scholarly journals Associations between early tumor shrinkage and depth of response and clinical outcomes in patients treated with 1st-line chemotherapy for advanced gastric cancer

2017 ◽  
Vol 21 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Hiroki Osumi ◽  
Daisuke Takahari ◽  
Eiji Shinozaki ◽  
Keisho Chin ◽  
Mariko Ogura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Clinical Outcomes ◽  
Tumor Shrinkage ◽  
Depth Of Response ◽  
Early Tumor Shrinkage ◽  
Early Tumor ◽  
Line Chemotherapy

Comparison of early tumor shrinkage between oxaliplatin plus S-1 and cisplatin plus S-1 in first-line chemotherapy with advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 75-75
Author(s):  
Hiroki Osumi ◽  
Daisuke Takahari ◽  
Eiji Shinozaki ◽  
Keisho Chin ◽  
Mariko Ogura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Predictive Factor ◽  
Phase Iii ◽  
Tumor Shrinkage ◽  
Independent Predictive Factor ◽  
Early Tumor Shrinkage ◽  
Study Results ◽  
Early Tumor ◽  
Line Chemotherapy

75 Background: Early tumor shrinkage (ETS) is regarded as predictive marker in metastatic colorectal cancer. In the phase III study comparing oxaliplatin plus S-1 (SOX) to cisplatin plus S-1 (SP) in patients with advanced gastric cancer (AGC), although response rates were almost same between two groups, ETS wasn’t evaluated. Therefore, in AGC, it is controversial whether ETS is predictive or not and which is more suitable regimen, especially as neo adjuvant chemotherapy (NAC). The aim of this study is to compare ETS in SOX with SP and to evaluate the relationship between ETS and clinical outcomes in AGC. Methods: We retrospectively enrolled consecutive 469 patients (SOX 128, SP 341) with histopathologically confirmed HER2 negative AGC treated as 1st-line chemotherapy or NAC in our institution between January 2010 and June 2016. ETS was defined relative change in the sum of the longest diameters of target regions at week 8 (±4) compared to baseline. (Cut-off: 20%). Tumor response was assessed computed tomography using the RECIST 1.1. Patients with peritoneal metastasis and/or bone metastasis without target region were excluded in this study. Results: 192 patients (SOX 60, SP 132) were included in this study. Median tumor shrinkage between SOX and SP were 30% (min-35%, max77%) and 21% (min-89%, max73%), respectively ( p= .16). The ratio of ETS between SOX and SP was 53.3% and 50.7%, respectively ( p= .75). ETS > 20% was associated with longer OS and PFS when compared with ETS≦20% in SOX group. (ETS > 20% vs≦20%: OS 15.3 vs 10.1 months, HR 0.47 p= .03 PFS 7.6 vs 4.2 months, HR 0.58 p= .09) On the other hand, ETS > 20% was associated with significantly longer PFS only when compared with ETS≦20% in SP group and significant independent predictive factor. (ETS > 20% vs≦20%: OS 15.7 vs 10.9 months, HR 0.79 p= .29 PFS 7.7 vs 4.0 months, HR 0.57 p= .01) In multivariate analysis, ETS remained significant independent predictive factor for PFS in SP group (HR 0.53, p= .006). Conclusions: The ratio of ETS was similar between SOX and SP. ETS may be an early-on-treatment predictor in AGC.

scholarly journals What is the best fluoropyrimidine + platinum for advanced gastric cancer (AGC) ? -the inspect of early tumor shrinkage-

2015 ◽  
Vol 26 ◽  
pp. vii104
Author(s):  
Naotoshi Sugimoto ◽  
Tetsuhiro Yoshinami ◽  
Sachiko Yamamoto ◽  
Toshinari Yagi ◽  
Fumio Imamura
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumor Shrinkage ◽  
Early Tumor Shrinkage ◽  
Early Tumor

