PMID- 36657323
OWN - NLM
STAT- MEDLINE
DCOM- 20230223
LR  - 20230325
IS  - 1879-0852 (Electronic)
IS  - 0959-8049 (Linking)
VI  - 181
DP  - 2023 Mar
TI  - A post hoc analysis of the EPAZ trial: The role of geriatric variables in elderly 
      soft tissue sarcoma patients on toxicity and outcome.
PG  - 145-154
LID - S0959-8049(22)01814-7 [pii]
LID - 10.1016/j.ejca.2022.12.012 [doi]
AB  - OBJECTIVE: The EPAZ study (NCT01861951) showed recently that pazopanib was 
      non-inferior to doxorubicin in patients >/=60 years treated in first line for 
      advanced soft tissue sarcoma . The current post-hoc analysis aimed to assess the 
      prognostic impact of frailty. METHODS: Geriatric assessments were evaluated at 
      baseline. Age >75 years, liposarcoma, ECOG = 2, G8 </=14, instrumental activities 
      of daily living (IADL) >/=1 and Charlson Comorbidity Index >/=2 were tested for their 
      impact on progression-free survival (PFS), overall survival (OS), CTCAE grade 3/4 
      adverse events (AEs) or serious AEs (SAEs), using univariate and multivariate 
      analysis models. RESULTS: univariate analysis showed an increased risk of grade 
      3/4 AEs and SAEs for ECOG = 2, G8 score </=14 or IADL >/=1, independent of treatment. 
      The multivariate analysis exhibited for pazopanib a significantly reduced risk 
      for grade 3/4 AEs (HR 0.53; p = 0.033), and in patients with G8 </=14 an increased 
      risk for SAEs (HR 2.67; p = 0.011). In the multivariate analysis, G8 </=14 was a 
      negative prognostic factor for PFS (HR 1.82; p = 0.009) and IADL >/=1 for OS (HR 
      2.02; p = 0.007). ECOG = 2 was the strongest negative predictor for PFS (HR 4.39; 
      p = 0.001) and OS (HR 3.74; p = 0.004). Neither age nor Charlson Comorbidity 
      Index showed any impact on PFS, OS, incidence of grade 3/4 AEs or SAEs. 
      CONCLUSIONS: This post hoc analysis demonstrated that age is not a denominator 
      for outcome or toxicity in elderly patients with soft tissue sarcoma . Instead, 
      geriatric and functional assessments should be used to counsel patients and 
      tailor therapy to individual needs. Moreover, pazopanib has a reduced risk for 
      grade 3/4 AEs compared to doxorubicin.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Hamacher, Rainer
AU  - Hamacher R
AD  - Department of Medical Oncology, Sarcoma Center, West German Cancer Center, 
      University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German 
      Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
FAU - Liu, Xiaofei
AU  - Liu X
AD  - Institute for Biostatistics, Hannover Medical School, Hannover, Germany.
FAU - Schuler, Markus K
AU  - Schuler MK
AD  - Division of Hematology, Oncology and Stem Cell Transplantation, Medical Clinic I, 
      Department of Medicine I, University Hospital Carl Gustav Carus, Technical 
      University Dresden, Dresden, Germany.
FAU - Hentschel, Leopold
AU  - Hentschel L
AD  - National Center for Tumor Diseases (NCT/UCC), University Hospital Carl Gustav 
      Carus, Dresden, Germany.
FAU - Schoffski, Patrick
AU  - Schoffski P
AD  - Department of General Medical Oncology, University Hospitals Leuven, Leuven 
      Cancer Institute, KU Leuven, Leuven, Belgium.
FAU - Kopp, Hans-Georg
AU  - Kopp HG
AD  - Robert Bosch Centrum fur Tumorerkrankungen Stuttgart, Stuttgart, Germany.
FAU - Bauer, Sebastian
AU  - Bauer S
AD  - Department of Medical Oncology, Sarcoma Center, West German Cancer Center, 
      University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German 
      Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
FAU - Kasper, Bernd
AU  - Kasper B
AD  - Sarcoma Unit, Mannheim University Medical Center, Mannheim, Germany.
