição por idade e as relações de parentesco estabelecidas entre eles foram calculados e comparados para cada país e por sexo. A média de coabitantes em função do nível de escolaridade e do estado civil foi comparada por país e por sexo. Resultados. A média do número de pessoas com quem os idosos convivem difere entre países. Oscila entre 2 pessoas em países como Argentina, Porto Rico e Uruguai e 4 ou mais pessoas em países como Honduras e Nicarágua. Essa diferença resulta da maior ou menor presença de jovens, filhos e outros familiares em casa. Quanto maior o nível de escolaridade, menor o número de coabitantes, exceto em Cuba e em Porto Rico, onde não são observadas diferenças. Em geral, as mulheres idosas vivem em moradias com menos pessoas que os homens, embora não seja o caso das pessoas solteiras ou divorciadas. Conclusões. A convivência com filhos e outros familiares é habitual na Região. As diferenças entre países e por nível educacional mostram que a família desempenha um papel importante na proteção social da velhice nos países menos desenvolvidos e nos grupos menos escolarizados.


Assuntos
Instituição de Longa Permanência para Idosos , Idoso , Habitação , Envelhecimento , Envelhecimento Saudável , Saúde do Idoso , América Latina , Região do Caribe , Habitação , Habitação para Idosos , Idoso , Saúde do Idoso , Serviços de Saúde para Idosos , Instituição de Longa Permanência para Idosos , Envelhecimento Saudável , Envelhecimento , América Latina , Região do Caribe , Idoso , Serviços de Saúde para Idosos , Habitação , Habitação para Idosos , Saúde do Idoso , Envelhecimento , Envelhecimento Saudável
6.
Proc Natl Acad Sci U S A ; 117(28): 16118-16120, 2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32576696

RESUMO

Based on harmonized census data from 81 countries, we estimate how age and coresidence patterns shape the vulnerability of countries' populations to outbreaks of coronavirus disease 2019 (COVID-19). We estimate variation in deaths arising due to a simulated random infection of 10% of the population living in private households and subsequent within-household transmission of the virus. The age structures of European and North American countries increase their vulnerability to COVID-related deaths in general. The coresidence patterns of elderly persons in Africa and parts of Asia increase these countries' vulnerability to deaths induced by within-household transmission of COVID-19. Southern European countries, which have aged populations and relatively high levels of intergenerational coresidence, are, all else equal, the most vulnerable to outbreaks of COVID-19. In a second step, we estimate to what extent avoiding primary infections for specific age groups would prevent subsequent deaths due to within-household transmission of the virus. Preventing primary infections among the elderly is the most effective in countries with small households and little intergenerational coresidence, such as France, whereas confining younger age groups can have a greater impact in countries with large and intergenerational households, such as Bangladesh.


Assuntos
Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Características da Família , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Adolescente , Adulto , Fatores Etários , Idoso , Betacoronavirus , COVID-19 , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Internacionalidade , Pessoa de Meia-Idade , Pandemias , Características de Residência , SARS-CoV-2 , Adulto Jovem
7.
Soc Sci Res ; 83: 102313, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31422838

RESUMO

Two broad forces shape the patterns of marital sorting by education: structural constraints and assortative mating. However, we lack specific and comparative quantification of the extent of these two forces. In this paper, we measure the specific contributions of (i) assortative mating, (ii) the level of college education and (iii) the gender gap in education on marital sorting patterns and the corresponding polarization levels between college and non-college educated couples. Unlike previous studies, we adopt a large-cross-national approach including 118 countries and more than 258 observations spanning from 1960 up to 2011. Methodologically, we develop counterfactual modelling techniques to compare observed patterns of marital sorting with expected patterns derived from alternative structural and assortative mating conditions. Our findings indicate that changes in college marital sorting and increases in polarization between college- and non-college-educated populations are overwhelmingly driven by structural constraints, namely the expansion of college education. Instead, educational assortative mating plays a limited role - accounting only for 5% of the observed changes in marriage market polarization.

