Second-line treatment in advanced gastric cancer: Data from the Spanish AGAMENON registry
Cotes Sanchís, Almudena; Gallego, Javier; Hernandez, Raquel; Arrazubi, Virginia; Custodio, Ana; Cano, Juana María; Aguado, Gema; Macias, Ismael; Lopez, Carlos; López, Flora; Visa, Laura; Garrido, Marcelo; Martinez Lago, Nieves Purificacion; Fernández Montes, Ana; Limón, María Luisa; Azkárate, Aitor; Pimentel, Paola; Reguera, Pablo; Ramchandani, Avinash; Cacho, Juan Diego; Martín Carnicero, Alfonso; Granja, Mónica; Martín Richard, Marta; Hernández Pérez, Carolina; Hurtado, Alicia; Serra, Olbia; Buxo, Elvira; Vidal Tocino, Rosario; Jimenez-Fonseca, Paula; Carmona-Bayonas, Alberto
Identificadores
Identificadores
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Fecha de publicación
2020Título de revista
PLoS One
Tipo de contenido
Journal Article
DeCS
protocolos de quimioterapia antineoplásica combinada | anciano | compuestos de platino | neoplasias gástricas | mediana edad | humanos | análisis de supervivencia | adulto | sistema de registros | antineoplásicosMeSH
Stomach Neoplasms | Platinum Compounds | Survival Analysis | Adult | Middle Aged | Humans | Registries | Aged | Antineoplastic Combined Chemotherapy Protocols | Antineoplastic AgentsResumen
BACKGROUND: Second-line treatments boost overall survival in advanced gastric cancer (AGC). However, there is a paucity of information as to patterns of use and the results achieved in actual clinical practice. MATERIALS AND METHODS: The study population comprised patients with AGC in the AGAMENON registry who had received second-line. The objective was to describe the pattern of second-line therapies administered, progression-free survival following second-line (PFS-2), and post-progression survival since first-line (PPS). RESULTS: 2311 cases with 2066 progression events since first-line (89.3%) were recorded; 245 (10.6%) patients died during first-line treatment and 1326/2066 (64.1%) received a second-line. Median PFS-2 and PPS were 3.1 (95% CI, 2.9-3.3) and 5.8 months (5.5-6.3), respectively. The most widely used strategies were monoCT (56.9%), polyCT (15.0%), ramucirumab+CT (12.6%), platinum-reintroduction (8.3%), trastuzumab+CT (6.1%), and ramucirumab (1.1%). PFS-2/PPS medians gradually increased in monoCT, 2.6/5.1 months; polyCT 3.4/6.3 months; ramucirumab+CT, 4.1/6.5 months; platinum-reintroduction, 4.2/6.7 months, and for the HER2+ subgroup in particular, trastuzumab+CT, 5.2/11.7 months. Correlation between PFS since first-line and OS was moderate in the series as a whole (Kendall's tau = 0.613), lower in those subjects who received second-line (Kendall's tau = 0.539), especially with ramucirumab+CT (Kendall's tau = 0.413). CONCLUSION: This analysis reveals the diversity in second-line treatment for AGC, highlighting the effectiveness of paclitaxel-ramucirumab and, for a selected subgroup of patients, platinum reintroduction; both strategies endorsed by recent clinical guidelines.