Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry

Background Although anthracycline-based triplets are one of the most widely used schedules to treat advanced gastric cancer (AGC), the benefit of including epirubicin in these therapeutic combinations remains unknown. This study aims to evaluate both the efficacy and tolerance of triplets with epiru...

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Autores: Carmona-Bayonas A, Jiménez-Fonseca P, Custodio A, Sánchez Cánovas M, Hernández R, Pericay C, Echavarria I, Lacalle A, Visa L, Rodríguez Palomo A, Mangas M, Cano JM, Buxo E, Álvarez-Manceñido F, García T, Lorenzo JE, Ferrer-Cardona M, Viudez A, Azkarate A, Ramchandani A, Arias D, Longo F, López C, Sánchez Bayona R, Limón ML, Díaz-Serrano A, Fernández Montes A, Sala P, Cerdá P, Rivera F, Gallego J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p7086
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/7086
Access Level:acceso abierto
Palabra clave:Anthracyclines
Epirubicin
Triplets:doublets
Gastric cancer
Stomach
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network_acronym_str ES
network_name_str España
repository_id_str
spelling Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer RegistryCarmona-Bayonas AJiménez-Fonseca PCustodio ASánchez Cánovas MHernández RPericay CEchavarria ILacalle AVisa LRodríguez Palomo AMangas MCano JMBuxo EÁlvarez-Manceñido FGarcía TLorenzo JEFerrer-Cardona MViudez AAzkarate ARamchandani AArias DLongo FLópez CSánchez Bayona RLimón MLDíaz-Serrano AFernández Montes ASala PCerdá PRivera FGallego JAnthracyclinesEpirubicinTriplets:doubletsGastric cancerStomachBackground Although anthracycline-based triplets are one of the most widely used schedules to treat advanced gastric cancer (AGC), the benefit of including epirubicin in these therapeutic combinations remains unknown. This study aims to evaluate both the efficacy and tolerance of triplets with epirubicin vs. doublets with platinum-fluoropyrimidine in a national AGC registry. Methods Patients with AGC treated with polychemotherapy without trastuzumab at 28 hospitals in Spain between 2008 and 2016 were included. The effect of anthracycline-based triplets against doublets was evaluated by propensity score matching (PSM) and Cox proportional hazards (PH) regression. Result A total of 1002 patients were included (doublets, n = 653; anthracycline-based triplets, n = 349). The multivariable Cox PH regression failed to detect significantly increased OS in favor of triplets with anthracyclines: HR 0.90 (95% CI, 0.78-1.05), p = 0.20035. After PSM, the sample contained 325 pairs with similar baseline characteristics. This method was also unable to reveal an increase in OS: 10.5 (95% CI, 9.7-12.3) vs. 9.9 (95% CI, 9.2-11.4) months, HR 0.91 (CI 95%, 0.76-1.083), and (log-rank test, p = 0.226). Response rates (42.1 vs. 33.1%, p = 0.12) and PFS (HR 0.95, CI 95%, 0.80-1.13, log-rank test, p = 0.873) were not significantly higher with epirubicin-based regimens. The triplets were associated with greater grade 3-4 hematological toxicity, and increased hospitalization due to toxicity by 68%. The addition of epirubicin is viable, but 23.7% discontinued treatment because of adverse effects or patient decision. Conclusion Anthracyclines added to platinum-fluoropyrimidine doublets did not improve the response rate or survival outcomes in patients with AGC but entailed greater toxicity.SPRINGER2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/7086Gastric CancerISSN: 14363291ISSNe: 14363305reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p70862026-06-11T12:45:17Z
dc.title.none.fl_str_mv Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
title Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
spellingShingle Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
Carmona-Bayonas A
Anthracyclines
Epirubicin
Triplets:doublets
Gastric cancer