8.
Stud Fam Plann ; 49(2): 127-142, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29749632

RESUMO

Despite substantial improvements in women's education, the age at which Latin American women marry (cohabit) or become mothers for the first time has barely decreased over the past four decades. We refer to this as the "stability paradox." We examine the relationship between years of schooling and transitions to first union or child, analyzing retrospective information from 50 cohorts of women born between 1940 and 1989 in 12 Latin American countries. Absolute and relative measures of schooling are compared. Data is drawn from 38 Demographic Health Surveys (DHS) conducted between 1986 and 2012 in these countries. Results show that expected postponement in family transitions due to educational expansion was offset by a rise in union formation and childbearing within strata of absolute education, but stayed approximately constant within strata of relative education. The relative measure of education retains the stratifying power of education but neutralizes any effect attached to a specific number of years of schooling and the learning skills associated with them. This is consistent with the idea that access to education in Latin America reproduces existing patterns of socioeconomic advantage, rather than creating a more equitable distribution of learning opportunities and outcomes.


Assuntos
Sucesso Acadêmico , Características da Família , Mulheres/educação , Adolescente , Coeficiente de Natalidade , Tomada de Decisões , Feminino , Humanos , América Latina , Estudos Retrospectivos , Fatores Socioeconômicos
9.
Popul Dev Rev ; 42(4): 615-625, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-28490820

RESUMO

The gender gap in education that has long favored men has reversed for young adults in almost all high and middle-income countries. In 2010, the proportion of women aged 25-29 with a college education was higher than that of men in more than 139 countries which altogether represent 86% of the world's population. According to recent population forecasts, women will have more education than men in nearly every country in the world by 2050, with the exception of only a few African and West Asian countries (KC et al. 2010). The reversal of the gender gap in education has major implications for the composition of marriage markets, assortative mating, gender equality, and marital outcomes such as divorce and childbearing (Van Bavel 2012). In this work, we focus on its implications for trends in assortative mating and, in particular, for educational hypergamy: the pattern in which husbands have more education than their wives. This represents a substantial update to previous studies (Esteve et al. 2012) in terms of the number of countries and years included in the analysis. We present findings from an almost comprehensive world-level analysis using census and survey microdata from 420 samples and 120 countries spanning from 1960 to 2011, which allow us to assert that the reversal of the gender gap in education is strongly associated with the end of hypergamy and increases in hypogamy (wives have more education that their husbands). We not only provide near universal evidence of this trend but extend our analysis to consider the implications of the end of hypergamy for family dynamics, outcomes and gender equality. We draw on European microdata to examine whether women are more likely to be the breadwinners when they marry men with lower education than themselves and discuss recent research regarding divorce risks among hypogamous couples. We close our analysis with an examination of attitudes about women earning more money than their husbands and about the implications for children when a woman works for pay.

10.
Demography ; 52(1): 183-208, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25604846

RESUMO

We explore the impact of sociodemographic change on marriage patterns in India by examining the hypothetical consequences of applying three sets of marriage pairing propensities-contemporary patterns by age, contemporary patterns by age and education, and changing propensities that allow for greater educational homogamy and reduced educational asymmetries--to future population projections. Future population prospects for India indicate three trends that will impact marriage patterns: (1) female deficit in sex ratios at birth; (2) declining birth cohort size; (3) female educational expansion. Existing literature posits declining marriage rates for men arising from skewed sex ratios at birth (SRBs) in India's population. In addition to skewed SRBs, India's population will experience female educational expansion in the coming decades. Female educational expansion and its impact on marriage patterns must be jointly considered with demographic changes, given educational differences and asymmetries in union formation that exist in India, as across much of the world. We systematize contemporary pairing propensities using data from the 2005-2006 Indian National Family Health Survey and the 2004 Socio-Economic Survey and apply these and the third set of changing propensities to multistate population projections by educational attainment using an iterative longitudinal projection procedure. If today's age patterns of marriage are viewed against age/sex population composition until 2050, men experience declining marriage prevalence. However, when education is included, women--particularly those with higher education--experience a more salient rise in nonmarriage. Significant changes in pairing patterns toward greater levels of educational homogamy and gender symmetry can counteract a marked rise in nonmarriage.


