Advanced gastric cancer: real-world analysis of second-line therapies

  • Cotes Sanchís A & al.
  • PLoS One
  • 1 Jan 2020

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A retrospective review of second-line treatments for advanced gastric cancer yields promising results for paclitaxel-ramucirumab and, in some patients, platinum reintroduction.

Why this matters

  • The results support current recommendations of polychemotherapy and ramucirumab plus chemotherapy in this population.

Study design

  • Retrospective analysis of the Spanish AGAMENON registry (N=2311).
  • Funding: None.

Key results

  • There were 2066 progression events (89.3%) after first-line therapy.
  • 10.6% of patients died during first-line treatment.
  • 64.1% received a second-line therapy.
  • Median PFS after second-line therapy (PFS-2) was 3.1 (95% CI, 2.9-3.3) months, whereas median postprogression survival (PPS) since first-line therapy was 5.8 (95% CI, 5.5-6.3) months.
  • PFS-2/PPS median values overall:
    • Monochemotherapy (56.9% of total): 2.6/5.1 months.
    • Polychemotherapy (15.0%): 3.4/6.3 months.
    • Ramucirumab+chemotherapy (12.6%): 4.1/6.5 months.
    • Platinum reintroduction (8.3%): 4.2/6.7 months.
  • PFS-2/PPS in HER2+ subgroup:
    • Monochemotherapy: 2.7/6.7 months.
    • Polychemotherapy: 3.0/8.6 months.
    • Ramucirumab+chemotherapy: 4.7/7.3 months.
    • Trastuzumab+chemotherapy: 4.8/10.5 months.
    • Platinum reintroduction: 5.2/11.7 months.
  • There was a moderate correlation between PFS since first-line and OS (Kendall’s τ=0.613).
    • This correlation was lower in second-line recipients (Kendall’s τ=0.539), particularly the ramucirumab+chemotherapy group (Kendall’s τ=0.413).

Limitations

  • Retrospective analysis.