Analysis and follow-up of the patients diagnosed with metastatic gastric adenocarcinoma in the Parc Taulí Hospital, Sabadell, between 2010 and 2013.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 169-169
Author(s):  
Marta Ferrer ◽  
Carles Pericay ◽  
Ismael Macias ◽  
Emma Dotor ◽  
Aleydis Pisa ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Clinical Information ◽  
Gastric Body ◽  
Second Line ◽  
First Line ◽  
Kaplan Meier ◽  
Secondary Endpoints ◽  
Third Line ◽  
Line Chemotherapy

169 Background: The primary endpoint of this study was to know the incidence and treatment of gastric carcinoma in our area. Other secondary endpoints were percentage of treated patients, overall survival (OS), survival in subgroups, and more frequent treatments. Methods: Since 2010 to 2013 all the patients diagnosed with metastatic gastric adenocarcinoma and treated at the hospital Parc Taulí from Sabadell were registered. The clinical information was compiled and analyzed. Survivals curves were determined with Kaplan-Meier functions Results: 168 patients were studied, with 79 metastatic (47%). 56% men and median age 67 years. Localizations were gastric body 52%, gastro-esophageal junction 20%, and antrum 25%. OS of the series was 5,05 months (95% CI, 2,99-7,10). 60% of the patients were treated with first line chemotherapy (CT). From them, 42% had a second line and 25% a third line. DFS were respectively 6,62 months (4,06-9,17), 4,29 months (2,28-6,30), and 2,88 months (1,12-4,64) for every line of treatment. OS of the patients that received chemotherapy was 9.7 months (6,40-13,00). CT more used in first line were triplets of fluropyrimidines, platinum and taxanes, in 45% (21 patients). Also just fluoropyrimidines and platinum without taxanes, in 38%. As a second line the predominant CT is also platinum and fluoropyrimidines (37%), and irinotecan (30%). In third line, 50% are combinations based on irinotecan. Conclusions: The OS of the patients who received CT is significantly prolonged respect the ones who didn’t. The data obtained matches the data already published in the literature, even the more frequent chemotherapy.

scholarly journals Response to first line chemotherapy regimen is associated with efficacy of Immune Checkpoint Blockade Therapies in Patients with Metastatic Urothelial Carcinoma

2021 ◽  
Author(s):  
Deniz Tural ◽  
Fatih Selçukbiricik ◽  
Ömer Fatih Ölmez ◽  
Ahmet Taner Sümbül ◽  
Mustafa Erman ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Factors ◽  
Urothelial Carcinoma ◽  
Immune Checkpoint ◽  
Clinical Benefit ◽  
Immune Checkpoint Blockade ◽  
First Line ◽  
Kaplan Meier ◽  
Line Chemotherapy

Abstract Background Atezolizumab (ATZ) has demonstrated antitumor activity in the previous studies in patients with metastatic platinum-resistant urothelial carcinoma. However, the response rate of ATZ was modest. Therefore, finding biologic or clinical biomarkers that could help to select patients who respond to the immune checkpoint blockade remains important. Patients and Methods In this study, we present the retrospective analysis of 105 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of patients were obtained from patient files and hospital records. The association between response to first-line chemotherapy and ATZ was using Fisher’s exact test. Median follow-up was calculated using the reverse Kaplan-Meier method. OS was estimated by using the Kaplan-Meier method. Results The median follow-up time was 23.5 months. Forty (74.1%) of patients who experienced clinical benefit after firs-line chemotherapy also had clinical benefit after atezolizumab, while only 14 (25.9%) of patients with initial PD after first-line chemotherapy subsequently experience clinical benefit with ATZ (p = 0.001). The median OS on ATZ of 14.8 and 3.4 months for patients with clinical benefit and progressive disease in response to first-line chemotherapy, respectively (p = 0.001). Three of the adverse prognostic factors according to the Bellmunt criteria were independent factors of short survival: liver metastases (Hazard Ratio [HR] = 1.9; p = 0.04), ECOG PS ≥ 1 (HR = 2.7; p = 0.001), and Hemoglobin level below 10 mg/dl (HR = 2.8; p < 0.001). In addition, patients with clinical benefit from first-line chemotherapy (HR = 0.39; p < 0.001) maintained a significant association with OS in multivariate analysis. Conclusions Our study demonstrated that clinical benefit from first-line chemotherapy was independent prognostic factors on OS in patients' use of ATZ as second-line treatment in metastatic bladder cancer. Furthermore, these findings are important for stratification factors for future immunotherapy study design in patients with bladder cancer who have progressed after first-line chemotherapy

