Anthracycline rechallenge using PLD is effective in patients with MBC who have a favourable performance status, regardless of setting, resistance, cumulative dose or time since prior conventional anthracycline therapy.
The treatment of patients with metastatic breast cancer (MBC), who failed one or more previous chemotherapy regimens, and whose favourable performance status justifies further treatment, represents a significant challenge to the oncologist.
Moreover, patients with a favourable ECOG performance status (0 or 1) exhibited a statistically significantly higher CBR than patients with impaired ECOG performance status (2) (36 53 vs 18.2%, respectively).
In univariate analyses, the CBR was significantly higher in patients with less exposure to prior chemotherapy, in taxane-naive patients, and in patients with a favourable Eastern Cooperative Group performance status of 0 vs 1 vs 2 (53.3 vs 35.5 vs 18.2% P<0.001).
For first-line chemotherapy, favourable ECOG performance status, normal serum alkaline phosphatase (⩽ULN), absence of visceral metastases, receipt of GC (vs other regimens), absence of Bajorin risk factors (Bajorin et al, 1999) and no prior perioperative chemotherapy were each associated with longer survival in univariate analyses (Table 2).
An accelerated prescription for whole brain irradiation (WBI) in the treatment of brain metastases has been reported to provide favourable survival in good performance status patients.
The objection may be raised that our results were only possible because we selected patients with favourable prognostic factors and good performance status who were in a particularly good condition to tolerate such an intensive and toxic approach (Van Glabbeke et al, 1999).
All three studies were performed in similar populations – predominantly clear cell, metastatic RCC, the majority of patients having undergone nephrectomy and having favourable or intermediate prognosis and good performance status.
Edeline et al. and Karadimou et al. suggested that patients with a history of first-line GP chemotherapy in an adjuvant setting and a relatively better ECOG performance status had a more favourable response after second-line MVAC chemotherapy [ 11, 12].
The baseline characteristics of the cohort indicate that this study population is typical of patients with locally advanced pancreatic cancer, and, in particular, sex, age, and performance status were not more favourable than those reported in other recent studies (Blackstock et al, 2003; Rich et al, 2004).
Fifth, glioblastoma patients included in our analysis had favourable prognostic features including young age and good performance status.
