Sex-related differences in survival were not identified in
a recent study by the north central cancer treatment group
( ncctg ). 9 trials ( six phase ii and 3 phase iii, five
of them platinum-based ), conducted from 1985 to twenty01, were
retrospectively thought of. within the multivariate analysis, sex
wasn't an freelance prognostic issue for improved overall
survival and time to progression. similar to the previously
mentioned study, a distinction in toxicity was observed : both
grade 3 hematologic and nonhematologic toxicities were
higher in girls than in men with or of one. sixty ( p zero. 0007 )
and one. 71 ( p 0. 001 ), respectively. 133
the tax 326 trial was a multinational, phase iii study
of docetaxel and carboplatin ( dcb ) or docetaxel and cisplatin
( dc ) versus the reference regimen of vinorelbine and cisplatin
( vc ). baseline characteristics were well balanced across treatment
teams. approximately 2 thirds of the patients in each
treatment cluster had stage iv disease. within the pairwise comparison
of dc versus vc, the overall survival times were 11. three versus
ten. one months, respectively ( p zero. 044 ). the 1- and 2-year survival
rates were 46% versus 41% and 21% versus 14% for dc
versus vc, respectively. the overall response rates were thirty one. 6% for
dc and twenty four. 5% for vc ( p zero. 029 ). mst and overall response
rates were similar within the pairwise comparison of dc versus vc,
and among every arm of the study, it's been reported a trend favoring
a survival advantage for ladies. 134, 135 similar to ecog
1594, sex differences in toxicity were conjointly noted : girls were
a lot of probably than men to develop grade 3 nausea and vomiting
and neurotoxicity across all 3 treatment arms, whereas the
different hematological and nonhematological toxicity was similar
for each teams.
one potential explanation for this higher survival outcome
in girls is differences in dna-repair capacities between the
sexes, creating girls a lot of responsive to platinum-based
chemotherapies. dna repair machinery ought to be, on average,
a lot of defective in girls, creating them a lot of susceptible
to respiratory carcinogens however conjointly a lot of sensitive to dnainterfering
agents.
nsclc is thought of a neoplastic disease relatively resistant
to chemotherapy, and this resistance has been associated
with elevated nucleotide excision repair ( ner ) in tumor tissue.
during a case-control study, 375 patients with newly diagnosed
nsclc were accrued, and ner activity was estimated
by the dna repair capability ( drc ) measured within the patient’s
peripheral blood lymphocytes by the host cell reactivation
assay. for each unit of increase in drc, a progressive increase
within the rr of death was observed. of these 86 patients
treated with chemotherapy, patients within the high quartile of
the drc distribution were at twice the rr of death as those
within the lowest quartile ( rr two. 72 ; 95% ci, one. twenty four to five. 95 ;
p zero. 01 ), whereas effective drc wasn't a risk issue for
death in patients who were not treated with chemotherapy.
in univariate analysis of the relationship between drc and
clinical and demographic variables, drc was significantly
higher in men than in girls ( eight. 37% two. 92% vs. seven. 13%
two. 37%, respectively ; p 0. 001 ) however wasn't connected stage
of disease, histology, differentiation of the tumor, or selfreported
weight loss. 136
a few fascinating knowledge concerning differential activity by sex
are emerging for paclitaxel poliglumex, a drug that combines
paclitaxel with poly-l-glutamic acid, a biodegradable polymer
that's broken right all the way down to the active type by cathepsin b, which
is modulated by estrogens. in 2 phase iii studies, paclitaxel
poliglumex didn't show any advantage over commonplace chemotherapy.
but, during a subgroup of 198 girls from these two
studies, it had been found that it created a more robust survival in younger
premenopausal girls, particularly those with higher circulating
levels of estrogens. 137 on the idea of those results, a phase iii
study comparing paclitaxel poliglumex and carboplatin versus
paclitaxel and carboplatin was designed, recruiting solely female
patients with advanced lung cancer patients, who are premenopausal
or taking estrogen replacement therapy. more studies
evaluating estrogen levels and outcomes in lung cancer patients
are required to grasp the mechanism and significance of
these findings. it's doable that estrogens not solely influence
tumor proliferation, however conjointly alter chemotherapy efficacy and/or
carcinogen metabolism to affect patient survival.
