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The future of our patients already treated with first line chemotherapy

The future of our patients already treated with first line chemotherapy. Jose R. Germà Lluch MD PhD Institut Català of Oncology. Colon Cancer QMT. Metastatic & Adjuvant. Breast Cancer QMT. Metastatic. Lung Cancer QMT. Metastatic. Lung Cancer QMT. Adjuvant. Breast Cancer

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The future of our patients already treated with first line chemotherapy

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  1. Thefuture of ourpatientsalreadytreatedwithfirst line chemotherapy Jose R. Germà Lluch MD PhD Institut Català of Oncology

  2. Colon Cancer QMT. Metastatic & Adjuvant Breast Cancer QMT. Metastatic Lung Cancer QMT. Metastatic Lung Cancer QMT. Adjuvant Breast Cancer QMT. Adjuvant 2000 1970 1980 1990 Early reviews reported OR in 6.5% of 3184 patients Review from 26 trials published between 1987-1991: - OR 8.7% (95% CI 6.4-9.0%). - OR rate >10%: vinblastine, trimetrexate, mitoguazone & estramustine. Yagoda A. Cancer 71:1098-109, 1993. Mitoxantrone/Prednisone as the palliative standard of care. Tannock IF. J Clin Oncol 14:1756-64, 1996. Kantoff PW. J Clin Oncol 17:2506-13, 1999. Docetaxel as the standard of care in HRPC leading to superior OS and improved RR in terms of pain, serum PSA levels and QOL. Tannock IF. N Engl J Med 351:1502-12, 2004. Petrylak DP. N Engl J Med 351:1513-20, 2004.

  3. TAX 327 SWOG 9916 1) It is secure. 1) Improvement in Sv at the cost of an increased rates of AEs. 2) Significant Improvement of: 2) Significant Improvement of: - Survival (18.9 vs 16.5 months). 24% risk of death reduction (p=0.009). - Survival (17.5 vs 15.6 months). - PSA response (45% vs 32%, p=0.0005). 20% risk of death reduction (p=0.02). - Pain improvement (35% vs 22%, p=0.01). - PSA response (50% vs 27%, p<0.001). - QOL (22% vs 13%, p=0.009).

  4. Institut Català d’Oncologia l’Hospitalet 116 Patients Median 23.133 (IC 95%; 17.909 – 28.358)

  5. Institut Català d’Oncologia l’Hospitalet 88 Patients Received Docetaxel in a 3 weekly Schedule: Mediana 26.567 (IC 95%; 19.197 – 33.936)

  6. Median age – 67 yo (49 – 80) Bone metastases – 63% Paliative Radiation 60% Bifosfonates Analgesic use – 0: 35% 1: 59.8% 2: 14.5% 3: 25.8% Median OS - 26.567 (IC 95%; 19.197 – 33.936)

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  9. CABAZITAXEL 09 / 32

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  17. Institut Català d’Oncologia l’Hospitalet 88 Patients Received Docetaxel in a 3 weekly Schedule: Mediana 10.500 (IC 95%; 5.313 – 15.687) Second-line chemotherapy 50% Ciclofosfamide 22% Mitoxantrone 11% Docetaxel (3 wk) 11% Docetaxel (weekly) 6% Abiraterone

  18. Docetaxel 2.4 m Cabecitaxel 2.4 m ORGAN CONFINED LOCALLY ADVANCED RISING PSA HORMONE NAIVE RISING PSA ANDROGEN INDEPENDENT CLINICAL METASTASIS AI ASYMPTOMATIC CLINICAL METASTASIS AI SYMPTOMATIC 02 / 32

  19. Docetaxel 2.4 m Cabezitaxel 2.4 m Abiraterone 3.9 m Sipuleucel-T 4.1 m ORGAN CONFINED LOCALLY ADVANCED RISING PSA HORMONE NAIVE RISING PSA ANDROGEN INDEPENDENT CLINICAL METASTASIS AI ASYMPTOMATIC CLINICAL METASTASIS AI SYMPTOMATIC 02 / 32

  20. MDV3100 MDV3100 PROSTVAC IPILIMUMAB Docetaxel 2.4 m Cabezitaxel 2.4 m Abiraterone 3.9 m Sipuleucel-T 4.1 m COMBINATIONS DENOSUMAB ORGAN CONFINED LOCALLY ADVANCED RISING PSA HORMONE NAIVE RISING PSA ANDROGEN INDEPENDENT CLINICAL METASTASIS AI ASYMPTOMATIC CLINICAL METASTASIS AI SYMPTOMATIC Abiraterone 02 / 32

  21. Thank you for your attention. jrgema@iconcologia.net Gran Via, s/n km 2,7 08907 L'Hospitalet - Barcelona Tels. 93 335 70 11 / 90 11 Fax 93 260 77 83 http://www.iconcologia.net

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