Salvage Chemotherapy for Pretreated Gastric Cancer: A Randomized Phase III Trial Comparing Chemotherapy Plus Best Supportive Care With Best Supportive Care Alone

Kang, Jung Hun; Lee, Soon Il; Lim, Do Hyoung; Park, Keon Woo; Oh, Sung Yong; Kwon, Hyuk Chan; Hwang, In Gyu; Lee, Sang Cheol; Nam, Eunmi; Shin, Dong Bok; Lee, Jeeyun; Park, Joon Oh; Park, Young Suk; Lim, Ho Yeong; Kang, Won Ki; Park, Se Hoon

doi:10.1200/jco.2011.39.4585

Cited by 556 publications

(409 citation statements)

References 20 publications

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“…It has been shown that chemotherapy can prolong survival in this setting [12]. This is true for first-line treatment as well as for second-and further-line chemotherapy (Table 1) [13][14][15][16][17]. Symptom control and quality of life have also been looked at in some studies, and have been demonstrated to be improved by chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

et al. 2013

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Section: Methodsmentioning

confidence: 99%

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

et al. 2013

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“…Compared with the best supportive care, first-line chemotherapy for advanced gastric cancer (AGC) improves survival time and quality of life (2)(3)(4); however, the median overall survival (OS) time is short (9-13 months) (5)(6)(7). Several previous studies have demonstrated that second-line chemotherapy confers a significant survival benefit over best supportive care in AGC, with median OS time ranging from 4 to 9.5 months (8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Correlation between human epidermal growth factor receptor 2 expression level and efficacy of trastuzumab beyond progression in metastatic gastric cancer

Kadowaki¹,

Masuishi²,

Taniguchi³

et al. 2017

Oncology Letters

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Abstract. There is currently no clinical data regarding the efficacy of trastuzumab treatment for the progression of human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (AGC) occurring during trastuzumab-based chemotherapy. The aim of this study was to retrospectively examine the clinical benefits of trastuzumab for HER2-positive AGC patients who progressed during first-line trastuzumab-based chemotherapy. Among the 108 patients treated with trastuzumab combined with fluoropyrimidine and cisplatin as first-line therapy, 46 HER2-positive AGC patients who received cytotoxic agents with or without trastuzumab subsequent to disease progression were included. Of these, the efficacy and safety outcomes of 26 patients who continued trastuzumab were compared with those of the 20 patients who discontinued trastuzumab. No difference in response rate (18.2 vs. 15.8%, P=1.00) was observed between the two groups. Progression-free survival (PFS) time was numerically longer in the chemotherapy combination with trastuzumab group than in the chemotherapy combination without trastuzumab group (median, 4.0 vs. 2.3 months), with no significance [hazard ratio (HR), 0.63; P=0.14]. In the subset analysis, continuation of trastuzumab significantly improved PFS time in selected subgroups of patients with tumors exhibiting HER2 expression scores of 3+ (HR, 0.41; P=0.04), intestinal-type histology (HR, 0.32; P<0.01), and a first PFS time of >6 months (HR, 0.44; P=0.04). The survival times for the trastuzumab beyond progression (TBP) and non-TBP groups were similar (HR, 1.06; P=0.88), with equivalent overall survival times in the subgroups with immunohistochemistry scores of 3+ (HR, 0.97; P=0.94), 0.53; P= 0.19), and a first PFS time of >6 months (HR, 0.62; P=0.31). There were no differences in the incidence rates of toxicity, including cardiac dysfunction, between the two groups. The study results suggest that selected HER2-positive AGC patients may benefit from trastuzumab continuation during first progression, and further prospective studies are warranted.

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“…No statistical significance was observed between the regimens prescribed as second-line treatments (p=0.12) (Kang et al, 2012). Although the higher median OS for patients receiving second-line treatment may be related to clinical rather than therapeutic factors, we recommend it whenever possible.…”

Section: Discussionmentioning

confidence: 88%

Individualized Chemotherapy for Metastatic Gastric Cancer: Retrospective Data from a University Hospital in Brazil

Aguiar

Ribas²,

Forones³

2015

Asian Pacific Journal of Cancer Prevention

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Background: Despite the decreased incidence, gastric cancer is still a frequent cause of cancer related death. The 1st line 2 or 3 drugs regimen is still a debatable issue. HER2 targeted therapy has emerged as the standard of care, but it is unavailable in the Brazilian Public Health System. The end-point of this trial was overall survival (OS) in patients with metastatic gastric cancer treated in a public university hospital in Brazil. The secondary end-points were efficacy and safety of regimens with 2 (F+P) or 3 (EOX) drugs to develop an institutional guideline to facilitate optimal treatments. Materials and Methods: In this retrospective study, 1st line regimens were evaluated for OS and PFS stratified by age and ECOG using Cox regression.

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Salvage Chemotherapy for Pretreated Gastric Cancer: A Randomized Phase III Trial Comparing Chemotherapy Plus Best Supportive Care With Best Supportive Care Alone

Abstract: To our knowledge, this is the largest phase III trial comparing SLC plus BSC with BSC alone in AGC. In pretreated patients, SLC is tolerated and significantly improves OS when added to BSC.

Cited by 556 publications

References 20 publications

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

Correlation between human epidermal growth factor receptor 2 expression level and efficacy of trastuzumab beyond progression in metastatic gastric cancer

Individualized Chemotherapy for Metastatic Gastric Cancer: Retrospective Data from a University Hospital in Brazil

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