A prognostic model in patients treated for metastatic gastric cancer with second-line chemotherapy

Kanagavel, Dheepak; Pokataev, Ilya; Fedyanin, M. Yu.; Tryakin, Alexey; Bazin, I.; Нариманов, М. Н.; Yakovleva, E.S.; Garin, A.; Tjulandin, Sergei

doi:10.1093/annonc/mdq032

Cited by 54 publications

(52 citation statements)

References 19 publications

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“…2 Progression-free survival and overall survival curves according to the risk groups: a progression-free survival; b overall survival studies analyzed the prognostic factors for MRGC patients undergoing second-line chemotherapy. A good PS was the most important prognostic factor of second-line chemotherapy in nearly all studies [6,[23][24][25]; in addition, a higher hemoglobin level [23][24][25], longer PFS from firstline chemotherapy [6,23,25], and a lower number of metastatic sites [6,25] were reported as independent prognostic factors for OS. Shim et al [15] reported a prognostic factor analysis of third-line therapy; poor PS (ECOG PS C2), low serum albumin level (\4.0 g/dl), poor histological grade, and shorter PFS following second-line chemotherapy (\2.7 months) were factors related to poor survival outcome.…”

Section: Discussionmentioning

confidence: 96%

Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival

Kang

et al. 2012

Gastric Cancer

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Background The aim of this study was to evaluate the activity and safety of the combination chemotherapy of 5-fluorouracil (5-FU), leucovorin, and irinotecan (FOLFIRI regimen) after failure of fluoropyrimidine, platinum, and taxane in gastric cancer (GC) and to evaluate the prognostic factors for survival. Methods Patients received biweekly FOLFIRI chemotherapy as third-line treatment. The FOLFIRI-1 consisted of irinotecan (180 mg/m 2 in a 2-h infusion) on day 1, and then leucovorin (200 mg/m 2 in a 2-h infusion) and 5-FU (a 400 mg/m 2 bolus, followed by 600 mg/m 2 in a 22-h continuous infusion) on days 1 and 2. FOLFIRI-2 consisted of irinotecan (180 mg/m 2 in a 2-h infusion) on day 1, and then leucovorin (400 mg/m 2 in a 2-h infusion) and 5-FU (a 400 mg/m 2 bolus, followed by 2400 mg/m 2 in a 46-h continuous infusion) on day 1. Results A total of 158 patients were included. The overall response rate was 9.6 % in patients with measurable lesions. The median progression-free survival (PFS) and overall survival (OS) were 2.1 months [95 % confidence interval (CI), 1.7-2.5] and 5.6 months (95 % CI, 4.7-6.5), respectively. The major grade 3/4 toxicity was myelosuppression (36.7 %). Good performance status (PS), fewer metastatic sites, and longer duration from the first-line to third-line chemotherapy were independent prognostic factors affecting both PFS and OS. Conclusions The FOLFIRI regimen showed antitumor activity and tolerable toxicity profiles against advanced GC in the third-line setting. Patients with good PS, fewer metastatic sites and longer previous treatment duration might have the maximal benefit from third-line chemotherapy.

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Section: Discussionmentioning

confidence: 96%

Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival

Kang

et al. 2012

Gastric Cancer

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“…Chau et al [19] pooled data on 1080 patients from three randomized first-line trials and demonstrated that PS C 2, the presence of liver and/or peritoneal metastases, and elevated alkaline phosphatase were prognostic factors correlated with poor outcome in the first-line setting. Subsequent analyses evaluating patients receiving different regimens of chemotherapy in the second-line setting have described PS C 2, number of metastatic sites, short TTP under first-line chemotherapy, and different laboratory test results, such as low hemoglobinand elevated WBC or alkaline phosphatase as prognostic factors associated with overall survival [24][25][26][27]. Today the use of molecular targeting agents is a new challenge in modern cancer therapy and these agents may have a significant impact on the treatment of GEC patients in the future [28].…”

Section: Discussionmentioning

confidence: 99%

Biweekly cetuximab and irinotecan as second-line therapy in patients with gastro-esophageal cancer previously treated with platinum

et al. 2011

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“…Therefore, it is important to predict whether patients may benefit from sequential salvage chemotherapy. Previous studies have indicated that several factors should be considered in order to assess the response to sequential salvage chemotherapy, such as the performance status of the patient, extent of disease (locally advanced or metastatic), cumulative toxicity, lack of cross-resistance of the tumor cells to previously used drugs and progression-free survival of the patient following previous chemotherapy (26,30). Therefore, predictive factors for the potential survival benefit of salvage chemotherapy with active cytotoxic agents require additional investigation to avoid the development of toxic effects in patients that are unlikely to benefit from the therapy.…”

Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

Impact of the availability of active cytotoxic agents on the survival of patients with advanced gastric cancer

et al. 2015

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Abstract. Several cytotoxic agents, including fluoropyrimidines, platinums, taxanes and irinotecan, are effective in the treatment of advanced gastric cancer (AGC). However, the effect of the availability of cytotoxic agents on survival has not yet been evaluated. Therefore, the present study assessed the impact of the availability of active cytotoxic agents on the survival of patients with AGC. The records of 216 patients with newly diagnosed AGC that were treated with palliative chemotherapy between March 2002 and November 2012 at Chungbuk National University Hospital were reviewed. For the present study, the patients were divided according to the availability of active cytotoxic agents over the course of treatment: Group 1 received fluoropyrimidine and platinum; group 2 received fluoropyrimidine, platinum and taxane or irinotecan; and group 3 received fluoropyrimidine, platinum, taxane and irinotecan. The median overall survival times for groups 1, 2 and 3 were 6.3, 9.9 and 14.3 months, respectively (P<0.0001). Multivariate analysis revealed that the Eastern Cooperative Oncology Group (ECOG) performance status and the availability of active cytotoxic agents were independent prognostic factors, as the hazard ratios for mortality were 3.25 for patients with an ECOG performance status of 2-3 [95% confidence interval (CI), 1.99-5.30; P<0.0001], 0.58 for patients in group 2 (95% CI, 0.42-0.80; P= 0.0009), and 0.40 for patients in group 3 (95% CI, 0.28-0.58; P<0.0001). The present study reveals that the availability of active cytotoxic agents is associated with an improved survival time in patients with AGC.

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A prognostic model in patients treated for metastatic gastric cancer with second-line chemotherapy

Abstract: With inadequate data from randomized controlled trials at the moment, our report indicates that second-line chemotherapy is effective and beneficial in patients with good performance status, higher Hb level along with higher TTP under first-line therapy.

Cited by 54 publications

References 19 publications

Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival

Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival

Biweekly cetuximab and irinotecan as second-line therapy in patients with gastro-esophageal cancer previously treated with platinum

Impact of the availability of active cytotoxic agents on the survival of patients with advanced gastric cancer

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