P17.13.A OUTCOME ANALYSIS OF PATIENTS WITH RECURRENT HIGH-GRADE GLIOMAS TREATED WITH ORAL ETOPOSIDE (VP16) IN ALBERTA, CANADA: A POPULATION-BASED RETROSPECTIVE STUDY
Notice bibliographique
Résumé
Abstract BACKGROUND Tumour recurrence in patients with gliomas is associated with short survival and there is no standard second-line therapy. Etoposide (VP16) taken orally is one of the systemic treatment options available with an acceptable safety profile in this patient population. MATERIAL AND METHODS We conducted a retrospective analysis of patients who received oral VP16 as monotherapy for the management of recurrent/progressive gliomas in Alberta, Canada 2009 - 2019 with the aim to identify the patients’ clinical and histological characteristics associated with improved outcomes with VP16. Eligible patients were identified using the provincial pharmacy records. As progression free survival (PFS) in second line treatment in these patients is < 3 months we defined as “benefiting” from VP16 those patients that completed 4 or more cycles/months of VP16. Two-tailed χ2 or Fisher’s exact tests were used to determine the significance of associations between proportions. Cox proportional hazards model and Kaplan-Meier survival analysis with log-rank test were used to determine factors associated with Overall Survival (OS) and PFS. RESULTS At the time of current abstract, data abstraction was completed for 200 out of 350 identified patients. Partial data analysis were performed on 197 patients who received at least one cycle of VP16 for recurrent glioma; 55 patients (28%) completed 4 or more cycles of VP16; patients with oligodendroglioma were 60% more likely to benefit while patients with glioblastoma were 1.56 times more likely to stop before 4 months of treatment. Patients that received 4 or more cycles of VP16 were younger (p=0.041); compared to patients > 61 years old, patients 21-31 and 41-61 years old were 82% and 29% less likely to stop before cycle 4, respectively (OR 0.18 and 0.71). Median OS from diagnoses for patients that did not benefit from VP16 was 22 (95% CI; 15.7 to 28.3) months compared to 45.7 (95% CI; 31.8 to 59.5) months in patients that were able to receive at least 4 cycles of VP16 (p=0.006). However, the proportion IDH mutated tumors, MGMT promoter methylation and use of dexamethasone at start of treatment did not differ between patients that benefit or not from VP16. As expected, lower KPS (p=0.007) and diagnoses of glioblastoma (p=0.001) were associated with worse OS. Better OS and PFS were associated with MGMT promoter methylation (p<0.0001 and p=0.030, respectively), 1p/19q codel (p=0.042 and p=0.018, respectively), and IDH mutation status (p<0.0001 and p=0.022, respectively). CONCLUSION In this retrospective series of patients with recurrent gliomas that started VP16 more than 1/4 of the patients received 4 or more cycles/months of treatment. Younger patients and those with oligodendrogliomas were more likely to benefit. We consider VP16 at 50 mg/day po a valid option for patients whose performance status would allow trying an additional line of palliative systemic treatment.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».