Optimal duration of first-line chemotherapy for advanced gastric cancer: data from the AGAMENON registry

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dc.contributor.authorViudez, A.
dc.contributor.authorCarmona Bayonas, A.
dc.contributor.authorGallego, J.
dc.contributor.authorLacalle, A.
dc.contributor.authorHernandez, R.
dc.contributor.authorCano, J. M.
dc.contributor.authorMacias, I
dc.contributor.authorCustodio, A.
dc.contributor.authorMartinez de Castro, E.
dc.contributor.authorSanchez, A.
dc.contributor.authorIglesia, L.
dc.contributor.authorReguera, P.
dc.contributor.authorVisa, L.
dc.contributor.authorAzkarate, A.
dc.contributor.authorSanchez Canovas, M.
dc.contributor.authorMangas, M.
dc.contributor.authorLimon, M. L.
dc.contributor.authorMartinez Torron, A.
dc.contributor.authorAsensio, E.
dc.contributor.authorRamchandani, A.
dc.contributor.authorMartin Carnicero, A.
dc.contributor.authorHurtado, A.
dc.contributor.authorCerda, P.
dc.contributor.authorGarrido, M.
dc.contributor.authorSanchez Bayonas, R.
dc.contributor.authorSerrano, R.
dc.contributor.authorJimenez Fonseca, P.
dc.contributor.authorAGAMENON Study Grp
dc.date.accessioned2024-01-10T13:51:34Z
dc.date.available2024-01-10T13:51:34Z
dc.date.issued2020
dc.description.abstractBackground The optimal duration of first-line chemotherapy for patients with advanced gastric cancer is unknown. Diverse clinical trials have proposed different strategies including limited treatment, maintenance of some drugs, or treatment until progression. Method The sample comprises patients from the AGAMENON multicenter registry without progression after second evaluation of response. The objective was to explore the optimal duration of first-line chemotherapy. A frailty multi-state model was conducted. Results 415 patients were divided into three strata: discontinuation of platinum and maintenance with fluoropyrimidine until progression (30%, n = 123), complete treatment withdrawal prior to progression (52%, n = 216), and full treatment until progression (18%, n = 76). The hazard of tumor progression decreased by 19% per month with the full treatment regimen. However, we found no evidence that fluoropyrimidine maintenance (hazard ratio [HR] 1.07, confidence interval [CI] 95%, 0.69-1.65) worsened progression-free survival (PFS) with respect to treatment until progression. Predictive factors for PFS were ECOG performance status, >= 3 metastatic sites, prior tumor response, and bone metastases. Toxicity grade 3/4 was more common in those who continued the full treatment until progression vs fluoropyrimidine maintenance (16% vs 6%). Conclusion The longer duration of the full initial regimen exerted a protective effect on the patients of this registry. Platinum discontinuation followed by fluoropyrimidine maintenance yields comparable efficacy to treatment up to PD, with a lower rate of serious adverse events.
dc.fechaingreso.objetodigital2024-03-18
dc.format.extent17 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1007/s12094-019-02183-y
dc.identifier.eissn1699-3055
dc.identifier.issn1699-048X
dc.identifier.pubmedidMEDLINE:31385226
dc.identifier.urihttps://doi.org/10.1007/s12094-019-02183-y
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79611
dc.identifier.wosidWOS:000524244200012
dc.information.autorucMedicina;Garrido M;S/I;7260
dc.issue.numero5
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final750
dc.pagina.inicio734
dc.publisherSPRINGER INTERNATIONAL PUBLISHING AG
dc.revistaCLINICAL & TRANSLATIONAL ONCOLOGY
dc.rightsacceso restringido
dc.subjectAdvanced gastric cancer
dc.subjectAGAMENON
dc.subjectTreatment duration
dc.subjectMaintenance
dc.subjectMulti-state
dc.subjectPHASE-III
dc.subjectCAPECITABINE
dc.subjectOXALIPLATIN
dc.subjectADENOCARCINOMA
dc.subjectMULTICENTER
dc.subjectMAINTENANCE
dc.subjectCOMBINATION
dc.subjectFLUOROURACIL
dc.subjectTRASTUZUMAB
dc.subjectBEVACIZUMAB
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleOptimal duration of first-line chemotherapy for advanced gastric cancer: data from the AGAMENON registry
dc.typeartículo
dc.volumen22
sipa.codpersvinculados7260
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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