Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/16641
Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry
StatisticsItem usage statistics
MetadataShow Dublin Core item record
AuthorJimenez Fonseca, Paula; Carmona-Bayonas, Alberto; Hernandez, Raquel; Custodio, Ana; Maria Cano, Juana; Lacalle, Alejandra; Echavarria, Isabel; Macias, Ismael; Mangas, Monserrat; Visa, Laura; Buxo, Elvira; Alvarez Mancenido, Felipe; Viudez, Antonio; Pericay, Carles; Azkarate, Aitor; Ramchandani, Avinash; Lopez, Carlos; Martinez de Castro, Eva; Fernandez Montes, Ana; Longo, Federico; Sanchez Bayona, Rodrigo; Luisa Limon, Maria; Diaz-Serrano, Asun; Martin Carnicero, Alfonso; Arias, David; Cerda, Paula; Rivera, Fernando; Maria Vieitez, Jose; Sanchez Canovas, Manuel; Garrido, M.; Gallego, J.; AGAMENON Study Grp
Document typeresearch article
CitationJimenez Fonseca P, Carmona-Bayonas A, Hernandez R, Custodio A, Maria Cano J, Lacalle A, et al. Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry. Br J Cancer. 2017 Sep 05;117(6):775-82. Epub 2017 Aug 1.
BACKGROUND: The choice of chemotherapy in HER2-negative gastric cancer is based on centre's preferences and adverse effects profile. No schedule is currently accepted as standard, nor are there any factors to predict response, other than HER2 status. We seek to evaluate whether Lauren type influences the efficacy of various chemotherapies and on patient overall survival (OS). METHODS: We have conducted a multicenter study in 31 hospitals. The eligibility criteria include diagnosis of stomach or gastroesophageal junction adenocarcinoma, HER2 negativity, and chemotherapy containing 2-3 drugs. Cox proportional hazards regression adjusted for confounding factors, with tests of 'treatment-by-histology' interaction, was used to estimate treatment effect. RESULTS: Our registry contains 1303 tumours analysable for OS end points and 730 evaluable for overall response rate (ORR). A decrease in ORR was detected in the presence of a diffuse component: odds ratio 0.719 (95% confidence interval (CI), 0.525-0.987), P = 0.039. Anthracycline-or docetaxel-containing schedules increased ORR only in the intestinal type. The diffuse type displayed increased mortality with hazard ratio (HR) of 1.201 (95% CI, 1.054-1.368), P = 0.0056. Patients receiving chemotherapy with docetaxel exhibited increased OS limited to the intestinal type: HR 0.65 (95% CI, 0.49-0.87), P = 0.024, with no increment in OS for the subset having a diffuse component. With respect to progression-free survival (PFS), a significant interaction was seen in the effect of docetaxel-containing schedules, with better PFS limited to the intestinal type subgroup, in the comparison against any other schedule: HR 0.65 (95% CI, 0.50-0.85), P = 0.015, and against anthracycline-based regimens: HR 0.64 (95% CI, 0.46-0.88), P = 0.046. CONCLUSIONS: As a conclusion, in this registry, Lauren classification tumour subtypes predicted survival and responded differently to chemotherapy. Future clinical trials should stratify effect estimations based on histology.
Keywordsadvanced gastric cancer
Antineoplastic Combined Chemotherapy Protocols
Resultado del Tratamiento
Persona de Mediana Edad
Protocolos de Quimioterapia Combinada Antineoplásica
Supervivencia sin Enfermedad
Sistema de Registros