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Sex moderates circadian chemotherapy effects on survival of patients with metastatic colorectal cancer : a meta-analysis
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Giacchetti, S., Dugue, P. A., Innominato, P. F., Bjarnason, G. A., Focan, C., Garufi, C., Tumolo, S., Coudert, B., Iacobelli, S., Smaaland, R., Tampellini, M., Adam, R., Moreau, T. and Lévi, Francis A. (2012) Sex moderates circadian chemotherapy effects on survival of patients with metastatic colorectal cancer : a meta-analysis. Annals of Oncology, Volume 23 (Number 12). pp. 3110-3116. doi:10.1093/annonc/mds148
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Official URL: http://dx.doi.org/10.1093/annonc/mds148
Abstract
BACKGROUND:
Molecular circadian clocks can modify cancer chemotherapy effects, with a possible moderation according to sex differences. We investigated whether sex determine the optimal delivery schedule of chemotherapy for metastatic colorectal cancer.
PATIENTS AND METHODS:
A meta-analysis was performed using individual data from three international Phase III trials comparing 5-fluorouracil, leucovorin and oxaliplatin administered in chronomodulated (chronoFLO) or conventional (CONV) infusions. The data from 345 females and 497 males were updated at 9 years. The main end point was survival.
RESULTS:
Overall survival was improved in males on chronoFLO when compared with CONV (P = 0.009), with respective median values of 20.8 (95% CL, 18.7 to 22.9) and 17.5 months (16.1 to 18.8). Conversely, median survival was 16.6 months (13.9 to 19.3) on chronoFLO and 18.4 months (16.6 to 20.2) on CONV in females (P = 0.012). The sex versus schedule interaction was a strong predictive factor of optimal treatment schedule, with a hazard ratio of 1.59 (1.30 to 1.75) for overall survival (P = 0.002) in multivariate analysis.
CONCLUSIONS:
Males lived significantly longer on chronomodulated chemotherapy rather than on conventional chemotherapy. The current chronoFLO schedule deserves prospective assessment as a safe and more effective first-line treatment option than conventional delivery for male patients.
| Item Type: | Journal Article | ||||||
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| Subjects: | Q Science > QP Physiology R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science > Centre for Systems Biology Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Circadian rhythms, Cancer—Chemotherapy--Sex differences , Metastasis , Rectum--Cancer , Colon (Anatomy)--Cancer | ||||||
| Journal or Publication Title: | Annals of Oncology | ||||||
| Publisher: | Oxford University Press | ||||||
| ISSN: | 0923-7534 | ||||||
| Official Date: | December 2012 | ||||||
| Dates: |
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| Volume: | Volume 23 | ||||||
| Number: | Number 12 | ||||||
| Number of Pages: | 7 | ||||||
| Page Range: | pp. 3110-3116 | ||||||
| DOI: | 10.1093/annonc/mds148 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| Funder: | Association pour la Recherche sur le Temps Biologique et la Chronothérapie (ARTBC International, Hôpital Universitaire Paul Brousse (Villejuif, France) |
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