Early tumor shrinkage and depth of response as predictors of favorable treatment outcomes in patients with metastatic colorectal cancer treated with FOLFOX/FOLFIRI plus cetuximab.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 631-631
Author(s):  
S.P. Somashekhar ◽  
Amit Rauthan ◽  
Ashwin K Rajgopal ◽  
Rohit Kumar C
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Tumor Shrinkage ◽  
Wild Type ◽  
First Line ◽  
Free Survival ◽  
Depth Of Response ◽  
Early Tumor Shrinkage ◽  
Early Tumor ◽  
Line Chemotherapy

631 Background: Early tumor shrinkage (ETS) and depth of response (DoR) predict overall survival (OS) in first-line chemotherapy + anti-EGFR monoclonal antibodies in KRAS wild-type metastatic colorectal cancer (mCRC). This association and the predictive accuracy of response measurements were investigated in the first-line setting for FOLFOX/FOLFIRI plus cetuximab. Methods: We performed a study of FOLFOX/FOLFIRI plus cetuximab as first-line treatment in Indian patients with KRAS wild-type mCRC. The primary endpoint was response rate (RR), and secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. Radiologic assessments at week 8 were used to calculate the relative change in the sum of the longest diameters of the target lesions. Cox regression models analysis investigated associations between ETS and overall survival (OS) and progression-free survival (PFS). Results: Sixty (78.9 %) of 76 patients had ETS, which was associated with prolonged PFS and OS. Both ETS and DoR were able to predict survival as accurately as RECIST response. Both ETS and DoR were associated with PFS and OS at the univariate analyses and in the multivariate models stratified for other prognostic variables. In the study patients, the RR, median PFS, and OS were 68.4 %, 13.1 months, and 30.6 months, respectively. Median DpR was 52%. The DpR correlated with OS as well as PFS. FOLFOX plus cetuximab was active as a first-line, with no major toxicities. Conclusions: Our prospective evaluation of chronological tumor shrinkage showed that ETS and DpR correlate with outcomes in patients with KRAS wild-type mCRC who receive cetuximab-based chemotherapy. Achieving rapid and deep tumor shrinkage consistently delays tumor progression and prolongs survival in patients treated with first-line chemotherapy plus cetuximab. ETS is a promising and valuable end point for clinical trials’ design deserving further investigation.

scholarly journals Early Tumor Shrinkage and Depth of Response Evaluation in Metastatic Pancreatic Cancer Treated with First Line Chemotherapy: An Observational Retrospective Cohort Study

Cancers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 939 ◽  
Author(s):  
Caterina Vivaldi ◽  
Lorenzo Fornaro ◽  
Carla Cappelli ◽  
Irene Pecora ◽  
Silvia Catanese ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Progression Free Survival ◽  
Metastatic Pancreatic Cancer ◽  
Tumor Shrinkage ◽  
First Line ◽  
Free Survival ◽  
Depth Of Response ◽  
Early Tumor Shrinkage ◽  
Early Tumor

Early tumor shrinkage (ETS) and depth of response (DoR) predict favorable outcomes in metastatic colorectal cancer. We aim to evaluate their prognostic role in metastatic pancreatic cancer (PC) patients treated with first-line modified-FOLFIRINOX (FOLFOXIRI) or Gemcitabine + Nab-paclitaxel (GemNab). Hence, 138 patients were tested for ETS, defined as a ≥20% reduction in the sum of target lesions’ longest diameters (SLD) after 6–8 weeks from baseline, and DoR, i.e., the maximum percentage shrinkage in the SLD from baseline. Association of ETS and DoR with progression-free survival (PFS) and overall survival (OS) was assessed. ETS was reached in 49 patients (39.5% in the FOLFOXIRI, 29.8% in the GemNab group; p = 0.280). In the overall population, ETS was significantly associated with better PFS (8.0 vs. 4.8 months, p < 0.001) and OS (13.2 vs. 9.7 months, p = 0.001). Median DoR was −27.5% (−29.4% with FOLFOXIRI and −21.4% with GemNab, p = 0.016): DoR was significantly associated with better PFS (9.0 vs. 6.7 months, p < 0.001) and OS (14.3 vs. 11.1 months, p = 0.031). Multivariate analysis confirmed both ETS and DoR are independently associated with PFS and OS. In conclusion, our study added evidence on the role of ETS and DoR in the prediction of outcome of PC patients treated with first-line combination chemotherapy.

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