FAU - Lindner, Lars
AU  - Lindner L
AD  - Department of Medicine III, University Hospital, Ludwig Maximilian University 
      Munich, Munich, Germany.
FAU - Chemnitz, Jens-Markus
AU  - Chemnitz JM
AD  - Community Hospital Middle Rine, Middle Rine, Germany; Department of Hematology, 
      Oncology, Clinical Infectious Diseases, Clinical Immunology, Hemostaseology and 
      Medical Intensive Care, University Hospital Cologne, Cologne, Germany.
FAU - Crysandt, Martina
AU  - Crysandt M
AD  - Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, 
      Medical Faculty, RWTH Aachen University, Center for Integrated Oncology Aachen 
      Bonn Cologne Dusseldorf (CIO ABCD), Aachen, Germany.
FAU - Stein, Alexander
AU  - Stein A
AD  - University Hospital Hamburg-Eppendorf, Hamburg-Eppendorf, Germany.
FAU - Steffen, Bjorn
AU  - Steffen B
AD  - University Hospital Frankfurt, Frankfurt, Germany.
FAU - Richter, Stephan
AU  - Richter S
AD  - National Center for Tumor Diseases (NCT/UCC), University Hospital Carl Gustav 
      Carus, Dresden, Germany.
FAU - Egerer, Gerlinde
AU  - Egerer G
AD  - University Hospital Heidelberg, Heidelberg, Germany.
FAU - Ivanyi, Philipp
AU  - Ivanyi P
AD  - Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, 
      Medical School Hannover, Hannover, Germany.
FAU - Kunitz, Annegret
AU  - Kunitz A
AD  - Vivantes Clinic Berlin-Spandau, Berlin-Spandau, Germany; Department of 
      Hematology, Oncology and Tumor Immunology, University Hospital Charite, Berlin, 
      Germany.
FAU - Grunwald, Viktor
AU  - Grunwald V
AD  - German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, 
      Germany; Interdisciplinary Genitourinary Oncology at the West-German Cancer 
      Center, Clinic for Internal Medicine (Tumor Research) and Clinic for Urology, 
      University Hospital Essen, Essen, Germany. Electronic address: 
      viktor.gruenwald@uk-essen.de.
LA  - eng
SI  - ClinicalTrials.gov/NCT01861951
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221227
PL  - England
TA  - Eur J Cancer
JT  - European journal of cancer (Oxford, England : 1990)
JID - 9005373
RN  - 80168379AG (Doxorubicin)
RN  - 0 (Indazoles)
RN  - 7RN5DR86CK (pazopanib)
SB  - IM
MH  - Aged
MH  - Humans
MH  - Activities of Daily Living
MH  - Doxorubicin/adverse effects
MH  - Indazoles/adverse effects
MH  - *Sarcoma/drug therapy
MH  - *Soft Tissue Neoplasms
OTO - NOTNLM
OT  - Doxorubicin
OT  - EPAZ
OT  - Elderly
OT  - Frailty
OT  - Geriatric
OT  - Pazopanib
OT  - Post-hoc
OT  - Prognosis
OT  - Soft tissue sarcoma
OT  - Toxicity
EDAT- 2023/01/20 06:00
MHDA- 2023/02/15 06:00
CRDT- 2023/01/19 18:15
PHST- 2022/09/19 00:00 [received]
PHST- 2022/12/02 00:00 [revised]
PHST- 2022/12/15 00:00 [accepted]
PHST- 2023/01/20 06:00 [pubmed]
PHST- 2023/02/15 06:00 [medline]
PHST- 2023/01/19 18:15 [entrez]
AID - S0959-8049(22)01814-7 [pii]
AID - 10.1016/j.ejca.2022.12.012 [doi]
PST - ppublish
SO  - Eur J Cancer. 2023 Mar;181:145-154. doi: 10.1016/j.ejca.2022.12.012. Epub 2022 
      Dec 27.