A novel clinical prognostic index for patients with advanced gastric cancer: possible contribution to the continuum of care

180 Background: In advanced gastric cancer (AGC), there are many reports about prognostic factors for overall survival (OS), and we have proposed a prognostic index using four prognostic factors (PS, number of metastatic sites, prior gastrectomy and ALP; Oncologist 2014) based on a phase III trial JCOG 9912 for the first-line treatment (Lancet Oncol. 2009). However, there is no report about prognostic factors for progression free survival (PFS). In this ancillary study, we explored whether prognostic factors are similar or not between OS and PFS. Methods: The subjects of this study were selected from the JCOG9912 which intended to confirm the superiority of irinotecan plus cisplatin (IP) and the non-inferiority of S-1 to5-FU for patients with AGC. Of all enrolled patients in JCOG9912, those who had target lesions and whose complete data were available were analyzed with multivariate analysis using Cox proportional hazard model. Results: 492 out of the 703 pts of JCOG9912 were analyzed, who received either 5-FU (n=163), IP (n=164) or S-1(n=165). The median PFS was 3.7 months for all the subjects, and 2.2 months for 5-FU, 4.9 months for IP and 3.8 months for S-1. Multivariate analysis in all 492 analyzed patients demonstrated seven independent prognostic factors for PFS (Table). Prognostic factors in each treatment were; sex (HR 1.66, 95%CI 1.11-2.49), PS (1.51, 1.04-2.18), Ca (0.39, 0.17-0.86), GPT (2.46, 1.30-4.66) and LDH (1.67, 1.16-2.48) in 5-FU, sex (1.77, 1.10-2.86) in IP, and Na (2.00, 1.01-3.99) and creatinine clearance (0.37, 0.15-0.93) in S-1. Conclusions: There were no common prognostic factors among the three treatment regimens. Prognostic factors for PFS may be different by treatment regimen, although further investigations with larger sample size are needed. [Table: see text]

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Three-Tier Prognostic Index in Young Adults With Advanced Gastric Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.667655 ◽

2021 ◽

Vol 11 ◽

Author(s):

Guang-Liang Chen ◽

Yan Huang ◽

Wen Zhang ◽

Xu Pan ◽

Wan-Jing Feng ◽

...

Keyword(s):

Gastric Cancer ◽

Young Adults ◽

Prognostic Factors ◽

Advanced Gastric Cancer ◽

Prognostic Index ◽

Risk Groups ◽

Radical Gastrectomy ◽

Cox Regression Analysis ◽

Poor Risk ◽

Number Of Patients

PurposeTo characterize clinical features and identify baseline prognostic factors for survival in young adults with advanced gastric cancer (YAAGC).Materials and MethodsA total of 220 young inpatients (age less than or equal to 40 years) with an initial diagnosis of advanced gastric cancer were retrospectively enrolled in this study.ResultsOf a consecutive cohort of 220 patients with YAAGC, the median overall survival (OS) time was 16.3 months. One-year survival rate was 43.6% (95% CI: 36.5 to 50.7). In this cohort, a female (71.4%, n = 157) predominance and a number of patients with poorly differentiated tumors (95.9%, n = 211) were observed. In the univariate analysis, OS was significantly associated with neutrophil–lymphocyte ratio (NLR) (≥3.12), hypoproteinemia (<40 g/L), presence of peritoneal or bone metastases, and previous gastrectomy of primary tumor or radical gastrectomy. In multivariate Cox regression analysis, hypoproteinemia [hazard ratio (HR) 1.522, 95% CI 1.085 to 2.137, p = 0.015] and high NLR level (HR 1.446, 95% CI 1.022 to 2.047, p = 0.021) were two independent poor prognostic factors, while previous radical gastrectomy was associated with a favorable OS (HR 0.345, 95% CI 0.205 to 0.583, p = 0.000). A three-tier prognostic index was constructed dividing patients into good-, intermediate-, or poor-risk groups. Median OS for good-, intermediate-, and poor-risk groups was 36.43, 17.87, and 11.27 months, respectively.ConclusionsThree prognostic factors were identified, and a three-tier prognostic index was devised. The reported prognostic index may aid clinical decision-making, patient risk stratification, and planning of future clinical studies on YAAGC.

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Prognostic factor of nivolumab for advanced gastric cancer patients with poor performance status patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.391 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 391-391

Author(s):

Toshihiko Matsumoto ◽

Ukyo Okazaki ◽

Yusuke Kurioka ◽

Shogo Kimura ◽

Takao Tsuzuki ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Prognostic Factor ◽

