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Cancer Chemotherapy and Pharmacology

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29.03.2018 | Original Article

Survival impact of post-progression chemotherapy in advanced gastric cancer: systematic review and meta-analysis

verfasst von: Sakura Iizumi, Atsuo Takashima, Kentaro Sakamaki, Satoshi Morita, Narikazu Boku

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 6/2018

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Abstract

Purpose

We conducted a systematic review and meta-analysis on survival impact of post-progression chemotherapy (post-Cx) after first-line chemotherapy (1st-Cx) and after second-line chemotherapy (2nd-Cx), and survival benefit of third-line chemotherapy (3rd-Cx) for advanced gastric cancer (AGC).

Methods

Phase III trials of systemic chemotherapy for AGC published in English between 2005 and 2015 or presented at annual meetings of ASCO or ESMO between 2013 and 2015 were searched. Numbers of patients, types of chemotherapy, patient baseline, proportion of patients receiving post-Cx (post-Cx%), median progression-free survival (mPFS), and median overall survival (mOS) of each treatment arm were surveyed; trials not reporting these parameters were excluded. Median post-progression survival (mPPS) was calculated as the difference between mOS and mPFS. Weighted Spearman’s correlation coefficients between post-Cx% and survival outcomes (mOS and mPPS) were calculated. The effect of post-Cx% on survival outcomes adjusted for the types of chemotherapy and patient characteristics was evaluated by meta-regression.

Results

Overall, 25 phase III trials of AGC were selected: 15 trials with 31 arms for 1st-Cx, and 10 trials with 16 arms for 2nd-Cx. Weighted Spearman’s correlation coefficients for post-Cx% and mOS/mPPS were 0.520/0.739 for 1st-Cx, and 0.767/0.823 for 2nd-Cx. Meta-regression analyses adjusting for types of chemotherapy, age, and PS showed that a 10% increase in post-Cx% was associated with prolongation of mOS by 1.033 months for 1st-Cx and 0.344 months for 2nd-Cx.

Conclusions

Post-Cx% both after 1st-Cx and 2nd-Cx were correlated with mOS/mPPS, suggesting a survival benefit of 3rd-Cx in addition to that of 2nd-Cx for AGC.

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Titel: Survival impact of post-progression chemotherapy in advanced gastric cancer: systematic review and meta-analysis
verfasst von: Sakura Iizumi
Atsuo Takashima
Kentaro Sakamaki
Satoshi Morita
Narikazu Boku
Publikationsdatum: 29.03.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Cancer Chemotherapy and Pharmacology / Ausgabe 6/2018
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-018-3569-9

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24.04.2024 | DGIM 2024 | Nachrichten

Springer Medizin

Survival impact of post-progression chemotherapy in advanced gastric cancer: systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Onkologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Update Onkologie

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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