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Fast Fact and Concept #099: Chemotherapy: response and survival data

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Title: Fast Fact and Concept #099: Chemotherapy: response and survival data

Author(s): Weissman, David E; von Gunten, Charles F

Key data in the decision process regarding chemotherapy includes the response rate, median duration of response and median survival, along with toxicity and quality of life information (see Fast Fact #14: Palliative Chemotherapy). The table below synthesized data for several common cancers. The data was derived by reviewing two standard oncology textbooks, along with a Medline search of recent relevant articles.

Cancer Type Response Rate Median Duration of Response Median Survival (1)
Breast (2) 25-55% 6-12 months 24-36 months
Colon (3) 25-35% 6-8 months 12-18 months
Lung - Non-Small Cell 20-30% 4-6 months 6-9 months
Esophagus 30-50% 4-6 months 6-9 months
Stomach 20-30% 4-6 months 6-9 months
Melanoma 15-25% 4-6 months 6-9 months
Pancreas (4) 15-25% 3-5 months 6-9 months
Liver (Hepatoma) 5-15% 2-4 months 6-9 months
Biliary (Cholangioca) 5-15% 2-4 months 6-9 months
  1. Median survival data includes both responders and non-responders; Patients who respond to chemotherapy typically live longer than those who do not.
  2. Breast cancer is an extremely heterogeneous disease, thus the large response rate range
  3. Data from trials of 5FU/Leukovorin versus Irinotecan or Oxaliplatin
  4. Trials of Gemcitabine combination chemotherapy -- some of these trials use the term "objective response" which is a less rigorous term than the traditional "partial response", thus the benefit may be overstated.
References
Cancer Principles and Practice of Oncology. 6th Edition DeVita, et al. 2001 Lippincott Williams and Wilkins
Cancer Treatment. 5th edition Haskell CM 2001 WB Saunders

Schiller JH. Harrington D. Belani CP. et al. The Eastern Cooperative Oncology Group.
Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. New England Journal of Medicine. 346(2):92-8, 2002

Copyright/Referencing Information: Users are free to download and distribute Fast Facts for educational purposes only. Citation for referencing: Weissman DE and von Gunten CF. Fast Facts and Concepts #99. Chemotherapy: response and survival data. October 2003. End-of-Life Physician Education Resource Center www.eperc.mcw.edu.

Disclaimer: Fast Facts provide educational information, this information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Fact information cites the use of a product in dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.

Creation Date: 10/2003

Format: Handouts

Purpose: Instructional Aid, Self-Study Guide, Teaching

Audience(s)
Training: Fellows, 3rd/4th Year Medical Students, PGY1 (Interns), PGY2-6, Physicians in Practice
Specialty: Anesthesiology, Emergency Medicine, Family Medicine, General Internal Medicine, Geriatrics, Hematology/Oncology, Neurology, OB/GYN, Ophthalmology, Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery
Non-Physician: Nurses

ACGME Competencies: Medical Knowledge, Patient Care

Keyword(s): Adult, Cancer, Radiation or chemotherapy


The Fast Facts series is distributed for educational use only and does not constitute medical advice. For the most current version of Fast Facts visit the EPERC web site at www.eperc.mcw.edu. This mirror version is provided subject to copyright restrictions for educational use within the Inter-Instutional Collaborating Network on End-of-Life Care (IICN).