Open AccessSecond-line treatment in advanced gastric cancer: Data from the Spanish AGAMENON registry
Author(s) -
Almudena Cotes Sanchís,
Javier Gállego,
Raquel Hernández,
Virginia Arrazubi,
Ana Custodio,
Juana María Cano,
Gema Aguado,
Ismael Macías,
Carlos López,
Flora López López,
Laura Visa,
Marcelo Garrido,
Nieves Martínez Lago,
Ana Montes,
María Luisa Limón,
Aitor Azkárate,
Paola Pimentel,
Pablo Reguera,
Avinash Ramchandani,
Juan Diego Cacho,
Alfonso Martín Carnicero,
Mónica Granja,
M Richard,
Carolina Hernández Pérez,
Alicia Hurtado,
Òlbia Serra,
Elvira Buxó,
R. Vidal Tocino,
Paula JiménezFonseca,
Alberto Carmona-Bayonas
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0235848
Subject(s) - ramucirumab , medicine , trastuzumab , progression free survival , cancer , second line treatment , cancer registry , population , paclitaxel , oncology , gastroenterology , chemotherapy , breast cancer , environmental health
Background Second-line treatments boost overall survival in advanced gastric cancer (AGC). However, there is a paucity of information as to patterns of use and the results achieved in actual clinical practice. Materials and methods The study population comprised patients with AGC in the AGAMENON registry who had received second-line. The objective was to describe the pattern of second-line therapies administered, progression-free survival following second-line (PFS-2), and post-progression survival since first-line (PPS). Results 2311 cases with 2066 progression events since first-line (89.3%) were recorded; 245 (10.6%) patients died during first-line treatment and 1326/2066 (64.1%) received a second-line. Median PFS-2 and PPS were 3.1 (95% CI, 2.9–3.3) and 5.8 months (5.5–6.3), respectively. The most widely used strategies were monoCT (56.9%), polyCT (15.0%), ramucirumab+CT (12.6%), platinum-reintroduction (8.3%), trastuzumab+CT (6.1%), and ramucirumab (1.1%). PFS-2/PPS medians gradually increased in monoCT, 2.6/5.1 months; polyCT 3.4/6.3 months; ramucirumab+CT, 4.1/6.5 months; platinum-reintroduction, 4.2/6.7 months, and for the HER2+ subgroup in particular, trastuzumab+CT, 5.2/11.7 months. Correlation between PFS since first-line and OS was moderate in the series as a whole (Kendall’s τ = 0.613), lower in those subjects who received second-line (Kendall’s τ = 0.539), especially with ramucirumab+CT (Kendall’s τ = 0.413). Conclusion This analysis reveals the diversity in second-line treatment for AGC, highlighting the effectiveness of paclitaxel-ramucirumab and, for a selected subgroup of patients, platinum reintroduction; both strategies endorsed by recent clinical guidelines.