a recent study by the north central cancer treatment group
( ncctg ). 9 trials ( six phase ii and 3 phase iii, five
of them platinum-based ), conducted from 1985 to twenty01, were
retrospectively thought of. within the multivariate analysis, sex
wasn't an freelance prognostic issue for improved overall
survival and time to progression. similar to the previously
mentioned study, a distinction in toxicity was observed : both
grade 3 hematologic and nonhematologic toxicities were
higher in girls than in men with or of one. sixty ( p zero. 0007 )
and one. 71 ( p 0. 001 ), respectively. 133
the tax 326 trial was a multinational, phase iii study
of docetaxel and carboplatin ( dcb ) or docetaxel and cisplatin
( dc ) versus the reference regimen of vinorelbine and cisplatin
( vc ). baseline characteristics were well balanced across treatment
teams. approximately 2 thirds of the patients in each
treatment cluster had stage iv disease. within the pairwise comparison
of dc versus vc, the overall survival times were 11. three versus
ten. one months, respectively ( p zero. 044 ). the 1- and 2-year survival
rates were 46% versus 41% and 21% versus 14% for dc
versus vc, respectively. the overall response rates were thirty one. 6% for
dc and twenty four. 5% for vc ( p zero. 029 ). mst and overall response
rates were similar within the pairwise comparison of dc versus vc,
and among every arm of the study, it's been reported a trend favoring
a survival advantage for ladies. 134, 135 similar to ecog
1594, sex differences in toxicity were conjointly noted : girls were
a lot of probably than men to develop grade 3 nausea and vomiting
and neurotoxicity across all 3 treatment arms, whereas the
different hematological and nonhematological toxicity was similar
for each teams.
one potential explanation for this higher survival outcome
in girls is differences in dna-repair capacities between the
sexes, creating girls a lot of responsive to platinum-based
chemotherapies. dna repair machinery ought to be, on average,
a lot of defective in girls, creating them a lot of susceptible
to respiratory carcinogens however conjointly a lot of sensitive to dnainterfering
agents.
nsclc is thought of a neoplastic disease relatively resistant
to chemotherapy, and this resistance has been associated
with elevated nucleotide excision repair ( ner ) in tumor tissue.
during a case-control study, 375 patients with newly diagnosed
nsclc were accrued, and ner activity was estimated
by the dna repair capability ( drc ) measured within the patient’s
peripheral blood lymphocytes by the host cell reactivation
assay. for each unit of increase in drc, a progressive increase
within the rr of death was observed. of these 86 patients
treated with chemotherapy, patients within the high quartile of
the drc distribution were at twice the rr of death as those
within the lowest quartile ( rr two. 72 ; 95% ci, one. twenty four to five. 95 ;
p zero. 01 ), whereas effective drc wasn't a risk issue for
death in patients who were not treated with chemotherapy.
in univariate analysis of the relationship between drc and
clinical and demographic variables, drc was significantly
higher in men than in girls ( eight. 37% two. 92% vs. seven. 13%
two. 37%, respectively ; p 0. 001 ) however wasn't connected stage
of disease, histology, differentiation of the tumor, or selfreported
weight loss. 136
a few fascinating knowledge concerning differential activity by sex
are emerging for paclitaxel poliglumex, a drug that combines
paclitaxel with poly-l-glutamic acid, a biodegradable polymer
that's broken right all the way down to the active type by cathepsin b, which
is modulated by estrogens. in 2 phase iii studies, paclitaxel
poliglumex didn't show any advantage over commonplace chemotherapy.
but, during a subgroup of 198 girls from these two
studies, it had been found that it created a more robust survival in younger
premenopausal girls, particularly those with higher circulating
levels of estrogens. 137 on the idea of those results, a phase iii
study comparing paclitaxel poliglumex and carboplatin versus
paclitaxel and carboplatin was designed, recruiting solely female
patients with advanced lung cancer patients, who are premenopausal
or taking estrogen replacement therapy. more studies
evaluating estrogen levels and outcomes in lung cancer patients
are required to grasp the mechanism and significance of
these findings. it's doable that estrogens not solely influence
tumor proliferation, however conjointly alter chemotherapy efficacy and/or
carcinogen metabolism to affect patient survival.
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