Survival Outcomes Following Combination of First-Line Platinum-Based Chemotherapy with S-1 in Patients with Advanced Gastric Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Patient Characteristics
2.2. Side Effects
2.3. Survival Outcomes
2.4. Cox Regression Analyses for PFS and OS
2.5. Other Surrogate Endpoints of Response
3. Discussion
4. Materials and Methods
4.1. Ethics Approval
4.2. Patients
4.3. Treatment Schedules
4.4. Patient Data
4.5. Statistical Analyses
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Clinicopathologic Data | n (%) | Oxaliplatin | Cisplatin | p |
---|---|---|---|---|
48 (100) | 33 (100) | 15 (100) | ||
Median Age (range) | 63 (24–84) | 60 (24–84) | 66 (47–81) | 0.407 |
Male | 37 (77.1) | 25 (75.8) | 12 (80.0) | 1.000 |
Primary site | 0.065 | |||
Stomach | 25 (52.1) | 14 (42.4) | 11 (73.3) | |
Gastroesophageal Junction | 23 (47.9) | 19 (57.6) | 4 (26.7) | |
Stage | 0.064 | |||
Locally Advanced | 29 (60.0) | 23 (69.7) | 6 (40.0) | |
Metastatic | 19 (39.6) | 10 (30.3) | 9 (60.0) | |
Histologic grade | ||||
II | 17 (35.4) | 11 (33.3) | 6 (40.0) | 0.749 |
III | 31 (64.6) | 22 (66.7) | 9 (60.0) | |
Previous Anticancer therapy | ||||
Considered for Surgery | 27 (56.3) | 22 (66.7) | 5 (33.3) | 0.058 |
Perioperative Chemotherapy | 5 (10.4) | 5 (15.2) | 0 (0.0) | 0.167 |
PS (ECOG/WHO) | 0.671 | |||
0 | 33 (68.8) | 22 (66.7) | 11 (73.3) | |
1 | 13 (27.1) | 10 (30.3) | 3 (20.0) | |
2 | 2 (4.2) | 1 (3.0) | 1 (6.7) |
Patient Characteristic | Regimen with | RR (95%CI) | p Value |
---|---|---|---|
Surgery | Oxaliplatin | 2.000 (0.934–4.255) | 0.058 |
Metastatic Stage | Cisplatin | 1.980 (1.021–3.846) | 0.064 |
Primary site: Stomach | Cisplatin | 1.727 (1.047–2.857) | 0.065 |
N (%) | Total Grade | Oxaliplatin Grade | Cisplatin Grade | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Adverse Reaction | I | II | III | I | II | III | I | II | III | |
Neutropenia | 22 (45.8) | 18 | 3 | 1 | 15 | 0 | 0 | 3 | 3 | 1 |
Anemia | 45 (93.7) | 34 | 10 | 1 | 28 | 5 | 0 | 6 | 5 | 1 |
Thrombocytopenia | 12 (25.0) | 10 | 2 | 0 | 5 | 1 | 0 | 5 | 1 | 0 |
Diarrhea | 29 (40.4) | 27 | 1 | 1 | 26 | 0 | 1 | 1 | 1 | 0 |
Nausea | 41 (85.4) | 37 | 4 | 0 | 26 | 2 | 0 | 11 | 2 | 0 |
Vomiting | 36 (75.0) | 32 | 4 | 0 | 21 | 2 | 0 | 11 | 2 | 0 |
Neuropathy sensory | 10 (20.8) | 10 | 0 | 0 | 10 | 0 | 0 | 0 | 0 | 0 |
Fatigue | 33 (68.7) | 27 | 5 | 1 | 25 | 0 | 0 | 2 | 5 | 1 |
Grade III * | 3 (6.3) | 1 (3.0) | 2 (13.3) | |||||||
Supportive drugs | ||||||||||
Antiemetic | 47 (97.9) | 33 (100) | 14 (93.3) | |||||||
Antidiarrheal | 3 (6.3) | 3 (9.1) | 0 (0.0) | |||||||
G-CSF | 39 (81.3) | 32 (97) | 7 (46.7) | |||||||
Erythropoietin | 20 (41.7) | 8 (24.2) | 12 (80) |
Survival Outcome | n (%) | Oxaliplatin | Cisplatin |
---|---|---|---|
48 (100) | 33 (100) | 15 (100) | |
Best response | |||
Complete Response (CR) | 6 (12.5) | 6 (18.2) | 0 (0.0) |
Partial Response (PR) | 14 (29.2) | 9 (27.3) | 5 (33.3) |
