Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Müller, M; Posch, F; Kiem, D; Barth, D; Horvath, L; Stotz, M; Schaberl-Moser, R; Pichler, M; Greil, R; Jost, PJ; Seeber, A; Amann, A; Schlick, K; Gerger, A; Riedl, JM.
Benefit of second-line therapy for advanced esophageal squamous cell carcinoma: a tri-center propensity score analysis.
Ther Adv Med Oncol. 2021; 13: 17588359211039930
Doi: 10.1177/17588359211039930
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- Leading authors Med Uni Graz
- Müller Moritz
- Riedl Jakob
- Co-authors Med Uni Graz
- Barth Dominik Andreas
- Gerger Armin
- Jost Philipp
- Pichler Martin
- Posch Florian
- Schaberl-Moser Renate
- Schlick Konstantin
- Stotz Michael
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- Abstract:
- Background: The level of evidence for palliative second-line therapy in advanced esophageal squamous cell carcinoma (aESCC) is limited. This is the first study that reports efficacy data comparing second-line therapy + active symptom control (ASC) versus ASC alone in aESCC. Methods: We conducted a tri-center retrospective cohort study (n = 166) including patients with aESCC who had experienced disease progression on palliative first-line therapy. A propensity score model using inverse probability of treatment weighting (IPTW) was implemented for comparative efficacy analysis of overall survival (OS) in patients with second-line + ASC (n = 92, 55%) versus ASC alone (n = 74, 45%). Results: The most frequent second-line regimens used were docetaxel (36%) and paclitaxel (18%). In unadjusted primary endpoint analysis, second-line + ASC was associated with significantly longer OS compared with ASC alone [hazard ratio (HR) = 0.49, 95% confidence interval (CI): 0.35-0.69, p < 0.0001]. However, patients in the second-line + ASC group were characterized by more favorable baseline features including a better Eastern Cooperative Oncology Group (ECOG) performance status, a longer first-line treatment duration and lower C-reactive protein levels. After rigorous adjusting for baseline confounders by re-weighting the data with the IPTW the favorable association between second-line and longer OS weakened but prevailed. The median OS was 6.1 months in the second-line + ASC group and 3.2 months in the ASC group, respectively (IPTW-adjusted HR = 0.40, 95% CI: 0.24-0.69, p = 0.001). Importantly, the benefit of second-line was consistent across several clinical subgroups, including patients with ECOG performance status ⩾1 and age ⩾65 years. The most common grade 3 or 4 adverse events associated with palliative second-line therapy were hematological toxicities. Conclusion: This real-world study supports the concept that systemic second-line therapy prolongs survival in patients with aESCC.
- Find related publications in this database (Keywords)
- best supportive care
- oesophageal cancer
- palliative treatment
- real-world study
- second line therapy