Chemotherapy: Response and Survival Data #99

Abstract

Background

Key data in the decision process regarding chemotherapy include the response rate, median duration of response, and median survival, along with toxicity and quality-of-life information (see Fast Fact #14). Table 1 synthesizes data for several common cancers. The data were derived by reviewing standard oncology textbooks, along with a Medline search of recent relevant articles.^1,2

Table 1.

Response and Survival Data for Common Solid Organ Cancers

	Response rate (%)	Median duration of response (months)	Median survival (months)
Breast	25–55	8–12	24–36
Lung (Nonsmall cell)
NSCLC, squamous^*	20–36	4–6	6–11
NSCLC, nonsquamous	20–35	4–6	10–12
Esophagus	30–50	4–6	6–9
GEJ^**	40–60	6–8	9–12
Gastric
HER2 negative	20–40	4–7	6–11
HER2 positive	∼50	6–7	12–14
Pancreas	20–32	4–6	8–11
Liver (Hepatocellular-HCC)	25–40	2–5
Nonhepatitis C-related HCC			6–10
Hepatitis C-related HCC			14
Biliary (cholangiocarcinoma)	20–35	4–8	9–14
Colon	30–45	8–10	16–21
Melanoma	15–40	4–14	6–15

NSCLC, non-squamous cell lung cancer.

GEL, gastro-esophageal junction.

Comments on the Response and Survival Data

• All data are for patients receiving first-line, commercially available, oral or IV chemotherapy, and/or biological therapy (e.g., monoclonal antibodies).

• “Response Rate” is defined as the percentage of complete and partial responders in a given trial, where “Partial Response” is ≥50% reduction in measurable tumor for one month.

• Response is typically determined after two cycles of treatment (usually one cycle every 21–28 days). Note: patients who progress after one cycle will generally continue progressing after two cycles.

• The data reflect mid-point ranges derived from the available clinical trials; most of the data represent combination chemotherapy trials. Note: for certain cancers, the benefit of combination versus single agent therapy is not proven (e.g., pancreas, biliary, and liver).

• This information is not representative of all cancer patients. The data represent the “best case” outcome, from a population of patients who were in good enough health to participate in a clinical trial (e.g., ambulatory and good functional status). Actual responses and response durations for a nonclinical trial population will likely be poorer.

• Second-line chemotherapy, after disease progression from first-line treatment, can be expected to have a lower response rate and shorter duration of response.

• Median survival data include both responders and nonresponders. Note: patients who respond to chemotherapy typically live longer than those who do not.

References

DeVita

, Lawrence

, Rosenberg

: DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2014.

Hong

, et al. eds. Holland-Frei Cancer Medicine, 8th ed. Hamilton, ON: BC Decker, 2010.