Assuntos
Casamento/etnologia , Casamento/estatística & dados numéricos , Dinâmica Populacional/estatística & dados numéricos , Adulto , Fatores Etários , Coeficiente de Natalidade , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Razão de Masculinidade , Fatores Socioeconômicos
11.
Demogr Res ; 30: 1621-1638, 2014 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-26161036

RESUMO

BACKGROUND: In the context of increasing cohabitation and growing demand for understanding the driving forces behind the cohabitation boom, most analyses have been carried out at a national level, not accounting for regional heterogeneity within countries. OBJECTIVE: This paper presents the geography of unmarried cohabitation in the Americas. We offer a large-scale, cross-national perspective together with small-area estimates of cohabitation. We decided to produce this map because: (i) geography unveils spatial heterogeneity and challenges explanatory frameworks that may work at the international level but have low explanatory power in regard to intra-national variation. (ii) we argue that historical pockets of cohabitation can still be identified by examining the current geography of cohabitation. (iii) our map is a first step toward understanding whether the recent increase in cohabitation is an intensification of pre-existing traditions or whether it has different roots that also imply a new geography. METHODS: Census microdata from 39 countries and 19,000 local units have been pulled together to map the prevalence of cohabitation among women. RESULTS: The results show inter- and intra-national regional contrasts. The highest rates of cohabitation are found in areas of Central America, the Caribbean, Colombia and Peru. The lowest rates are mainly found in the United States and Mexico. In all countries the spatial autocorrelation statistics indicates substantial spatial heterogeneity. CONCLUSIONS: Our results raise the question as to which forces have shaped these patterns and remind us that such forces need to be taken into account to understand recent patterns, particularly increases, in cohabitation.

12.
Demography ; 50(6): 2209-25, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23904391

RESUMO

In this article, we explore the impacts that education expansion and increased levels in educational homogamy have had on couples' isolated illiteracy rates, defined as the proportion of illiterates in union that are married to an illiterate partner. First, we develop the methodology to decompose isolated illiteracy rates into two main components: one related to level of homogamy among illiterates, and the other related to the educational distribution of the spouses. Second, we use harmonized international census microdata from IPUMS and DHS data for 73 countries and 217 samples to investigate which of the two components is more important in shaping the level of isolated illiteracy. Our results indicate that the expansion of literacy has been more powerful than the increases in the tendency toward homogamy in its impact on isolated illiteracy rates. As the percentage of illiterates decreases over time, an increasingly large proportion of them marry literate individuals, showing that opportunities for intermarriage among illiterates expand despite the strengthening of homogamy.


Assuntos
Escolaridade , Competência em Informação , Casamento/tendências , Cônjuges/educação , Feminino , Inquéritos Epidemiológicos , Humanos , Internacionalidade , Masculino , Fatores Socioeconômicos , Cônjuges/estatística & dados numéricos
13.
Popul Res Policy Rev ; 32(1): 81-102, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-25506110

RESUMO

The explosive expansion of non-marital cohabitation in Latin America since the 1970s has led to the narrowing of the gap in educational homogamy between married and cohabiting couples (what we call "homogamy gap") as shown by our analysis of 29 census samples encompassing eight countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico and Panama (N = 2,295,160 young couples). Most research on the homogamy gap is limited to a single decade and a small group of developed countries (the United States, Canada, and Europe). We take a historical and cross-national perspective and expand the research to a range of developing countries, where since early colonial times traditional forms of cohabitation among the poor, uneducated sectors of society have coexisted with marriage, although to widely varying degrees from country to country. In recent decades, cohabitation is emerging in all sectors of society. We find that among married couples educational homogamy continues to be higher than for those who cohabit, but in recent decades the difference has narrowed substantially in all countries. We argue that assortative mating between cohabiting and married couples tend to be similar when the contexts in which they are formed are also increasingly similar.

