This study provides evidence that GSH is a promising and effective new drug for the prevention of CDDP-induced neuropathy, and that it does not reduce the clinical activity of chemotherapeutic drugs.

No established second-line chemotherapy is available for patients with advanced gastric cancer failing to respond or progressing to first-line chemotherapy. However, 20 -40% of these patients commonly receive second-line chemotherapy. We evaluated the influence of clinico-pathologic factors on the survival of 175 advanced gastric cancer patients, who received second-line chemotherapy at three oncology departments. Univariate and multivariate analyses found five factors which were independently associated with poor overall survival: performance status 2 (hazard ratio (HR), 1.79; 95% CI, 1.16 -2.77; P ¼ 0.008), haemoglobin p11.5 g l À1 (HR, 1.48; 95% CI, 1.06 -2.05; P ¼ 0.019), CEA level 450 ng ml À1 (HR, 1.86; 95% CI, 1.21 -2.88; P ¼ 0.004), the presence of greater than or equal to three metastatic sites of disease (HR, 1.72; 95% CI, 1.16 -2.53; P ¼ 0.006), and time-toprogression under first-line chemotherapy p6 months (HR, 1.97; 95% CI, 1.39 -2.80; Po0.0001). A prognostic index was constructed dividing patients into low-(no risk factor), intermediate-(one to two risk factors), or high-(three to five risk factors) risk groups, and median survival times for each group were 12.7 months, 7.1 months, and 3.3 months, respectively (Po0.001). In the absence of data deriving from randomised trials, this analysis suggests that some easily available clinical factors may help to select patients with advanced gastric cancer who could derive more benefit from second-line chemotherapy.

No abstract

No abstract

p53 status measured by immunohistochemistry does not seem to be useful to identify unresponsive patients with low TS expression.