# 099 Chemotherapy: Response and Survival Data, 2nd ed

FAST FACT AND CONCEPT #099 PDF


Author(s): David E Weissman MD and Charles F von Gunten MD

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

Comments on the Response and Survival Data

  • All data are for patients receiving chemotherapy for metastatic or locally advanced cancer (not receiving adjuvant or neoadjuvant chemotherapy).
  • All data is for first-line, commercially available oral or IV chemotherapy or biological therapy (such as monoclonal antibodies). 
  • ‘Response Rate’ is defined as the percentage of complete and partial responders in a given trial, where ‘Partial Response’ = > 50% reduction in measurable tumor for one month. 
  • Response is typically determined after 2 cycles of treatment (usually one cycle every 21-28 days); however, patients who progress after 1 cycle will generally continue progressing after two.
  • The data reflect mid-point ranges derived from the available clinical trials; most of the data represent combination chemotherapy trials. Note: for certain cancers, the benefit of combination vs. single agent therapy is not proven (e.g. pancreas, biliary, liver). 
  • This information is not representative of all cancer patients. The data represent the ‘best case’ outcome, from a population of patients who were in good enough health to participate in a clinical trial (e.g. ambulatory, good functional status). Actual responses and response durations for a non-clinical trial population will likely be poorer.
  • Data for biliary, pancreas, esophagus and liver come from many small trials (< 50 patients), thus the upper end figures are likely to be overestimated.
  • Second-line chemotherapy, following disease progression from first-line treatment, can be expected to have a lower response rate and shorter duration of response.
  • Median survival data includes both responders and non-responders; patients who respond to chemotherapy typically live longer than those who do not.

 

 

Response

Rate

Median Duration of

Response

Median Survival
Breast 25-55% 6-12 months 24-36 months
Colon 25-35% 6-8 months 12-18 months
Esophagus 30-50% 4-6 months 6-9 months
Lung (Non-Small Cell) 20-30% 4-6 months 6-9 months
Stomach 20-50% 4-6 months 6-12 months
Melanoma 15-25% 4-6 months 6-9 months
Pancreas 10-25% 3-5 months 6-9 months
Liver (Hepatocellular) 5-15% 2-4 months 6-9 months
Biliary (Cholangio) 15-25% 2-4 months 6-9 months

 

References

  1. DeVita VT, et al, eds. Cancer: Principles and Practice of Oncology. 7th Edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
  2. Kufe DW, et al, eds. Holland-Frei Cancer Medicine. 7th Edition. Hamilton, Ontario: BC Decker; 2006.

Fast Facts and Concepts are edited by Drew A Rosielle MD, Palliative Care Center, Medical College of Wisconsin. For more information write to: drosiell@mcw.edu. More information, as well as the complete set of Fast Facts, are available at EPERC: www.eperc.mcw.edu.

Version History: This Fast Fact was originally edited by David E Weissman MD. 2nd Edition was edited by Drew A Rosielle and published November 2007. Current version re-copy-edited April 2009.

Copyright/Referencing Information: Users are free to download and distribute Fast Facts for educational purposes only. Weissman DE, von Gunten CF. Chemotherapy: Response and Survival data, 2nd Edition. Fast Facts and Concepts. November 2007; 99. Available at: http://www.eperc.mcw.edu/EPERC/FastFactsIndex/ff_099.htm.

Disclaimer: Fast Facts and Concepts provide educational information. This information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Facts cite the use of a product in a 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.

ACGME Competencies: Medical Knowledge, Patient Care

Keyword(s): Non-Pain Symptoms and Syndromes; Prognosis