14.
Popul Dev Rev ; 38(1): 55-81, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22833864

RESUMO

The article describes the rise of unmarried cohabitation in Latin American countries during the last 30 years of the twentieth century, both at the national and regional levels. It documents that this major increase occurred in regions with and without traditional forms of cohabitation alike. In addition, the striking degree of catching up of cohabitation among the better-educated population segments is illustrated. The connections between these trends and economic (periods of high inflation) and cultural (reduction of stigmas in ethical domains) factors are discussed. The conclusion is that the periods of inflation and hyperinflation may have been general catalysts, but no clear indications of correlation were found between such economic factors and the rise in cohabitation. The shift toward more tolerance for hitherto stigmatized forms of conduct (e.g., homosexuality, euthanasia, abortion, singleparent household) is in line with the rise of cohabitation in regions of Argentina, Chile, and Brazil where cohabitation used to be uncommon. Further rises in cohabitation during the first decade of the twenty-first century are expected in a number of countries (e.g., mexico) despite conditions of much lower inflation.


Assuntos
Características Culturais , Características de Residência , Pessoa Solteira , Comportamento Social , Fatores Socioeconômicos , Características Culturais/história , História do Século XX , História do Século XXI , América Latina/etnologia , Características de Residência/história , Pessoa Solteira/educação , Pessoa Solteira/história , Pessoa Solteira/legislação & jurisprudência , Pessoa Solteira/psicologia , Comportamento Social/história , Fatores Socioeconômicos/história
16.
Popul Res Policy Rev ; 29(5): 609-637, 2010 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-23172982

RESUMO

We use census microdata to assess the levels of educational homogamy in six Latin American countries: Argentina, Brazil, Chile, Costa Rica, Ecuador and Mexico. This paper contributes to the literature on homogamy in three ways. First, by conducting a comparative analysis between countries belonging to the still little-studied region of Latin America, which is still undergoing intense and varied processes of demographic, economic, social, and political modernization. Second, by simultaneously including variables of structural and individual nature. Finally, by making progress with respect to the interactions between educational homogamy and other important variables associated with high levels of social inequality in the region: race, ethnicity and birthplace.

17.
Papeles Poblac ; 16(66): 9-40, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-25593515

RESUMO

This paper investigates the effect of consensual union dissolution on the observed levels of women never in union as estimated from the marital status variable in Latin American population censuses. We compare census data with data from Demographic and Health Surveys (DHS) for those countries and years where both sources are available (Bolivia, Brazil, Colombia, and Peru). Results show that the proportions of women never in union based on the census 'marital status' variable are systematically higher than those estimated from the DHS. This overestimation is due to individuals formerly in consensual unions declaring themselves as single at the time of the census. The large proportion of single women that have children is strong evidence of this and at the same time appears to be a valid and practical option to correct the bias.

18.
BMC Cancer ; 6: 285, 2006 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-17156477

RESUMO

BACKGROUND: Anti-angiogenic treatment is believed to have at least cystostatic effects in highly vascularized tumours like pancreatic cancer. In this study, the treatment effects of the angiogenesis inhibitor Cilengitide and gemcitabine were compared with gemcitabine alone in patients with advanced unresectable pancreatic cancer. METHODS: A multi-national, open-label, controlled, randomized, parallel-group, phase II pilot study was conducted in 20 centers in 7 countries. Cilengitide was administered at 600 mg/m2 twice weekly for 4 weeks per cycle and gemcitabine at 1000 mg/m2 for 3 weeks followed by a week of rest per cycle. The planned treatment period was 6 four-week cycles. The primary endpoint of the study was overall survival and the secondary endpoints were progression-free survival (PFS), response rate, quality of life (QoL), effects on biological markers of disease (CA 19.9) and angiogenesis (vascular endothelial growth factor and basic fibroblast growth factor), and safety. An ancillary study investigated the pharmacokinetics of both drugs in a subset of patients. RESULTS: Eighty-nine patients were randomized. The median overall survival was 6.7 months for Cilengitide and gemcitabine and 7.7 months for gemcitabine alone. The median PFS times were 3.6 months and 3.8 months, respectively. The overall response rates were 17% and 14%, and the tumor growth control rates were 54% and 56%, respectively. Changes in the levels of CA 19.9 went in line with the clinical course of the disease, but no apparent relationships were seen with the biological markers of angiogenesis. QoL and safety evaluations were comparable between treatment groups. Pharmacokinetic studies showed no influence of gemcitabine on the pharmacokinetic parameters of Cilengitide and vice versa. CONCLUSION: There were no clinically important differences observed regarding efficacy, safety and QoL between the groups. The observations lay in the range of other clinical studies in this setting. The combination regimen was well tolerated with no adverse effects on the safety, tolerability and pharmacokinetics of either agent.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Desoxicitidina/análogos & derivados , Neoplasias Pancreáticas/tratamento farmacológico , Venenos de Serpentes/uso terapêutico , Adulto , Inibidores da Angiogênese/toxicidade , Antimetabólitos Antineoplásicos/uso terapêutico , Antimetabólitos Antineoplásicos/toxicidade , Divisão Celular/efeitos dos fármacos , Desoxicitidina/uso terapêutico , Desoxicitidina/toxicidade , Humanos , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Qualidade de Vida , Venenos de Serpentes/toxicidade , Inquéritos e Questionários , Taxa de Sobrevida , Gencitabina
19.
Clin Transl Oncol ; 7(1): 3-11, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15890149