Response to docetaxel (D)/carboplatin (C)-based chemotherapy as first- and second-line therapy in patients with metastatic hormone-refractory prostate cancer (HRPC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5156-5156
Author(s):  
M. Nakabayashi ◽  
O. Sartor ◽  
S. Jacobus ◽  
M. M. Regan ◽  
D. K. McKearn ◽  
...  
Keyword(s):  
Median Survival ◽  
Treatment Options ◽  
Second Line ◽  
First Line ◽  
Kaplan Meier ◽  
Psa Response ◽  
Hormone Refractory ◽  
D 20 ◽  
Chemotherapy Initiation ◽  
Line Chemotherapy

5156 Background: Effective treatment options for HRPC patients are limited. We evaluated efficacy of D/C-based chemotherapy as first- and second-line chemotherapy. Methods: We retrospectively identified all patients with HRPC treated with D/C-based chemotherapy at DFCI. Regimens either included estramustine (EDC) or not (DC). Patients treated with EDC received D 20–70 mg/m2 q1–4 weeks, E 140mg TID and C AUC 4–6 q 3–4 weeks. Patients treated with DC received D 50–70 mg/m2 and C AUC 4–5 q 3–4 weeks. PSA declines and measurable response were assessed per PSA Working Group and RECIST criteria, respectively. Time to event from chemotherapy initiation based on Kaplan-Meier method. Results: 58 patients were included: 27 patients received EDC, 35 received DC, and 4 received both regimens. Median age and PSA at initiation of chemotherapy was 58 years (range: 42–78) and 132.6 ng/ml (range: 0.3–5352.5), respectively. Table shows median duration of PSA response and TTP, by regimen. Most patients received EDC as first-line chemotherapy (89%). PSA declines ≥ 50% were observed in 24 patients (88.9%, 95% C.I. 71–98) and PSA declined in all 27 patients by a median of 81.3 % (range 33–100). Of 8 patients with measurable disease (MD), 2 had confirmed PR and 4 had SD. Median survival was 17.5 months (95% C.I. 12.0–24.5). 34 out of 35 patients received DC as ≥ 2nd line chemotherapy. PSA declines ≥ 50% were seen in 7 DC patients (20%, 95%C.I. 8–37) and PSA declined in 24 patients with a median of 37.7 % (range 2.0–100). Of 15 patients with MD at baseline, one had confirmed CR, one had PR, and 6 patients had SD. Median survival was 14.8 months (95% C.I. 9–19). The most common reversible grade 4 toxicity with either regimen was neutropenia (6.9%). Conclusions: D/C-based chemotherapy is well tolerated and active in HRPC. As first line chemotherapy, EDC demonstrated PSA declines ≥50% in 88.9% of patients. DC was active as ≥ 2nd-line chemotherapy with PSA declines ≥50% seen in 20%. [Table: see text] No significant financial relationships to disclose.

Outcome after liver transplantation compared with chemotherapy in colorectal cancer patients with nonresectable liver-only disease.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 531-531
Author(s):  
Svein Dueland ◽  
Tormod Kyrre Guren ◽  
Morten Hagness ◽  
Bengt Glimelius ◽  
Pål-Dag Line ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Second Line ◽  
First Line ◽  
Liver Malignancies ◽  
Data Set ◽  
The Difference ◽  
Third Line ◽  
Colorectal Cancer Patients ◽  
Clinical Trial Information ◽  
Line Chemotherapy