Advanced Gastric Cancer ◽

Performance Status ◽

Prognostic Index ◽

Poor Performance ◽

Poor Performance Status ◽

Good Group ◽

Poor Group

391 Background: Nivolumab has changed the treatment of advanced gastric cancer (AGC). Nivolumab shows better outcome compared to best supportive care in AGC patients who received at least two prior regimen. Although there is not reliable date of poor performance status(PS) AGC patients who received nivolumab. We investigated efficacy and safety of nivolumab for AGC patients with poor PS. Methods: We retrospectively collected clinicopathologic data from patients with AGC who received nivolumab monotherapy in Himeji Red Cross Hospital from October 2017 to June 2019. Results: 49 AGC patients who received nivolumab were analyzed. 27 patients were PS 0 or 1(Good Group), and 22 patients were PS 2 or 3(Poor Group). Median progression free survival and overall survival was 61 days and 180 days in Good Group and 36 days and 85 days in Poor Group. Overall survival (OS) was significantly shorter in Poor group(180 days vs 85 days, p = 0.0255). Disease control rate was 23% in Good group and 9% in Poor group. 33% patients were experienced immune related adverse event (iRAE) in Good Group, and 18% in Poor Group. We investigated prognostic factor of OS in Poor Group such as Royal Marsden Hospital Score(RMH score), modified Glasgow prognostic score(mGPS), and Japan Clinical Oncology Group (JCOG) prognostic index. RMH score and JCOG prognostic index good or moderate group was significantly longer overall survival than poor group (93 days vs 35 days (p = 0.0214)). JCOG prognostic index was most correlated with OS among these tools. Conclusions: This study suggested that nivolumab has a modest effect and is feasible as third line or later line for AGC patients. JCOG prognostic index was suggested to be effective in predicting prognosis in AGC patients who received nivolumab.

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Association of the Pretreatment Lung Immune Prognostic Index with Survival Outcomes in Advanced Gastric Cancer Patients Treated with Immune Checkpoint Inhibitors

Clinics and Research in Hepatology and Gastroenterology ◽

10.1016/j.clinre.2021.101748 ◽

2021 ◽

pp. 101748

Author(s):

Baicun Hou ◽

Peng Wang ◽

Tingting Liu ◽

Shixue Chen ◽

Tao Li ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Cancer Patients ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Prognostic Index ◽

Survival Outcomes ◽

Gastric Cancer Patients

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A new angiogenesis prognostic index with VEGFA, PlGF, and angiopoietin1 predicts survival in patients with advanced gastric cancer

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-1509-80 ◽

2017 ◽

Vol 47 ◽

pp. 399-406 ◽

Cited By ~ 7

Author(s):

Sedef Hande AKTAŞ ◽

Hakan AKBULUT ◽

Ozan YAZICI ◽

Nurullah ZENGİN ◽

Halime Nalan AKGÜN ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Prognostic Index

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Validation of the JCOG prognostic index in advanced gastric cancer using individual patient data from the SPIRITS and G-SOX trials

Gastric Cancer ◽

10.1007/s10120-017-0702-0 ◽

2017 ◽

Vol 20 (5) ◽

pp. 757-763 ◽

Cited By ~ 6

Author(s):

Daisuke Takahari ◽

Junki Mizusawa ◽

Wasaburo Koizumi ◽

Ichinosuke Hyodo ◽

Narikazu Boku

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Individual Patient Data ◽

Prognostic Index ◽

Patient Data

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Evaluation of usefulness of Royal Marsden Hospital prognostic index in second-line chemotherapy of advanced gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.163 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 163-163

Author(s):

Takahide Sasaki ◽

Yoshito Komatsu ◽

Satoshi Yuki ◽

Kazuaki Harada ◽

Yoshimitsu Kobayashi ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Prognostic Factor ◽

Advanced Gastric Cancer ◽

Prognostic Index ◽

Second Line ◽

First Line ◽

Second Line Chemotherapy ◽

Royal Marsden Hospital ◽

Line Chemotherapy

163 Background: Royal Marsden Hospital prognostic Index (RMH-I), which was based on performance status, ALP, liver metastasis and peritoneal metastasis, was reported as prognostic factor of advanced esophago-gastric cancer before first line chemotherapy (Chau I, et al. J Clin Oncol 22:2395-2403, 2004). Usefulness of RMH-I in second line chemotherapy is not elucidated. Methods: Advanced gastric cancer patients who started second line chemotherapy in Hokkaido University Hospital from July 2001 to May 2013 with prior fluoropyrimidine plus platinum administration were retrospectively analyzed. Univariate and multivariate analysis for overall survival were performed using patient characteristics (RMH-I, hemoglobin, CRP, CEA, Alb, TTP in first line, primary lesion resection, and bone metastasis). Survival analyses were performed with Kaplan-Meier method, log-rank test and Cox proportional hazards model. Results: There were 77 eligible patients. Male/Female were 52/25, median age was 60 years (range 31-80) and unresectable/recurrent were 70/7. Median survival was 7.1 months. The distribution and median survival for RMH-I groups were as follows: good risk (n = 8), 8.2 months; moderate risk (n = 57), 9.6 months; and poor risk (n = 12), 4.4 months. Although poor risk group showed shorter survival time, there were not significant difference regardless of RMH-I in Cox multivariate analysis (HR 1.12, 95%CI 0.61-2.09, P=0.72). Conclusions: In this retrospective analysis, RMH-I was not independent prognostic factor in second line chemotherapy of advanced gastric cancer. Prognostic factors in this population need to be investigated further.

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Multimodality Treatment in Metastatic Gastric Cancer: Working Together to Tailor the Continuum of Care

Journal of Clinical Medicine ◽

10.3390/jcm10235492 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5492

Author(s):

Angelica Petrillo

Keyword(s):

Gastric Cancer ◽

Multimodality Treatment ◽

Metastatic Gastric Cancer ◽

Continuum Of Care ◽

Working Together ◽

The Continuum

Gastric cancer (GC) represents one of the most frequent and lethal tumors worldwide today, finding itself in fifth place in terms of incidence and third in terms of mortality [...]

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