Detailed Information on Publication Record
2019
Individualization of Treatment Improves the Survival of Children With High-Risk Solid Tumors: Comparative Patient Series Analysis in a Real-Life Scenario
KÝR, Michal, Kristýna POLÁŠKOVÁ, Zuzana KUTTNEROVÁ, Tomáš MERTA, Jakub NERADIL et. al.Basic information
Original name
Individualization of Treatment Improves the Survival of Children With High-Risk Solid Tumors: Comparative Patient Series Analysis in a Real-Life Scenario
Authors
KÝR, Michal (203 Czech Republic, guarantor, belonging to the institution), Kristýna POLÁŠKOVÁ (203 Czech Republic, belonging to the institution), Zuzana KUTTNEROVÁ (703 Slovakia, belonging to the institution), Tomáš MERTA (203 Czech Republic, belonging to the institution), Jakub NERADIL (203 Czech Republic, belonging to the institution), Jitka BERKOVCOVÁ (203 Czech Republic), Ondřej HORKÝ (203 Czech Republic), Marta JEŽOVÁ (203 Czech Republic, belonging to the institution), Renata VESELSKÁ (203 Czech Republic, belonging to the institution), Giannoula Lakka KLEMENT (124 Canada), Dalibor VALÍK (203 Czech Republic) and Jaroslav ŠTĚRBA (203 Czech Republic, belonging to the institution)
Edition
Frontiers in Oncology, Lausanne, Frontiers Media S.A. 2019, 2234-943X
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30204 Oncology
Country of publisher
Switzerland
Confidentiality degree
není předmětem státního či obchodního tajemství
References:
Impact factor
Impact factor: 4.848
RIV identification code
RIV/00216224:14110/19:00108598
Organization unit
Faculty of Medicine
UT WoS
000475875500001
Keywords in English
cancer; children; personalized medicine; targeted therapy; comparative effectiveness research; clinical trials; metronomic
Tags
International impact, Reviewed
Změněno: 26/4/2021 12:55, Mgr. Tereza Miškechová
Abstract
V originále
Introduction: The individualization of treatment is attractive, especially in children with high-risk cancer. In such a rare and very heterogeneous group of diseases, large population-based clinical randomized trials are not feasible without international collaboration. We therefore propose comparative patient series analysis in a real-life scenario. Methods: Open cohort observational study, comparative analysis. Seventy patients with high-risk solid tumors diagnosed between 2003 and 2015 and in whom the treatment was individualized either empirically or based on biomarkers were analyzed. The heterogeneity of the cohort and repeated measurements were advantageously utilized to increase effective sample size using appropriate statistical tools. Results: We demonstrated a beneficial effect of empirically given low-dose metronomic chemotherapy (HR 0.46 for relapses, p = 0.017) as well as various repurposed or targeted agents (HR 0.15 for deaths, p = 0.004) in a real-life scenario. However, targeted agents given on the basis of limited biological information were not beneficial. Conclusions: Comparative patient series analysis provides institutional-level evidence for treatment individualization in high-risk pediatric malignancies. Our findings emphasize the need for a comprehensive, multi omics assessment of the tumor and the host as well whenever molecularly driven targeted therapies are being considered. Low-dose metronomic chemotherapy or local control of the disease may be a more rational option in situations where targeted treatment cannot be justified by robust evidence and comprehensive biological information. "Targeted drugs" may be given empirically with a realistic benefit expectation when based on robust rationale.
Links
LM2015090, research and development project |
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MUNI/A/1586/2018, interní kód MU |
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NV16-33209A, research and development project |
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NV16-34083A, research and development project |
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90089, large research infrastructures |
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