Efficacy of chemotherapy for patients with gastric cancer with early recurrence during or after adjuvant chemotherapy with S-1 alone: A multicenter retrospective study

Author:

Yamaguchi Toshifumi1,Kumagai Koshi2,Yagi Shusuke2,Nomura Takashi3,Nagashima Kengo4,Watanabe Masaya5,Makuuchi Rie6,Kawakami Kentaro7,Matsushima Tomohiro8,Kadowaki Shigenori9,Haruta Shusuke10,Cho Haruhiko11,Kakihara Naoki12,Otsuka Shinya13,Yamada Takanobu14,Imai Yoshiro1,Boku Narikazu15

Affiliation:

1. Osaka Medical and Pharmaceutical University Hospital

2. Cancer Institute Hospital of JFCR

3. Yamagata Prefectural Central Hospital

4. Keio University Hospital

5. Shizuoka General Hospital

6. Shizuoka Cancer Center

7. Keiyukai Sapporo Hospital

8. Saitama Cancer Center

9. Aichi Cancer Center Hospital

10. Toranomon Hospital

11. Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital

12. Japanese Red Cross Kyoto Daini Hospital

13. National Hospital Organization Fukuyama Medical Center

14. Kanagawa Cancer Center

15. IMSUT Hospital, University of Tokyo

Abstract

Abstract

This study aimed to survey the efficacy of chemotherapy regimens in the real world setting and explore the most promising regimen for patients experiencing early recurrence for gastric cancer. We retrospectively reviewed the clinical course of 207 patients with gastric cancer, who developed early recurrence during or within 6 months after completing S-1 adjuvant therapy at 19 Japanese institutions between 2012 and 2016. The treatment regimens after recurrence were fluoropyrimidines plus platinum-based regimens (FP) in 91 (44%) patients, paclitaxel-based regimens (PTX) in 102 (49%), and irinotecan-based regimens (IRI) in 14 (7%). The overall response and disease control rates were 28.7% and 54.1%. Median progression-free survival (PFS) and overall survival (OS) were 5.1 and 12.9 months, respectively. In the FP, PTX, and IRI regimens, the median PFS and OS were 5.9, 4.1, 4.1 months and 12.8, 12.9, and 11.8 months, respectively. The combination of PTX and ramucirumab demonstrated the most favorable survival. Multivariate analyses for OS showed that recurrence during adjuvant chemotherapy and undifferentiated histological type were independent poor prognostic factors. Although the prognosis of patients with early recurrence even withadjuvant S-1 was poor, PTX plus ramucirumab therapy could be a potential treatment option.

Publisher

Springer Science and Business Media LLC

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