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Published in: Journal of Cancer Research and Clinical Oncology 8/2013

01-08-2013 | Original Paper

Progression-free survival and post-progression survival in patients with advanced gastric cancer treated with first-line chemotherapy

Published in: Journal of Cancer Research and Clinical Oncology | Issue 8/2013

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Abstract

Purpose

The impact of post-progression survival (PPS) on the overall survival (OS) of patients with advanced gastric cancer (AGC) has not yet been reported in detail. We analyzed prospectively collected data from AGC patients who received first-line chemotherapy including fluoropyrimidine plus platinum.

Methods

We partitioned OS into progression-free survival (PFS) and PPS in each patient and analyzed correlations between OS and either PFS or PPS using the Spearman rank correlation coefficient (ρ).

Results

A total of 291 AGC patients met the inclusion criteria with median PFS, PPS, and OS of 5.3, 8.1, and 14.8 months, respectively. PFS and OS for each patient showed a correlation of ρ = 0.75 [95 % confidence interval (CI) 0.69–0.81]. PPS and OS showed a correlation of ρ = 0.87 (95 % CI 0.84–0.91). According to multivariate analysis, performance status at progression, PFS of first-line chemotherapy, and use of second-line chemotherapy were independently associated with PPS.

Conclusions

These results indicate that both PFS and PPS are correlated with OS in first-line chemotherapy for AGC, suggesting the importance of reporting detailed patient characteristics and treatment course after disease progression in clinical trials of first-line chemotherapy for AGC.
Literature
go back to reference Ajani JA, Rodriguez W, Bodoky G, Moiseyenko V, Lichinitser M, Gorbunova V, Vynnychenko I, Garin A, Lang I, Falcon S (2010) Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol 28:1547–1553PubMedCrossRef Ajani JA, Rodriguez W, Bodoky G, Moiseyenko V, Lichinitser M, Gorbunova V, Vynnychenko I, Garin A, Lang I, Falcon S (2010) Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol 28:1547–1553PubMedCrossRef
go back to reference Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Ruschoff J, Kang YK (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376:687–697PubMedCrossRef Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Ruschoff J, Kang YK (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376:687–697PubMedCrossRef
go back to reference Burzykowski T, Buyse M, Piccart-Gebhart MJ, Sledge G, Carmichael J, Lück HJ, Mackey JR, Nabholtz JM, Paridaens R, Biganzoli L, Jassem J, Bontenbal M, Bonneterre J, Chan S, Basaran GA, Therasse P (2008) Evaluation of tumor response, disease control, progression-free survival, and time to progression as potential surrogate end points in metastatic breast cancer. J Clin Oncol 26:1987–1992PubMedCrossRef Burzykowski T, Buyse M, Piccart-Gebhart MJ, Sledge G, Carmichael J, Lück HJ, Mackey JR, Nabholtz JM, Paridaens R, Biganzoli L, Jassem J, Bontenbal M, Bonneterre J, Chan S, Basaran GA, Therasse P (2008) Evaluation of tumor response, disease control, progression-free survival, and time to progression as potential surrogate end points in metastatic breast cancer. J Clin Oncol 26:1987–1992PubMedCrossRef
go back to reference Buyse M, Burzykowski T, Carroll K, Michiels S, Sargent DJ, Miller LL, Elfring GL, Pignon JP, Piedbois P (2007) Progression-free survival is a surrogate for survival in advanced colorectal cancer. J Clin Oncol 25:5218–5224PubMedCrossRef Buyse M, Burzykowski T, Carroll K, Michiels S, Sargent DJ, Miller LL, Elfring GL, Pignon JP, Piedbois P (2007) Progression-free survival is a surrogate for survival in advanced colorectal cancer. J Clin Oncol 25:5218–5224PubMedCrossRef
go back to reference Catalano V, Graziano F, Santini D, D’Emidio S, Baldelli AM, Rossi D, Vincenzi B, Giordani P, Alessandroni P, Testa E, Tonini G, Catalano G (2008) Second-line chemotherapy for patients with advanced gastric cancer: who may benefit? Br J Cancer 99:1402–1407PubMedCrossRef Catalano V, Graziano F, Santini D, D’Emidio S, Baldelli AM, Rossi D, Vincenzi B, Giordani P, Alessandroni P, Testa E, Tonini G, Catalano G (2008) Second-line chemotherapy for patients with advanced gastric cancer: who may benefit? Br J Cancer 99:1402–1407PubMedCrossRef