Stomach
title_short Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
title_full Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
title_fullStr Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
title_full_unstemmed Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
title_sort Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry
dc.creator.none.fl_str_mv Carmona-Bayonas A
Jiménez-Fonseca P
Custodio A
Sánchez Cánovas M
Hernández R
Pericay C
Echavarria I
Lacalle A
Visa L
Rodríguez Palomo A
Mangas M
Cano JM
Buxo E
Álvarez-Manceñido F
García T
Lorenzo JE
Ferrer-Cardona M
Viudez A
Azkarate A
Ramchandani A
Arias D
Longo F
López C
Sánchez Bayona R
Limón ML
Díaz-Serrano A
Fernández Montes A
Sala P
Cerdá P
Rivera F
Gallego J
author Carmona-Bayonas A
author_facet Carmona-Bayonas A
Jiménez-Fonseca P
Custodio A
Sánchez Cánovas M
Hernández R
Pericay C
Echavarria I
Lacalle A
Visa L
Rodríguez Palomo A
Mangas M
Cano JM
Buxo E
Álvarez-Manceñido F
García T
Lorenzo JE
Ferrer-Cardona M
Viudez A
Azkarate A
Ramchandani A
Arias D
Longo F
López C
Sánchez Bayona R
Limón ML
Díaz-Serrano A
Fernández Montes A
Sala P
Cerdá P
Rivera F
Gallego J
author_role author
author2 Jiménez-Fonseca P
Custodio A
Sánchez Cánovas M
Hernández R
Pericay C
Echavarria I
Lacalle A
Visa L
Rodríguez Palomo A
Mangas M
Cano JM
Buxo E
Álvarez-Manceñido F
García T
Lorenzo JE
Ferrer-Cardona M
Viudez A
Azkarate A
Ramchandani A
Arias D
Longo F
López C
Sánchez Bayona R
Limón ML
Díaz-Serrano A
Fernández Montes A
Sala P
Cerdá P
Rivera F
Gallego J
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anthracyclines
Epirubicin
Triplets:doublets
Gastric cancer
Stomach
topic Anthracyclines
Epirubicin
Triplets:doublets
Gastric cancer
Stomach
description Background Although anthracycline-based triplets are one of the most widely used schedules to treat advanced gastric cancer (AGC), the benefit of including epirubicin in these therapeutic combinations remains unknown. This study aims to evaluate both the efficacy and tolerance of triplets with epirubicin vs. doublets with platinum-fluoropyrimidine in a national AGC registry. Methods Patients with AGC treated with polychemotherapy without trastuzumab at 28 hospitals in Spain between 2008 and 2016 were included. The effect of anthracycline-based triplets against doublets was evaluated by propensity score matching (PSM) and Cox proportional hazards (PH) regression. Result A total of 1002 patients were included (doublets, n = 653; anthracycline-based triplets, n = 349). The multivariable Cox PH regression failed to detect significantly increased OS in favor of triplets with anthracyclines: HR 0.90 (95% CI, 0.78-1.05), p = 0.20035. After PSM, the sample contained 325 pairs with similar baseline characteristics. This method was also unable to reveal an increase in OS: 10.5 (95% CI, 9.7-12.3) vs. 9.9 (95% CI, 9.2-11.4) months, HR 0.91 (CI 95%, 0.76-1.083), and (log-rank test, p = 0.226). Response rates (42.1 vs. 33.1%, p = 0.12) and PFS (HR 0.95, CI 95%, 0.80-1.13, log-rank test, p = 0.873) were not significantly higher with epirubicin-based regimens. The triplets were associated with greater grade 3-4 hematological toxicity, and increased hospitalization due to toxicity by 68%. The addition of epirubicin is viable, but 23.7% discontinued treatment because of adverse effects or patient decision. Conclusion Anthracyclines added to platinum-fluoropyrimidine doublets did not improve the response rate or survival outcomes in patients with AGC but entailed greater toxicity.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/7086
url https://fisabio.portalinvestigacion.com/publicaciones/7086
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER
publisher.none.fl_str_mv SPRINGER
dc.source.none.fl_str_mv Gastric Cancer
ISSN: 14363291
ISSNe: 14363305
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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