Optimal duration of first-line chemotherapy for advanced gastric cancer: data from the AGAMENON registry

Viúdez, A.; Carmona-Bayonas, Alberto; Gállego, Javier; Lacalle, A.; Hernández, R; Cano, Juana María; Macías, Ismael; Custodio, Ana; Castro, Eva Martínez de; Sánchez, Alvaro; Iglesia, L; Reguera, Pablo; Visa, Laura; Azkárate, Aitor; Sánchez-Cánovas, Manuel; Mangas, Monserrat; Limón, María Luisa; Martínez-Torrón, A; Asensio, Esther Pérez; Ramchandani, Avinash; Carnicero, Alfonso Martín; Hurtado, Alicia; Cerdá, Paula; Garrido, Marcelo; Sánchez-Bayonas, R; Serrano, Raquel; Jiménez‐Fonseca, Paula

doi:10.1007/s12094-019-02183-y

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…those having a high tumor burden, without toxicity). 21 Beyond the average treatment effects, our study suggests that subgroup effects could be particularly relevant in choosing the optimum backbone of chemotherapy based on ORR and on the trend in survival endpoints. Thus, should this hypothesis that FOLFOX-T might be more efficacious than ToGA regimens be confirmed, it would be especially pertinent in populations who benefit less from this strategy, such as diffuse tumors and those that are HER2+ on IHQ2+/ FISH+.…”

Section: Discussionmentioning

confidence: 91%

External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry

et al. 2021

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Background: Trastuzumab combined with cisplatin and fluoropyrimidines, either capecitabine or 5-fluorouracile (XP/FP), is the standard first-line treatment for advanced, HER2-positive, gastric cancer patients based on the ToGA trial. Despite the lack of phase III trials, many clinicians administer trastuzumab with alternative regimens. One meta-analysis suggests that substituting cisplatin for oxaliplatin might lead to greater efficacy and less toxicity. Methods: 594 patients with HER2-positive gastroesophageal adenocarcinoma were recruited from the AGAMENON-SEOM registry. The objective was to evaluate the external validity of clinical trials with chemotherapy and trastuzumab. Results: The regimens used in at least 5% of the patients were XP (27%), oxaliplatin and capecitabine (CAPOX) (26%), oxaliplatin and 5-fluorouracil (FOLFOX) (14%), FP (14%), triplet with anthracycline/docetaxel (7%), and carboplatin-FU (5%). Median exposure to trastuzumab was longer with FOLFOX (11.4 months, 95% CI, 9.1–21.0) versus ToGA regimens (7.5, 6.4–8.5), p < 0.001. Patients with HER2-IHC 3+ cancers had higher response rates than those with IHC 2+/FISH+, odds-ratio 1.97 (95% CI, 1.25–3.09). The results achieved with CAPOX–trastuzumab were comparable to those attained with ToGA regimens. FOLFOX–trastuzumab was superior to ToGA schemes in terms of overall survival (OS), with a greater magnitude of effect in IHC 2+/FISH+ tumors (HR 0.47, 0.24–0.92) compared with IHC 3+ (HR 0.69, 0.49–0.96), and in diffuse (HR 0.37, 0.20–0.69) versus intestinal-type tumors (HR 0.76, 0.54–1.06). Conclusion: We have updated the external validity of clinical trials with trastuzumab in first-line treatment of gastric cancer. Our data confirm the comparable outcomes of ToGA regimens and CAPOX–trastuzumab in clinical practice and point toward a possible benefit of FOLFOX–trastuzumab, contingent on the subtypes typically less sensitive to trastuzumab, to be confirmed in clinical trials.

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Section: Discussionmentioning

confidence: 91%

External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry

et al. 2021

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“…It is crucial to discontinue L-OHP before developing severe PSN, because there is no effective method for PSN prevention. A retrospective observational study using data from the AGAMENON registry, wherein 31 Spanish centers and 1 Chilean center participated, reported that platinum discontinuation, followed by fluoropyrimidine maintenance, was an effective strategy for first-line chemotherapy for AGC to maintain treatment efficacy, with a low rate of serious AEs (23). The "stop-and-go" strategy was also reported as an appropriate approach to reduce the incidence of severe neurotoxicity while maintaining treatment efficacy www.globalhealthmedicine.com Global Health & Medicine -Advance Publication (P4) continuous infusion of 5-FU (OS: 10.6 months versus 9.4 months; hazard ratio: 0.94; 95% confidence interval, 0.72-1.22; one-sided p = 0.31) (31).…”

Section: Application Of L-ohp For Agc With Ascites or Inadequate Oralmentioning

confidence: 99%

Current status of doublet combinations of platinum and fluoropyrimidines using oxaliplatin for advanced gastric cancer

Yagi

Yamada

Terayama

et al. 2021

GHM

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“…The patient population assessed derive from the Spanish AGAMENON registry that enlists the collaboration of 34 Spanish hospitals and one center in Chile and recruits consecutive cases of unresectable or metastatic, locally advanced adenocarcinoma of the stomach, gastroesophageal junction, or distal esophagus [31][32][33][34][35][36][37][38][39].…”

Section: Patients and Designmentioning

confidence: 99%

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

et al. 2020

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Optimal duration of first-line chemotherapy for advanced gastric cancer: data from the AGAMENON registry

Cited by 8 publications

References 31 publications

External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry

External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry

Current status of doublet combinations of platinum and fluoropyrimidines using oxaliplatin for advanced gastric cancer

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

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