go back to reference Chau I, Norman AR, Cunningham D, Waters JS, Oates J, Ross PJ (2004) Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer. Pooled analysis from three multicenter, randomized, controlled trials using individual patient data. J Clin Oncol 22:2395–2403PubMedCrossRef Chau I, Norman AR, Cunningham D, Waters JS, Oates J, Ross PJ (2004) Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer. Pooled analysis from three multicenter, randomized, controlled trials using individual patient data. J Clin Oncol 22:2395–2403PubMedCrossRef
go back to reference Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F (2008) Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 358:36–46PubMedCrossRef Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F (2008) Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 358:36–46PubMedCrossRef
go back to reference Efron B (1979) Bootstrap methods: another look at the jackknife. Ann Stat 7:1–26CrossRef Efron B (1979) Bootstrap methods: another look at the jackknife. Ann Stat 7:1–26CrossRef
go back to reference Hashimoto K, Takashima A, Nagashima K, Okazaki SS, Nakajima TE, Kato K, Hamaguchi T, Yamada Y, Shimada Y (2010) Progression-free survival in first-line chemotherapy is a prognostic factor in second-line chemotherapy in patients with advanced gastric cancer. J Cancer Res Clin Oncol 136:1059–1064PubMedCrossRef Hashimoto K, Takashima A, Nagashima K, Okazaki SS, Nakajima TE, Kato K, Hamaguchi T, Yamada Y, Shimada Y (2010) Progression-free survival in first-line chemotherapy is a prognostic factor in second-line chemotherapy in patients with advanced gastric cancer. J Cancer Res Clin Oncol 136:1059–1064PubMedCrossRef
go back to reference Hotta K, Fujiwara Y, Matsuo K, Kiura K, Takigawa N, Tabata M, Tanimoto M (2009) Time to progression as a surrogate marker for overall survival in patients with advanced non-small cell lung cancer. J Thorac Oncol 4:311–317PubMedCrossRef Hotta K, Fujiwara Y, Matsuo K, Kiura K, Takigawa N, Tabata M, Tanimoto M (2009) Time to progression as a surrogate marker for overall survival in patients with advanced non-small cell lung cancer. J Thorac Oncol 4:311–317PubMedCrossRef
go back to reference Johnson KR, Ringland C, Stokes BJ, Anthony DM, Freemantle N, Irs A, Hill SR, Ward RL (2006) Response rate or time to progression as predictors of survival in trials of metastatic colorectal cancer or non-small-cell lung cancer: a meta-analysis. Lancet Oncol 7:741–746PubMedCrossRef Johnson KR, Ringland C, Stokes BJ, Anthony DM, Freemantle N, Irs A, Hill SR, Ward RL (2006) Response rate or time to progression as predictors of survival in trials of metastatic colorectal cancer or non-small-cell lung cancer: a meta-analysis. Lancet Oncol 7:741–746PubMedCrossRef
go back to reference Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150PubMedCrossRef Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150PubMedCrossRef
go back to reference Kang YK, Kang WK, Shin DB, Chen J, Xiong J, Wang J, Lichinitser M, Guan Z, Khasanov R, Zheng L, Philco-Salas M, Suarez T, Santamaria J, Forster G, McCloud PI (2009) Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomised phase III noninferiority trial. Ann Oncol 20:666–673PubMedCrossRef Kang YK, Kang WK, Shin DB, Chen J, Xiong J, Wang J, Lichinitser M, Guan Z, Khasanov R, Zheng L, Philco-Salas M, Suarez T, Santamaria J, Forster G, McCloud PI (2009) Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomised phase III noninferiority trial. Ann Oncol 20:666–673PubMedCrossRef
go back to reference Kang JH, Lee SI, Lim do H, Park KW, Oh SY, Kwon HC, Hwang IG, Lee SC, Nam E, Shin DB, Lee J, Park JO, Park YS, Lim HY, Kang WK, Park SH (2012) Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol 30:1513–1518PubMedCrossRef Kang JH, Lee SI, Lim do H, Park KW, Oh SY, Kwon HC, Hwang IG, Lee SC, Nam E, Shin DB, Lee J, Park JO, Park YS, Lim HY, Kang WK, Park SH (2012) Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol 30:1513–1518PubMedCrossRef
go back to reference Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9:215–221PubMedCrossRef Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9:215–221PubMedCrossRef
go back to reference Pozzo C, Ohashi Y, on behalf of the GASTRIC project (2009) Meta-analyses of randomized trials assessing the influence of chemotherapy and prognostic factor in advanced/recurrent gastric cancer. J Clin Oncol 27:15s (suppl; abstr 4550)CrossRef Pozzo C, Ohashi Y, on behalf of the GASTRIC project (2009) Meta-analyses of randomized trials assessing the influence of chemotherapy and prognostic factor in advanced/recurrent gastric cancer. J Clin Oncol 27:15s (suppl; abstr 4550)CrossRef
