PRINCIPLES: There are very limited data suggesting a benefit for second-line chemotherapy in advanced gastric cancer. Therefore, the number of patients who receive further treatment after failure of first-line chemotherapy varies considerably, ranging from 14% to 75%. In the absence of a demonstrated survival benefit of second-line chemotherapy, appropriate selection of patients based on survival predictors is essential. However, no clinico-pathologic parameters are currently widely adopted in clinical practice. We looked exclusively at Caucasian patients with metastatic gastric cancer treated with second-line chemotherapy to see if we could establish prognostic factors for survival. METHODS: This study retrospectively evaluated 43 Caucasian patients with metastatic gastric cancer treated with second-line chemotherapy at the Geneva University Hospital. Prognostic values of clinico-pathologic parameters were analysed by Cox regression for overall survival (OS). RESULTS: Univariate analysis found three variables to be associated with survival: progression-free survival (PFS) at first-line chemotherapy of more than 26 weeks (hazard ratio (HR) = 0.33, confidence interval (CI) 95% 0.16-0.65, p = 0.002), previous curative surgery (HR = 0.51, CI 95% 0.27-0.96, p = 0.04) and carcinoma embryonic antigen (CEA) >6.5 μg/l (HR = 1.97, CI 95% 1.06-3.65, p = 0.03). CONCLUSIONS: In line with published data, sensitivity to previous chemotherapy identifies Caucasian patients who will survive the longest following second-line chemotherapy. A low tumour burden and previous curative gastrectomy also seem to have a positive prognostic value.
PRINCIPLES: There are very limited data suggesting a benefit for second-line chemotherapy in advanced gastric cancer. Therefore, the number of patients who receive further treatment after failure of first-line chemotherapy varies considerably, ranging from 14% to 75%. In the absence of a demonstrated survival benefit of second-line chemotherapy, appropriate selection of patients based on survival predictors is essential. However, no clinico-pathologic parameters are currently widely adopted in clinical practice. We looked exclusively at Caucasian patients with metastatic gastric cancer treated with second-line chemotherapy to see if we could establish prognostic factors for survival. METHODS: This study retrospectively evaluated 43 Caucasian patients with metastatic gastric cancer treated with second-line chemotherapy at the Geneva University Hospital. Prognostic values of clinico-pathologic parameters were analysed by Cox regression for overall survival (OS). RESULTS: Univariate analysis found three variables to be associated with survival: progression-free survival (PFS) at first-line chemotherapy of more than 26 weeks (hazard ratio (HR) = 0.33, confidence interval (CI) 95% 0.16-0.65, p = 0.002), previous curative surgery (HR = 0.51, CI 95% 0.27-0.96, p = 0.04) and carcinoma embryonic antigen (CEA) >6.5 μg/l (HR = 1.97, CI 95% 1.06-3.65, p = 0.03). CONCLUSIONS: In line with published data, sensitivity to previous chemotherapy identifies Caucasian patients who will survive the longest following second-line chemotherapy. A low tumour burden and previous curative gastrectomy also seem to have a positive prognostic value.
Authors: S Keskin; I Yıldız; F Sen; F Aydogan; L Kilic; M Ekenel; S Saglam; B Sakar; R Disci; F Aykan Journal: Clin Transl Oncol Date: 2012-10-02 Impact factor: 3.405
Authors: M Martin-Richard; R Gallego; C Pericay; J Garcia Foncillas; B Queralt; E Casado; J Barriuso; V Iranzo; I Juez; L Visa; E Saigi; A Barnadas; X Garcia-Albeniz; J Maurel Journal: Invest New Drugs Date: 2013-12 Impact factor: 3.850