Abstract
Purpose: We analyzed the natural history of advanced gastric cancer with sequential salvage chemotherapy following first-line treatment. Methods: We studied 532 patients with unresectable gastric adenocarcinoma who were treated at Yonsei Cancer Center (2000-2008). The patients were managed with multiple sequential salvage chemotherapy as allowed by performance status and toxicity profiles. The tumor response was assessed every two cycles. Results: Four hundred sixty patients received palliative chemotherapy and 72 received supportive care only. The median overall survival was 12.0 months for all patients, 12.1 months for the chemotherapy group, and 2.5 months for the supportive care group (P <0.001). In the chemotherapy group, 87% received first-line chemotherapy, 47% second-line, 23% third-line, 9% fourth-line, and 3% fifthline. Response rates were 24.8, 12.6, 10.9, 2.6, and 0% and disease control rates were 76.3, 60.1, 54.2, 54.2, and 53.3% for first-to fifth-line treatment, respectively. The median progression-free survival was 5.5, 3.4, 2.5, 1.9, and 2.0 months and overall survival was 12.1, 7.9, 5.5, 5.0, and 6.8 months. Performance status and metastatic pattern were consistent prognostic factors throughout salvage treatment. Conclusions: Clinical trials may be feasible in second-or third-line salvage chemotherapy for gastric cancer. Future clinical trials in these settings should take into account the low response rate, short progression-free survival, and the prognostic factors for optimal trial design.
| Original language | English |
|---|---|
| Pages (from-to) | 797-805 |
| Number of pages | 9 |
| Journal | Cancer Chemotherapy and Pharmacology |
| Volume | 66 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2010 Sep 1 |
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All Science Journal Classification (ASJC) codes
- Oncology
- Toxicology
- Pharmacology
- Cancer Research
- Pharmacology (medical)
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Outcomes of multiple salvage chemotherapy for advanced gastric cancer : Implications for clinical practice and trial design. / Moon, Yong Wha; Rha, SunYoung; Jeung, Hei Cheul; Kim, Chan; Hong, Min Hee; Chang, Hyun; Roh, Jae Kyung; Noh, Sung Hoon; Kim, Byung Soo; Chung, Hyuncheol.
In: Cancer Chemotherapy and Pharmacology, Vol. 66, No. 4, 01.09.2010, p. 797-805.Research output: Contribution to journal › Article
TY - JOUR
T1 - Outcomes of multiple salvage chemotherapy for advanced gastric cancer
T2 - Implications for clinical practice and trial design
AU - Moon, Yong Wha
AU - Rha, SunYoung
AU - Jeung, Hei Cheul
AU - Kim, Chan
AU - Hong, Min Hee
AU - Chang, Hyun
AU - Roh, Jae Kyung
AU - Noh, Sung Hoon
AU - Kim, Byung Soo
AU - Chung, Hyuncheol
PY - 2010/9/1
Y1 - 2010/9/1
N2 - Purpose: We analyzed the natural history of advanced gastric cancer with sequential salvage chemotherapy following first-line treatment. Methods: We studied 532 patients with unresectable gastric adenocarcinoma who were treated at Yonsei Cancer Center (2000-2008). The patients were managed with multiple sequential salvage chemotherapy as allowed by performance status and toxicity profiles. The tumor response was assessed every two cycles. Results: Four hundred sixty patients received palliative chemotherapy and 72 received supportive care only. The median overall survival was 12.0 months for all patients, 12.1 months for the chemotherapy group, and 2.5 months for the supportive care group (P <0.001). In the chemotherapy group, 87% received first-line chemotherapy, 47% second-line, 23% third-line, 9% fourth-line, and 3% fifthline. Response rates were 24.8, 12.6, 10.9, 2.6, and 0% and disease control rates were 76.3, 60.1, 54.2, 54.2, and 53.3% for first-to fifth-line treatment, respectively. The median progression-free survival was 5.5, 3.4, 2.5, 1.9, and 2.0 months and overall survival was 12.1, 7.9, 5.5, 5.0, and 6.8 months. Performance status and metastatic pattern were consistent prognostic factors throughout salvage treatment. Conclusions: Clinical trials may be feasible in second-or third-line salvage chemotherapy for gastric cancer. Future clinical trials in these settings should take into account the low response rate, short progression-free survival, and the prognostic factors for optimal trial design.
AB - Purpose: We analyzed the natural history of advanced gastric cancer with sequential salvage chemotherapy following first-line treatment. Methods: We studied 532 patients with unresectable gastric adenocarcinoma who were treated at Yonsei Cancer Center (2000-2008). The patients were managed with multiple sequential salvage chemotherapy as allowed by performance status and toxicity profiles. The tumor response was assessed every two cycles. Results: Four hundred sixty patients received palliative chemotherapy and 72 received supportive care only. The median overall survival was 12.0 months for all patients, 12.1 months for the chemotherapy group, and 2.5 months for the supportive care group (P <0.001). In the chemotherapy group, 87% received first-line chemotherapy, 47% second-line, 23% third-line, 9% fourth-line, and 3% fifthline. Response rates were 24.8, 12.6, 10.9, 2.6, and 0% and disease control rates were 76.3, 60.1, 54.2, 54.2, and 53.3% for first-to fifth-line treatment, respectively. The median progression-free survival was 5.5, 3.4, 2.5, 1.9, and 2.0 months and overall survival was 12.1, 7.9, 5.5, 5.0, and 6.8 months. Performance status and metastatic pattern were consistent prognostic factors throughout salvage treatment. Conclusions: Clinical trials may be feasible in second-or third-line salvage chemotherapy for gastric cancer. Future clinical trials in these settings should take into account the low response rate, short progression-free survival, and the prognostic factors for optimal trial design.
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UR - http://www.scopus.com/inward/citedby.url?scp=77955865764&partnerID=8YFLogxK
U2 - 10.1007/s00280-010-1295-z
DO - 10.1007/s00280-010-1295-z
M3 - Article
C2 - 20221831
VL - 66
SP - 797
EP - 805
JO - Cancer Chemotherapy and Pharmacology
JF - Cancer Chemotherapy and Pharmacology
SN - 0344-5704
IS - 4
ER -