Prognostic factors in 868 advanced gastric cancer patients treated with second-line chemotherapy in the real world View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-09

AUTHORS

Valentina Fanotto, Stefano Cordio, Giulia Pasquini, Caterina Fontanella, Lorenza Rimassa, Francesco Leone, Gerardo Rosati, Daniele Santini, Riccardo Giampieri, Samantha Di Donato, Gianluca Tomasello, Nicola Silvestris, Filippo Pietrantonio, Francesca Battaglin, Antonio Avallone, Mario Scartozzi, Eufemia Stefania Lutrino, Davide Melisi, Lorenzo Antonuzzo, Antonio Pellegrino, Valter Torri, Giuseppe Aprile

ABSTRACT

BACKGROUND: Although second-line therapy is often considered for advanced gastric cancer patients, the optimal candidates are not well defined. METHODS: We retrospectively collected baseline parameters, tumour features, and treatment data for 868 advanced gastric cancer patients exposed to multiple treatment lines at 19 Italian centres. Cross-tables and chi-square tests were used to describe categorical features. To predict the impact of clinical variables on progression-free survival and overall survival, Kaplan-Meier and Cox regression analyses were performed. RESULTS: At the start of second-line therapy, median age was 64.8 years (25th-75th percentiles: 55.2-71.9 years). Overall, 43% of patients received single-agent chemotherapy, 47.4% a doublet, and 7.3% a triplet. Median second-line progression-free survival was 2.8 months (25th-75th percentiles: 1.8-5.2 months) and median second-line overall survival was 5.6 months (25th-75th percentiles: 2.9-10.0 months). Multivariate analysis showed that performance status, LDH level, neutrophils/lymphocytes ratio, and progression-free survival in the first-line therapy all impacted on prognosis. Based on these four prognostic factors, a prognostic index was constructed that divided patients into good, intermediate, and poor risk groups; median second-line overall survival for each group was 7.7, 4.5, and 2.0 months, respectively (log-rank p < 0.0001). CONCLUSIONS: Advanced gastric cancer patients with a favourable ECOG performance status, lower LDH levels, and a lower neutrophils/lymphocytes ratio at the start of second-line therapy seem to have better outcomes, regardless of age and intensity of treatment. A longer progression-free survival in the first-line therapy also had positive prognostic value. Our real-life study might help clinicians to identify the patients who may benefit most from a second-line therapy. More... »

PAGES

825-833

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10120-016-0681-6

DOI

http://dx.doi.org/10.1007/s10120-016-0681-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024754403

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28028664


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