scholarly journals Multimodality Treatment Including Triplet Regimen as First-Line Chemotherapy May Improve Prognosis of Serum AFP-Elevated Gastric Cancer with Liver Metastasis

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Yakun Wang ◽  
Lin Shen ◽  
Ming Lu ◽  
Zhi Ji ◽  
Xiaotian Zhang
Keyword(s):  
Gastric Cancer ◽  
Liver Metastasis ◽  
Poor Prognosis ◽  
Local Treatment ◽  
Multimodality Treatment ◽  
First Line ◽  
High Incidence ◽  
Gastric Cancer Patients ◽  
Line Chemotherapy ◽  
Triplet Regimen

Serum α-fetoprotein- (AFP-) elevated gastric cancer is a rare tumor that has a poor prognosis due to high incidence of liver metastasis. This study sought to investigate the optimal treatment modality. A total of 319 gastric cancer patients with liver metastasis (GCLM) whose serum AFP levels were tested before treatment were enrolled in this study. They were classified as the serum AFP ≥ 20 ng/ml group (n=74) and the AFP < 20 ng/ml group (n=245). Median OS of the AFP < 20 ng/ml group was significantly longer than that of the AFP ≥ 20 ng/ml group (15.7 m versus 10.9 m, P=0.004). ORR of first-line chemotherapy was 43.3% and 56.1% of the two groups, respectively (P=0.024). Of patients who received doublet regimen, ORR of the AFP ≥ 20 ng/ml group was significantly lower (38.2 versus 56.9%, P=0.013), while in those received triplet regimens, ORR between two groups was similar (66.7% versus 66.7%, P=0.676). Moreover, for patients of the AFP ≥ 20 ng/ml group, those who reached PR had a longer survival period (15.4 m versus 9.4 m, P=0.017), and combined with local treatment for liver metastasis also seemed to improve prognosis (19.2 m versus 8.4 m, P=0.003). In conclusion, serum AFP-elevated GCLM had a poorer prognosis. Multimodality treatment including aggressive first-line chemotherapy with triplet regimen may be needed when treating them.

Elevation of Neutrophil-to-Lymphocyte Ratio before First-Line Chemotherapy Predicts a Poor Prognosis for Second-Line Chemotherapy in Gastric Cancer

Oncology ◽  
2018 ◽  
Vol 96 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Dai Inoue ◽  
Shuhei Sekiguchi ◽  
Wataru Yamagata ◽  
Gen Maeda ◽  
Daiki Yamada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Poor Prognosis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Second Line ◽  
First Line ◽  
Lymphocyte Ratio ◽  
Second Line Chemotherapy ◽  
Line Chemotherapy

Tumor angiogenesis genotyping and efficacy of first-line chemotherapy in metastatic gastric cancer patients.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 64-64
Author(s):  
Mario Scartozzi ◽  
Riccardo Giampieri ◽  
Cristian Loretelli ◽  
Alessandro Bittoni ◽  
Alessandra Mandolesi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Metastatic Gastric Cancer ◽  
Second Line ◽  
Tumour Angiogenesis ◽  
First Line ◽  
Altered Expression ◽  
Second Line Chemotherapy ◽  
Gastric Cancer Patients ◽  
Line Chemotherapy

64 Background: An altered expression of tumour angiogenesis-related factors has been constantly associated to a more aggressive phenotype and an increased relapse rate in several tumour types, including gastric cancer. Besides correlating with prognosis, tumour-driven angiogenesis seemed also able to influence response/resistance to chemotherapy in pre-clinical models. We examined the role of tumour angiogenesis genotyping in determining clinical outcome in metastatic gastric cancer patients receiving first-line chemotherapy. Methods: VEGF-A, VEGF-C, FLT1, KDR and FLT4 genotyping was performed on gastric tumours from 94 consecutive patients receiving platinum-based first-line chemotherapy. Results: Only theVEGF A rs25648 correlated with RR (PR = 18% among patients showing the VEGF A rs25648 CT or TT genotype vs. 44% among patients showing the VEGF A rs25648 CC genotype, p = 0.04). The VEGF A (rs2010963) and VEGF C (rs4604600 and rs7664413) correlated with mPFS and the VEGF A rs25648 and FLT4 rs307833 correlated with both mPFS and OS. Among other clinical variables tested (sex, age, ECOG performance status, gastrectomy, adjuvant chemotherapy, metastatic sites and second-line chemotherapy) only the use of second-line chemotherapy correlated with improved overall survival (10.2 months vs. 6.3 months for patients who received or did not receive second-line, p= 0.003). At multivariate the VEGF A rs25648 maintained an independent role in determining both median PFS (HR = 1.65 95% CI: 1.12-2.78, p= < 0.0001) and OS (HR = 1.58, 95% CI: 1.17-2.65, p = 0.0003). The use of second-line chemotherapy also showed an independent role in determining median OS (HR = 0.58, 95% CI: 0.38-0.87, p= 0.003). Conclusions: VEGF A rs25648 genotyping may help identifying a patients subgroup unlikely to benefit from a first-line, platinum-based combination and potentially candidate to alternative therapy choices. Our data may help designing future clinical trials with the aim to investigate the outcome of different chemotherapy regimens in different patients groups prospectively stratified according to angiogenesis profile.

scholarly journals DNA damage repair and survival outcomes in advanced gastric cancer patients treated with first-line chemotherapy

2017 ◽  
Vol 140 (11) ◽  
pp. 2587-2595 ◽  
Author(s):  
Livia Ronchetti ◽  
Elisa Melucci ◽  
Francesca De Nicola ◽  
Frauke Goeman ◽  
Beatrice Casini ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Dna Damage ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Dna Damage Repair ◽  
Survival Outcomes ◽  
First Line ◽  
Damage Repair ◽  
Gastric Cancer Patients ◽  
Line Chemotherapy
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