Stable Disease (SD) | 12 (25.0) | 9 (27.3) | 3 (20.0) |
Progressive Disease (PD) | 15 (31.3) | 8 (24.2) | 7 (46.7) |
Overall survival (OS) | |||
Deaths | 20 (41.7) | 6 (18.2) | 14 (93.3) |
1-year OS | 55.9% | 81.4% | 22.5% |
2-year OS | 26.8% | 58.2% | 0.0% |
Median OS m (95%CI) | 14.6 (8.4–20.8) | 24.7 (10.1–39.3) | 5.4 (3.9–6.8) |
Progression - free survival (PFS) | |||
Events | 36 (75.0) | 21 (63.6) | 15 (100) |
1-year PFS | 18.1% | 18.9% | 13.3% |
2-year PFS | 3.6% | 6.3% | 0.0% |
Median PFS m (95%CI) | 5.1 (3. 7–6.5) | 8.4 (5.0–11.9) | 3.7 (1.4–6.0) |
Median follow up m (range) | 7.1 (2.0–45.8) | 5.0 (1.4–29.2) | 5.3 (0.7–19.1) |
ORR (CR + PR) | 20 (41.7) | 15 (45.5) | 5 (33.3) |
Median duration ORR m (95%CI) | 8.2 (2.3–14.10) | 8.2 (4.0–12.4) | 2.9 (1.6–4.2) |
DCR (CR + PR + SD) | 32 (66.7) | 24 (72.7) | 8 (53.3) |
Median duration DCR m (95%CI) | 5.4 (1.1–9.7) | 6.1 (5.0–7.3) | 2.3 (1.6–3.0) |
PFS | OS | |||||
---|---|---|---|---|---|---|
Variable | HR | 95%CI | p Value | HR | 95%CI | p Value |
PS (ECOG/WHO) | ||||||
0 | 1 | 1 | ||||
1 and 2 | 3.559 | 1.458–8.676 | 0.005 | 5.364 | 1.512–19.04 | 0.009 |
Fatigue Grade | ||||||
I | 1 | 1 | ||||
II and III | 6.456 | 2.309–18.05 | 0.002 | 113.1 | 12.07–1060 | 0.000 |
Sensory Neuropathy | ||||||
Grade 0 | 2.536 | 0.890–7.229 | 0.082 | 2.492 | 0.576–10.78 | 0.222 |
Grade 1 | 1 | 1 | ||||
Platinum Agent | ||||||
Cisplatin | 1.904 | 0.966–3.75 | 0.063 | 6.764 | 2.427–18.84 | 0.000 |
Oxaliplatin | 1 | 1 | ||||
Surgery | ||||||
No | 1 | |||||
Yes | 0.605 | 0.309–1.183 | 0.142 | 0.510 | 0.209–1.240 | 0.137 |
Histologic Grade | ||||||
II | 1 | 1 | ||||
III | 2.084 | 1.002–4.336 | 0.045 | 1.667 | 0.657–4.229 | 0.282 |
Stage | ||||||
Metastatic | 2.049 | 1.032–4.065 | 0.040 | 2.099 | 0.868–5.079 | 0.100 |
Locally advanced | 1 | 1 |
PFS | OS | |||||
---|---|---|---|---|---|---|
Variable | HR | 95%CI | p Value | HR | 95%CI | p Value |
Cisplatin vs. Oxaliplatin | 1 | 1 | ||||
Cisplatin | 1.661 | 0.724–3.813 | 0.231 | 9.634 | 2.845–32.62 | 0.000 |
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Koumarianou, A.; Ntavatzikos, A.; Vallilas, C.; Kampoli, K.; Kakoseou, Z.; Karamouzis, M.V. Survival Outcomes Following Combination of First-Line Platinum-Based Chemotherapy with S-1 in Patients with Advanced Gastric Cancer. Cancers 2020, 12, 3780. https://doi.org/10.3390/cancers12123780
Koumarianou A, Ntavatzikos A, Vallilas C, Kampoli K, Kakoseou Z, Karamouzis MV. Survival Outcomes Following Combination of First-Line Platinum-Based Chemotherapy with S-1 in Patients with Advanced Gastric Cancer. Cancers. 2020; 12(12):3780. https://doi.org/10.3390/cancers12123780
Chicago/Turabian StyleKoumarianou, Anna, Anastasios Ntavatzikos, Christos Vallilas, Katerina Kampoli, Zoi Kakoseou, and Michalis V. Karamouzis. 2020. "Survival Outcomes Following Combination of First-Line Platinum-Based Chemotherapy with S-1 in Patients with Advanced Gastric Cancer" Cancers 12, no. 12: 3780. https://doi.org/10.3390/cancers12123780