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Poster display session

1116 - Accuracy and prognostic significance of oncologists’ estimates and scenarios for survival time in a randomised phase 2 trial of regorafenib in advanced gastric cancer

Date

09 Sep 2017

Session

Poster display session

Presenters

Anuradha Vasista

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

A. Vasista1, A. Martin1, N. Pavlakis2, K. Sjoquist1, S. Snow3, D. Jonker4, Y.J. Chua5, R. Epstein6, A. Bonaventura7, M. Khasraw8, S.C. Varma9, N. Singhal10, D.T. Ransom11, F. Aubin12, R. Burkes13, H. Lim14, F. Lemay15, S. Begbie16, M.R. Stockler1, B. Kiely1

Author affiliations

  • 1 Medical Oncology, NHMRC Clinical Trials Centre, 1450 - Camperdown/AU
  • 2 Medical Oncology, Royal North Shore Hospital, 2065 - St Leonards/AU
  • 3 Medical Oncology, Queen Elizabeth II Health Sciences Centre, Nova Scotia/CA
  • 4 Medical Oncology, Ottawa Health Research Institute, K1H8L6 - Ottawa/CA
  • 5 Medical Oncology, Canberra Hospital, 2605 - Garran/AU
  • 6 Medical Oncology, St Vincents Hospital, 2010 - Darlinghurst/AU
  • 7 Medical Oncology, Newcastle Private Hospital, 2298 - Newcastle/AU
  • 8 Medical Oncology, Geelong Hospital, 3220 - Geelong/AU
  • 9 Medical Oncology, Townsville Hospital, 4814 - Douglas/AU
  • 10 Medical Oncology, Royal Adelaide Hospital, 5000 - Adelaide/AU
  • 11 Medical Oncology, St John of God, Subiaco, Subiaco/AU
  • 12 Medical Oncology, Hospital Notre Dame, H2L 4M1 - Montreal/CA
  • 13 Medical Oncology, Mount Sinai Hospital, M5G 1X5 - Toronto/CA
  • 14 Medical Oncology, BCCA Vancouver Cancer Centre, V5Z 4E6 - Vancouver/CA
  • 15 Medical Oncology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke/CA
  • 16 Medical Oncology, North Coast Cancer Centre, 2444 - Port Macquarie/AU
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Resources

Abstract 1116

Background

We have proposed that best, worst and typical scenarios for survival, based on simple multiples of an individual’s expected survival time (EST) estimated by their oncologist, are a useful way of formulating and explaining prognosis in advanced cancer. We aimed to determine the accuracy and prognostic significance of such estimates in a multicentre, randomized trial.

Methods

66 oncologists estimated the EST at baseline for each of 152 participants in the INTEGRATE trial. We expected oncologists’ estimates of EST to be well calibrated (∼50% of patients living longer or shorter than their EST) and imprecise (

Results

Oncologists’ estimates of EST were well calibrated (45% shorter than observed), imprecise (29% lived within 0.67 to 1.33 times observed), and moderately discriminative (Harrell C-statistic 0.62, P = 0.001). Scenarios derived from oncologists’ estimates were remarkably accurate: 9% of patients died within a quarter of their EST, 12% lived longer than three times their EST and 57% lived within half to double their EST. Oncologists estimates of EST (in months) were independently significant predictors of overall survival (HR = 0.89, 95% CI 0.83 to 0.95, P = 0.001) in a Cox model including ECOG performance status, primary site, number of metastatic sites, neutrophil to lymphocyte ratio≥ 3, treatment group, age, and the EORTC QLQC30 physical function score.

Conclusions

Oncologists’ estimates of survival time were well calibrated, moderately discriminative, and independently significant predictors of overall survival. Best, worst and typical scenarios for survival based on simple multiples of the EST were remarkably accurate and would provide a useful method for estimating and explaining prognosis in this setting.

Clinical trial identification

Legal entity responsible for the study

NHMRC Clinical Trials Centre

Funding

None

Disclosure

N. Pavlakis: Consultant and/or advisory role, honoraria: Specialised Therapeutics, Pfizer, Novartis, Amgen, Bayer, BI, Roche, Sanofi Aventis, Merch-Serono, AstraZeneca. K. Sjoquist: Travel to ASCO funded by Merck-Serono in 2013. S. Snow: Consultant and/or advisory role: Celgene. Honoraria: Celgene, Merck, BMS, Roche, Novartis, BI, Amgen, Eli Lilly, Astra Zenenca. Research funding: Merck, BMS. A. Bonaventura, D.T. Ransom: Travel expenses: Ipsen. M. Khasraw: Consultant and/or advisory role: AbbVie, BMS, Eli Lilly. Research funding: AbbVie and STA. N. Singhal: Honoraria: Novartis, Pfizer. Travel expenses: Astra Zeneca. R. Burkes: Consultant and/or advisory role: Astra Zeneca, Merck Serono, Eli Lilly, Roche, Amgen. Honoraria: AstraZeneca, Merck Serono, Eli Lilly, Roche, Amgen. F. Lemay: Consultant and/or advisory role: Esperas Pharma Inc. Honoraria: Esperas Pharma Inc. All other authors have declared no conflicts of interest.

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