531 Background: Surgical treatment of colorectal liver metastases (CLM) is the only treatment option with curative potential; however, only about 10-20% of the patients are candidates for surgical resection. The majority of CLM patients has non-resectable disease, and receives palliative chemotherapy. These patients have poor prognosis with median OS of about 20-24 months after starting first-line chemotherapy and only about 10% survive five years. Methods: Individual data from patients with non-resectable liver only disease who had received liver transplantation (Ltx) (SECA-study, Hagness et al., Ann Surg. 2013) were compared to a similar group of patients with non-resectable liver only metastases included in the NORDIC VII study (first-line Flox chemotherapy ± Cetuximab, Tveit et al., J Clin Oncol. 2012). Twenty one patient included in the Ltx study were compared to 47 patients with liver only metastases included in the NORDIC VII study. All patients in the NORDIC VII study started first-line chemotherapy, whereas 57% of patients in the Ltx study had received second- or third-line chemotherapy at time of Ltx. Results: Median age of the Ltx group was 56 years (range 45-65 years) and 57 years (range 34-65 years) in the Nordic VII study. Median tumor size was 4.5cm (range 2.8-13.0cm) and 5.0cm (range 1.4-16.0cm) in the Ltx and Nordic VII groups, respectively. 5 year OS in the Ltx group was 60% compared to a 5 year OS of 9% in the NORDIC VII group. The 5 year OS of the 21 patients in the NORDIC VII data set with the longest OS was 19%. The patients in the Ltx study who had received only first-line chemotherapy at time of Ltx had a 5 year OS of 80%. Patients in the NORDIC VII study had an OS from end of second-line chemotherapy of 6-7 months. In comparison, patients with progressive disease on second-line/third-line chemotherapy at time of Ltx, had a median OS of 39 months and a 5 year OS of 30%. Conclusions: Patients with non-resectable CLMonly, has a dramatic improved OS after Ltx compared to chemotherapy. The difference could not be explained by patient selection. Selected patients with CRC obtain OS similar to Ltx patients transplanted for primary liver malignancies. Selected CRC patients should therefore be considered for Ltx. Clinical trial information: NCT01311453.

scholarly journals Patient Profile and Treatment Patterns in a Commercially Insured Population with Follicular Lymphoma

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5880-5880
Author(s):  
Nathan H Fowler ◽  
Yanni Hao ◽  
Stephen Lim ◽  
Guifang Chen ◽  
Frank Li ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Research Funding ◽  
Second Line ◽  
First Line ◽  
Advisory Committees ◽  
First Line Therapy ◽  
Line Therapy ◽  
Third Line ◽  
Line Of Therapy

Introduction: Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma in the Western hemisphere. Patient characteristics and burden of FL are incomplete and vary from previous studies. This study evaluated patient profile, including patient characteristics, treatment patterns, and duration using real-world data. Methods: Using the Truven MarketScan® databases, patients with FL who were newly initiated with FL indicated regimens were identified from 1/1/2010-12/31/2013 (initial treatment identification period). Patients were selected if they were ≥18 years old, had 1 FL ICD-9 code (202.0) as primary or secondary diagnosis, at least 1 FL commonly prescribed systemic anti-cancer therapy after the diagnosis, and did not use any FL indicated regimen in the past 6 months prior to first agent included in the initial treatment identification period. These patents were followed ≥3 months or to June 30, 2018. Primary outcomes were the distribution of regimens by line, the number of patients who switched from first- to second-line therapies, and from second- to third-line therapies. The treatment duration by line of therapy and regimen were also analyzed. Discontinuation was defined as 3 months without receiving a regimen after treatment. Results: This study identified 4,970 patients who initiated treatment for FL. Of these patients, 48.1% were female (n=2,390), with a mean age of 62.0 (SD: 14.0) years. The average follow-up time was approximately 2 years (median: 733 days). In this analysis, 4,970 patients with FL received first-line therapy for 153 days (median: 94 days), 1,985 received second-line therapy (39.9% of patients who received first-line therapy) for 208 days (median: 80 days), and 664 received third-line therapy (13.4% of patients who received first-line therapy) for 117 days (median: 43 days). Of the 4,970 patients on first-line therapy, 453 (9.1%) remained on first-line therapy, 2,532 (51.0%) discontinued treatment, and 1,985 (39.9%) patients switched to the next line of therapy during the follow-up period. Of the 1,985 patients who switched to second-line therapy, 328 (16.5%) remained by the end of follow-up period, 993 (50.0%) discontinued, and 664 (33.4%) switched to the next line of therapy during the follow-up period. Of the 664 patients who switched to third-line therapy, 125 (18.8%) remained, 269 (40.5%) discontinued, and 270 (40.7%) switched to the next line of therapy. The most common first-line regimens in descending order received by patients were rituximab (n=1,478, 29.7%), R-CHOP (n=1,368, 27.5%), BR (n=1,050, 21.1%), R-CVP (n=371, 7.5%), and FCR (n=63, 1.3%). Second-line treatment regimens were (N=1,985) rituximab (n=992, 50.0%), BR (n=202, 10.2%), R-CHOP (n=138, 7.0%), and R-CVP (n=120, 6.1%). Third-line treatment regimens were (N=664) rituximab (n=228, 34.3%), BR (n=91, 13.7%), R-CHOP (n=75, 11.3%), cyclophosphamide (n=35, 5.3%) and R-CVP (n=31, 4.7%). Conclusion: This data set describes the percentage of patients that transition from first- to second-line and second- to third-line treatment for FL. The primary regimens used across the treatment lines conform to those recommended by the NCCN guidelines. In addition, smaller numbers of non-recommended regimens were reported. Disclosures Fowler: Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees, Research Funding; ABBVIE: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis Pharmaceuticals Corporation: Consultancy; Roche: Membership on an entity's Board of Directors or advisory committees, Research Funding. Hao:Novartis Pharmaceuticals Corporation: Employment, Equity Ownership. Lim:Novartis Pharmaceuticals Corporation: Employment. Chen:Novartis Pharmaceuticals Corporation: Consultancy, Employment. Li:Novartis Pharmaceuticals Corporation: Employment. Arcona:Novartis Pharmaceuticals Corporation: Employment.

