Second-line treatment in advanced gastric cancer: Data from the Spanish AGAMENON registry

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 reg...

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Detalhes bibliográficos
Autores: Cotes Sanchis, Almudena, Gallego, Javier, Hernandez, Raquel, Arrazubi, Virginia, Custodio, Ana, Maria Cano, Juana, Aguado, Gema, Macias, Ismael, Lopez, Carlos, Lopez, Flora, Visa, Laura, Garrido, Marcelo, Martinez Lago, Nieves, Fernandez Montes, Ana, Luisa Limon, Maria, Azkárate, Aitor, Pimentel, Paola, Reguera, Pablo, Ramchandani, Avinash, Diego Cacho, Juan, Martin Carnicero, Alfonso, Granja, Monica, Martin Richard, Marta, Hernandez Perez, Carolina, Hurtado, Alicia, Serra, Olbia, Buxo, Elvira, Vidal Tocino, Rosario, Jimenez-Fonseca, Paula, Carmona-Bayonas, Alberto
Formato: artículo
Fecha de publicación:2020
País:España
Recursos:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/11571
Acesso em linha:https://hdl.handle.net/20.500.13003/11571
Access Level:acceso abierto
Palavra-chave:Aged, 80 and over
Middle Aged
Antineoplastic Agents, Immunological
Male
Female
Registries
Stomach Neoplasms
Drug Utilization
Aged
Platinum Compounds
Survival Analysis
Antineoplastic Agents, Phytogenic
Adult
Humans
Antineoplastic Combined Chemotherapy Protocols
Sistema de Registros
Femenino
Neoplasias Gástricas
Antineoplásicos Inmunológicos
Análisis de Supervivencia
Utilización de Medicamentos
Masculino
Humanos
Persona de Mediana Edad
Antineoplásicos Fitogénicos
Protocolos de Quimioterapia Combinada Antineoplásica
Anciano
Anciano de 80 o más Años
Adulto
Compuestos de Platino
Descrição
Resumo: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.

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