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    Oral etoposide as a single agent in childhood and young adult cancer in England: Still a poorly evaluated palliative treatment

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    Authors
    Fraser, J.
    Fardus-Reid, F.
    Irvine, L.
    Elliss-Brookes, L.
    Fern, L.
    Cameron, A. L.
    Pritchard-Jones, K.
    Feltbower, R. G.
    Shelton, J.
    Stiller, C
    McCabe, Martin G
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    Affiliation
    National Cancer Registration and Analysis Service (NCRAS), Public Health England, London
    Issue Date
    2021
    
    Metadata
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    Abstract
    Background: Oral etoposide is commonly used in palliative treatment of childhood and young adult cancer without robust evidence. We describe a national, unselected cohort of young people in England treated with oral etoposide using routinely collected, population-level data. Methods: Patients aged under 25 years at cancer diagnosis (1995-2017) with a treatment record of single-agent oral etoposide in the Systemic AntiCancer Dataset (SACT, 2012-2018) were identified, linked to national cancer registry data using NHS number and followed to 5 January 2019. Overall survival (OS) was estimated for all tumours combined and by tumour group. A Cox model was applied accounting for age, sex, tumour type, prior and subsequent chemotherapy. Results: Total 115 patients were identified during the study period. Mean age was 11.8 years at cancer diagnosis and 15.5 years at treatment with oral etoposide. Median OS was 5.5 months from the start of etoposide; 13 patients survived beyond 2 years. Survival was shortest in patients with osteosarcoma (median survival 3.6 months) and longest in CNS embryonal tumours (15.5 months). Across the cohort, a median of one cycle (range one to nine) of etoposide was delivered. OS correlated significantly with tumour type and prior chemotherapy, but not with other variables. Conclusions: This report is the largest series to date of oral etoposide use in childhood and young adult cancer. Most patients treated in this real world setting died quickly. Despite decades of use, there are still no robust data demonstrating a clear benefit of oral etoposide for survival.
    Citation
    Fraser J, Fardus‐Reid F, Irvine L, Elliss‐Brookes L, Fern L, Cameron AL, et al. Oral etoposide as a single agent in childhood and young adult cancer in England: Still a poorly evaluated palliative treatment. Pediatr Blood Cancer. 2021 Jul 6.
    Journal
    Pediatric Blood and Cancer
    URI
    http://hdl.handle.net/10541/624494
    DOI
    10.1002/pbc.29204
    PubMed ID
    34227732
    Additional Links
    https://dx.doi.org/10.1002/pbc.29204
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1002/pbc.29204
    Scopus Count
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    All Paterson Institute for Cancer Research

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