RESUMO

Current issues of adjuvant therapy for colon cancer concern the introduction of drugs other than fluorouracil-5/leucovorin (5-FU/LV), the benefits for stage II patients, the use of new primary endpoints and the influence of age on treatment benefits. These issues were addressed in a panel discussion and the conclusions were the following: FOLFOX4 is the first regimen that shows superiority over 5-FU/LV. The use of 3-year disease-free survival as primary endpoint could encourage the quicker adoption of improved therapeutic strategies into clinical practice. Available data suggest that there are some benefits for stage II patients, and the decision needs to be individualised for each patient. Further, therapeutic decisions based solely on the patient's age are inappropriate, and geriatric assessment tools will help in making this decision. This information would improve patient and physician understanding of the recent data regarding the potential benefits of adjuvant therapy.


Assuntos
Neoplasias do Colo/terapia , Fatores Etários , Idoso , Quimioterapia Adjuvante , Ensaios Clínicos como Assunto , Intervalo Livre de Doença , Humanos
20.
Clin. transl. oncol. (Print) ; 7(1): 3-11, ene.-feb. 2005.
Artigo em En | IBECS | ID: ibc-038814

RESUMO

Las controversias actuales referentes al tratamiento adyuvante del cáncer de colon incluyen la introducción de fármacos más allá de 5-FU/LV, el beneficio que ofrece a los pacientes con estadio II, el uso de nuevas variables y la influencia de la edad sobre los beneficios del tratamiento. Estas controversias fueron discutidas en un panel de expertos y las conclusiones fueron las siguientes: FOLFOX4 es el primer régimen que ha demostrado superioridad frente a 5-FU/LV. El uso de la supervivencia libre de enfermedad a 3 años como variable principal de los estudios podrá permitir una adopción más rápida de estrategias terapéuticas. Los datos disponibles sugieren que existe beneficio para los pacientes con estadio II, y la decisión terapéutica debe ser individualizada. Finalmente, también se llegó a la conclusión de que las decisiones basadas únicamente en la edad no son apropiadas, y las herramientas de valoración geriátrica servirán de apoyo. Esta información puede mejorar el entendimiento de pacientes y médicos acerca de los datos recientes relativos a los beneficios del tratamiento adyuvante


Current issues of adjuvant therapy for colon cancer concern the introduction of drugs other than fluorouracil-5/leucovorin (5-FU/LV), the benefits for stage II patients, the use of new primary endpoints and the influence of age on treatment benefits. These issues were addressed in a panel discussion and the conclusions were the following: FOLFOX4 is the first regimen that shows superiority over 5-FU/LV. The use of 3-year disease-free survival as primary endpoint could encourage the quicker adoption of improved therapeutic strategies into clinical practice. Available data suggest that there are some benefits for stage II patients, and the decision needs to be individualised for each patient. Further, therapeutic decisions based solely on the patient's age are inappropriate, and geriatric assessment tools will help in making this decision. This information would improve patient and physician understanding of the recent data regarding the potential benefits of adjuvant therapy


Assuntos
Idoso , Humanos , Neoplasias do Colo/terapia , Quimioterapia Adjuvante
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