Outcomes of patients with metastatic colorectal carcinoma (MCRC) treated with first and second line chemotherapy at a multicenter cancer clinic

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13529-13529
Author(s):  
H. J. Lim ◽  
C. Lohrisch ◽  
C. Kollmannsberger ◽  
S. Gill ◽  
H. Kennecke ◽  
...  
Keyword(s):  
Median Number ◽  
Second Line ◽  
First Line ◽  
Related Factors ◽  
Second Line Chemotherapy ◽  
First Line Therapy ◽  
Line Therapy ◽  
Kaplan Meier ◽  
Group B ◽  
Line Chemotherapy

13529 Background: In British Columbia (BC), FOLFIRI and FOLFOX were approved for the treatment of MCRC in 2002. The effect on survival of various treatment and patient related factors was determined for patients with MCRC treated with sequential doublet chemotherapy. Methods: Eligible patients received either FOLFOX or FOLFIRI first-line with a cross over to the alternative regimen for second-line therapy. Patient records were retrospectively reviewed for patient and disease characteristics, treatment, toxicity and survival. Analysis of survival was performed by the Kaplan-Meier method. Results: Between March 2002 and June 2004, 106 new patients met the criteria above. Sixty five patients were treated with a sequence of FOLFOX-FOLFIRI (Group A): 67% M, median age 57y, rectal 20%. Forty-one were treated with the sequence FOLFIRI-FOLFOX (Group B): 64% M, median age 58y, 27% rectal. Survival was statistically similar in both groups. Progression requiring second line chemotherapy within 4 weeks of a first line treatment was associated with inferior survival (13 months vs. 21 months (p<0.018). Grade 3 or 4 toxicity was experienced in 27.5% of the patients treated with FOLFOX and 22% of the patients treated with FOLFIRI. Conclusions: In the general population with MCRC, the median survival achieved with sequential doublet therapy is consistent with that reported in clinical trials. A superior sequence was not identified. The median number of first line chemotherapy cycles with FOLFOX and FOLFIRI was similar, reflecting the general clinical practice in BC to give 10 - 12 cycles of therapy followed by a planned break. Patients who required initiation of second line chemotherapy within 4 weeks of stopping the first line therapy experienced an inferior prognosis. Univariate and multivariate analysis showed no significance of sex, age, site (colon versus rectal), and ECOG status as predictive factors. [Table: see text] No significant financial relationships to disclose.

scholarly journals Lapatinib as second-line treatment after the double block pertuzumab-trastuzumab: a case report

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 185-190
Author(s):  
Valentina Magri ◽  
Simone Scagnoli ◽  
Gabriele Piesco ◽  
Giulia Pomati
Keyword(s):  
Whole Brain Radiotherapy ◽  
Trastuzumab Emtansine ◽  
Second Line ◽  
First Line ◽  
Her2 Positive ◽  
Early Recovery ◽  
Brain Radiotherapy ◽  
Free Interval ◽  
Third Line ◽  
Line Chemotherapy

We report the case of a young, 36-year-old patient diagnosed with multifocal breast carcinoma, undergoing neoadjuvant chemotherapy, surgery and adjuvant treatment. The patient presented an early recovery of liver disease after only 7 months of free interval. Histological reevaluation after liver biopsy revealed a HER2-positive disease, for which it was treated with first line chemotherapy including double anti-HER2 block. After 3 cycles the disease progressed at liver and encephalic level. It was therefore decided to treat brain localizations with whole-brain radiotherapy and to start a second line with capecitabine associated with lapatinib. This chemo-radiotherapy approach allowed to control the disease for 8 months. Following further progression (lymph node and bone), a third line was chosen with trastuzumab emtansine (TDM1). The encephalic disease remained stable for another 8 months, when due to visceral progression and worsening of clinical picture, TDM1 was interrupted and supportive therapies were started (Oncology). .

