BACKGROUND: The standard of chemotherapy regimens for advanced or metastatic gastric cancer and the clinical outcome were heterogeneous in Asian versus non-Asian countries. This study aimed to explore predictors of safety and efficacy of chemotherapy for patients with advanced or metastatic gastric cancer. METHODS: Treatment group-based meta-analysis and met a regression were performed to analyze results of randomized trials published since 2005 for advanced or metastatic gastric cancer patients who received systemic chemotherapy as first-line treatment. Data were extracted and synthesized according to the Cochrane guidelines. RESULTS: Twenty-five trials (8 Asian, 17 Western or international) with 56 treatment groups were analyzed. Asian trials reported a lower percentage of gastroesophageal junctional carcinoma, higher percentage of diffuse type histology, and more frequent use of second-line chemotherapy. Meta-analysis revealed significant heterogeneity both in treatment safety (grade 3–4 neutropenia and diarrhea) and efficacy [6-month progression-free survival(PFS) and 1-year overall survival (OS)]. Meta-regression analyses indicate that Asian trials are associated with an 8.2% lower incidence of grade 3–4 neutropenia and 2.1%lower incidence of grade 3–4 diarrhea. A lower percentage of patients with gastroesophageal junction carcinoma and the use of combination regimens predicted better PFS. The use of second-line chemotherapy predicts better 1-year OS,which will increase by 10% for every 10% increase inpatients who received second-line chemotherapy. CONCLUSION: Geographic region (Asian vs. non-Asian) is an independent predictor of safety in systemic therapy for gastric cancer.
BACKGROUND: The standard of chemotherapy regimens for advanced or metastatic gastric cancer and the clinical outcome were heterogeneous in Asian versus non-Asian countries. This study aimed to explore predictors of safety and efficacy of chemotherapy for patients with advanced or metastatic gastric cancer. METHODS: Treatment group-based meta-analysis and met a regression were performed to analyze results of randomized trials published since 2005 for advanced or metastatic gastric cancerpatients who received systemic chemotherapy as first-line treatment. Data were extracted and synthesized according to the Cochrane guidelines. RESULTS: Twenty-five trials (8 Asian, 17 Western or international) with 56 treatment groups were analyzed. Asian trials reported a lower percentage of gastroesophageal junctional carcinoma, higher percentage of diffuse type histology, and more frequent use of second-line chemotherapy. Meta-analysis revealed significant heterogeneity both in treatment safety (grade 3–4 neutropenia and diarrhea) and efficacy [6-month progression-free survival(PFS) and 1-year overall survival (OS)]. Meta-regression analyses indicate that Asian trials are associated with an 8.2% lower incidence of grade 3–4 neutropenia and 2.1%lower incidence of grade 3–4 diarrhea. A lower percentage of patients with gastroesophageal junction carcinoma and the use of combination regimens predicted better PFS. The use of second-line chemotherapy predicts better 1-year OS,which will increase by 10% for every 10% increase inpatients who received second-line chemotherapy. CONCLUSION: Geographic region (Asian vs. non-Asian) is an independent predictor of safety in systemic therapy for gastric cancer.
Authors: Jaffer A Ajani; Miguel B Fodor; Sergei A Tjulandin; Vladimir M Moiseyenko; Yee Chao; Sebastiao Cabral Filho; Alejandro Majlis; Sylvie Assadourian; Eric Van Cutsem Journal: J Clin Oncol Date: 2005-08-20 Impact factor: 44.544
Authors: Eric Van Cutsem; Vladimir M Moiseyenko; Sergei Tjulandin; Alejandro Majlis; Manuel Constenla; Corrado Boni; Adriano Rodrigues; Miguel Fodor; Yee Chao; Edouard Voznyi; Marie-Laure Risse; Jaffer A Ajani Journal: J Clin Oncol Date: 2006-11-01 Impact factor: 44.544
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Authors: Arnaud D Roth; Nicola Fazio; Roger Stupp; Stephen Falk; Jürg Bernhard; Piercarlo Saletti; Dieter Köberle; Markus M Borner; Kaspar Rufibach; Rudolf Maibach; Martin Wernli; Martin Leslie; Robert Glynne-Jones; Lukas Widmer; Matthew Seymour; Filippo de Braud Journal: J Clin Oncol Date: 2007-08-01 Impact factor: 44.544
Authors: David R Gandara; Tomoya Kawaguchi; John Crowley; James Moon; Kiyoyuki Furuse; Masaaki Kawahara; Satoshi Teramukai; Yuichiro Ohe; Kaoru Kubota; Stephen K Williamson; Oliver Gautschi; Heinz Josef Lenz; Howard L McLeod; Primo N Lara; Charles Arthur Coltman; Masahiro Fukuoka; Nagahiro Saijo; Masanori Fukushima; Philip C Mack Journal: J Clin Oncol Date: 2009-05-26 Impact factor: 44.544
Authors: Takanobu Yamada; Takaki Yoshikawa; Masataka Taguri; Tsutomu Hayashi; Toru Aoyama; Henry M Sue-Ling; Kiran Bonam; Jeremy D Hayden; Heike I Grabsch Journal: Gastric Cancer Date: 2015-03-12 Impact factor: 7.370