Outcome of Transplant-Eligible Patients with Hodgkin Lymphoma with An Inadequate Response to Second Line Chemotherapy with Gemcitabine, Dexamethasone, Cisplatin (GDP).

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2179-2179
Author(s):  
Tara Seshadri ◽  
Christine Massey ◽  
Noemi Puig ◽  
Armand Keating ◽  
Michael Crump ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Salvage Chemotherapy ◽  
Inadequate Response ◽  
Second Line ◽  
First Line ◽  
Second Line Chemotherapy ◽  
Disease Characteristics ◽  
Mass Size ◽  
Line Chemotherapy

Abstract Introduction: Standard practice for patients (pts) with Hodgkin Lymphoma (HL) who relapse or are refractory to primary therapy is second line chemotherapy followed by an autologous hematopoietic cell transplant (AHCT) in those who demonstrate chemotherapysensitive disease. Management of pts who achieve less than a partial remission (PR) to first line salvage chemotherapy is unclear. We evaluated the utility of further chemotherapy in pts unresponsive to GDP and to determine transplant outcomes of pts with stable disease (SD). Methods: This was a retrospective, single centre study of 118 pts from 2001–2008 with refractory/relapsed HL after ABVD or equivalent chemotherapy who were eligible for AHCT and received GDP as first line salvage chemotherapy. Patients undergoing AHCT had progenitor cells mobilized with cyclophosphamide (2g/m2 D1), etoposide (200mg/ m2 D1–3) and G-CSF. Intensive therapy consisted of etoposide 60mg/kg and melphalan 180mg/m2. Involved field radiation was given after AHCT to disease sites &gt; 5cm. Response assessment prior to AHCT was performed using CT +/−gallium scan. Patients achieving PR or complete remission (CR) to GDP proceeded to AHCT. Pts with progressive disease (PD) on GDP were offered second line salvage chemotherapy with miniBEAM (MB; melphalan, etoposide, cytarabine, BCNU). Patients with SD post GDP were generally given further MB if residual mass was &gt;5cm or if they remained gallium avid. Results: Median age was 38, (range 18–65), 42% were female, 80% had nodular sclerosis HL. At diagnosis, 21% had limited stage (1A/2A); 29% received radiotherapy. At relapse/ progression 36% had limited stage; 25% had B symptoms; 39% had primary refractory disease; median largest mass size was 4cm (range 1–12cm). Median follow up for transplanted (n=110) and non-transplanted (n=8) pts was 25.2 and 19 months, respectively. Response rate (PR+CR) to GDP chemotherapy was 75% (88/118). Response to GDP was unknown in 1 pt. 21 patients had SD and 8 had PD. 8 pts with SD post-GDP received MB resulting in 1 PR, 4 SD (1 gallium avid) and 3 PD. Eight pts with PD post-GDP received MB resulting in 4 PR, 1 SD (gallium avid) and 3 PD. Of the 16 MB pts, 8 responded adequately (PR or SD and gallium negative) and proceeded to AHCT. Median PFS for these 8 transplanted pts was 3.5 months (range 1–23), 2 year PFS was 23%. Of the 16 pts who received MB, only 3 (19%) remain in remission, 2 with less than 6 months follow up. We compared the disease characteristics (age, gender, mass size, stage, B symptoms, time to relapse) at first relapse/progression between the pts in SD transplanted after GDP alone to the 8 pts transplanted after MB. Patients receiving MB and AHCT were more likely to have B symptoms at relapse compared to pts with SD transplanted after GDP alone, p=0.048). For pts undergoing AHCT after GDP alone, 2 year PFS for those achieving PR/CR (n=88) to GDP compared to those only achieving SD (n=13) was similar − 69% for both groups (95%CI 59–81% for PR/CR and 48–99% for SD). No difference in disease characteristics at relapse was noted between the two groups. Conclusion: Selected patients (i.e. those with low bulk who are gallium negative) transplanted in SD after GDP have a comparable outcome to those transplanted in PR/CR. Patients who require additional therapy to achieve disease control prior to AHCT have a high relapse rate despite aggressive treatment. Additional studies evaluating functional imaging to direct further therapy and novel treatment strategies for pts with an inadequate response to chemotherapy pre-AHCT are warranted.

Survival patterns by line of treatment of stage IV colorectal (CRC) patients from local U.S. oncology practice.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14141-e14141
Author(s):  
Charles Kreilick ◽  
Susan H Foltz Boklage ◽  
Sean D Sullivan ◽  
Scott David Ramsey ◽  
Sally Haislip ◽  
...  
Keyword(s):  
Single Agent ◽  
Stage Iv ◽  
Second Line ◽  
First Line ◽  
Kaplan Meier ◽  
Third Line ◽  
Survival Patterns ◽  
Oncology Practice ◽  
Lost To Follow Up ◽  
The Impact

e14141 Background: Stage IV CRC patients have varying survival results from multiple lines of treatment. The objective of this study was to evaluate in a real world context, the impact of adding a third line of chemotherapy to a stage IV CRC population. Methods: The Georgia Cancer Specialist database (2005-2011) was used. Patients with stage IV colon or rectal cancer and treated with chemotherapy were followed from initial CRC diagnosis until death, study end or lost to follow-up. Patients were stratified into lines and type of protocol for treatments. Kaplan-Meier curves were used to compare the overall survival results between lines of therapy. Results: There were 335 patients with confirmed stage IV CRC of which 35% received one protocol, 27% two protocols, and 38% received three or more protocols. The most common first line agents consisted of FOLFOX with or without bevacizumab or FOLFIRI with or without bevacizumab. Some single agent 5FU or 5FU with bevacizumab was observed in first line. The most common second agents were the FOLFOX or FOLFIRI not given in first line. However single agent capecitabine, cetuximab and bevacizumab were observed. In third line similar single agents but more panitumumab and capecitabine combinations were observed. Of those treated with second line (45) and three or more lines (75). The median survival was no different between the patients that received second line and those that went on to a third line (Log-Rank p=0.1249). Conclusions: The addition of adding a third line to a stage IV population that already received a second line failed show an association to increase survival. The benefit of adding a third line may benefit some patients and the particular combination of therapy needs to be explored in future studies.

Optimal indications for second-line chemotherapy in advanced gastric cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 105-105
Author(s):  
Hiroko Hasegawa ◽  
Kazumasa Fujitani ◽  
Shoichi Nakazuru ◽  
Motohiro Hirao ◽  
Eiji Mita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Advanced Gastric Cancer ◽  
Performance Status ◽  
Second Line ◽  
First Line ◽  
Second Line Chemotherapy ◽  
Clinicopathological Variables ◽  
Line Chemotherapy

105 Background: It remains uncertain whether every patient with advanced gastric cancer (AGC) who progresses after first-line chemotherapy should receive second-line chemotherapy. We conducted the present study to identify the optimal indications for second-line chemotherapy. Methods: In this retrospective study, 101 patients were included in univariate and multivariate analyses to identify clinicopathological variables independently associated with longer survival post progression (SPP), defined as the time from recognition of disease progression on first-line chemotherapy to death from any cause or last follow-up. Results: Median SPP of all patients was 340 days. On multivariate analysis, both performance status (PS) 2 (hazard ratio (HR), 14.234; 95% confidence interval (CI), 2.766–73.258), serum albumin (Alb) level < 3.5 g/dl (HR, 2.088; 95% CI, 1.047–4.060) at initiation of second-line chemotherapy, and time to progression (TTP) < 170 days on first-line chemotherapy (HR, 2.497; 95% CI, 1.227–5.083) were identified as independent prognostic factors for shorter SPP. Median SPP was 496, 375, and 232 days in patients with 0, 1, and 2 of these 3 negative prognostic factors, respectively (p = 0.0002). Conclusions: The present study suggests that second-line chemotherapy would be less beneficial in patients with 2 or more of the following 3 negative prognostic factors: PS 2, Alb < 3.5 g/dl at initiation of second-line chemotherapy, and TTP < 170 days on first-line chemotherapy.

Sign in / Sign up

Export Citation Format

Share Document