go back to reference Saad ED, Katz A, Hoff PM, Buyse M (2010) Progression-free survival as surrogate and as true end point: insights from the breast and colorectal cancer literature. Ann Oncol 21:7–12PubMedCrossRef Saad ED, Katz A, Hoff PM, Buyse M (2010) Progression-free survival as surrogate and as true end point: insights from the breast and colorectal cancer literature. Ann Oncol 21:7–12PubMedCrossRef
go back to reference Seidel C, Busch J, Weikert S, Steffens S, Fenner M, Ganser A, Grunwald V (2012) Progression free survival of first line vascular endothelial growth factor-targeted therapy is an important prognostic parameter in patients with metastatic renal cell carcinoma. Eur J Cancer 48:1023–1030PubMedCrossRef Seidel C, Busch J, Weikert S, Steffens S, Fenner M, Ganser A, Grunwald V (2012) Progression free survival of first line vascular endothelial growth factor-targeted therapy is an important prognostic parameter in patients with metastatic renal cell carcinoma. Eur J Cancer 48:1023–1030PubMedCrossRef
go back to reference Shitara K, Burzykowski T, On behalf of GASTRIC project (2011) Progression-free survival as surrogate endpoint of overall survival in patients with advanced/recurrent gastric cancer: Individual patient data analysis on 4,102 patients from 20 randomized trials. J Clin Oncol 29 (suppl; abstr 4095) Shitara K, Burzykowski T, On behalf of GASTRIC project (2011) Progression-free survival as surrogate endpoint of overall survival in patients with advanced/recurrent gastric cancer: Individual patient data analysis on 4,102 patients from 20 randomized trials. J Clin Oncol 29 (suppl; abstr 4095)
go back to reference Shitara K, Matsuo K, Yokota T, Takahari D, Shibata T, Ura T, Inaba Y, Yamaura H, Sato Y, Najima M, Muro K (2011) Prognostic factors for metastatic colorectal cancer patients undergoing irinotecan-based second-line chemotherapy. Gastrointest Cancer Res 4:168–172PubMed Shitara K, Matsuo K, Yokota T, Takahari D, Shibata T, Ura T, Inaba Y, Yamaura H, Sato Y, Najima M, Muro K (2011) Prognostic factors for metastatic colorectal cancer patients undergoing irinotecan-based second-line chemotherapy. Gastrointest Cancer Res 4:168–172PubMed
go back to reference Shitara K, Ikeda J, Yokota T, Takahari D, Ura T, Muro K, Matsuo K (2012a) Progression-free survival and time to progression as surrogate markers of overall survival in patients with advanced gastric cancer: analysis of 36 randomized trials. Invest New Drugs 30:1224–1231PubMedCrossRef Shitara K, Ikeda J, Yokota T, Takahari D, Ura T, Muro K, Matsuo K (2012a) Progression-free survival and time to progression as surrogate markers of overall survival in patients with advanced gastric cancer: analysis of 36 randomized trials. Invest New Drugs 30:1224–1231PubMedCrossRef
go back to reference Shitara K, Ikeda J, Kondo C, Takahari D, Ura T, Muro K, Matsuo K (2012b) Reporting patient characteristics and stratification factors in randomized trials of systemic chemotherapy for advanced gastric cancer. Gastric Cancer 15:137–143PubMedCrossRef Shitara K, Ikeda J, Kondo C, Takahari D, Ura T, Muro K, Matsuo K (2012b) Reporting patient characteristics and stratification factors in randomized trials of systemic chemotherapy for advanced gastric cancer. Gastric Cancer 15:137–143PubMedCrossRef
go back to reference Thuss-Patience PC, Kretzschmar A, Deist T, Hinke A, Bichev D, Lebedinzew B (2011) Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer—a randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Eur J Cancer 47:2306–2314PubMedCrossRef Thuss-Patience PC, Kretzschmar A, Deist T, Hinke A, Bichev D, Lebedinzew B (2011) Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer—a randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Eur J Cancer 47:2306–2314PubMedCrossRef
go back to reference Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, Rodrigues A, Fodor M, Chao Y, Voznyi E, Risse ML, Ajani JA (2006) Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 study group. J Clin Oncol 24:4991–4997PubMedCrossRef Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, Rodrigues A, Fodor M, Chao Y, Voznyi E, Risse ML, Ajani JA (2006) Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 study group. J Clin Oncol 24:4991–4997PubMedCrossRef
go back to reference Van Cutsem E, Yeh KH, Bang YJ, Shen L, Ajani JA, ShenL, Ajani JA, Bai YX, Chung HC, Pan HM, Chin K, Muro K, Kim YH, Smith H, Costantini C, Musalli S, Rizvi S, Sahmoud T, Ohtsu A (2012) Phase III trial of everolimus (EVE) in previously treated patients with advanced gastric cancer (AGC): GRANITE-1. Gastrointestinal cancer symposium LBA3 Van Cutsem E, Yeh KH, Bang YJ, Shen L, Ajani JA, ShenL, Ajani JA, Bai YX, Chung HC, Pan HM, Chin K, Muro K, Kim YH, Smith H, Costantini C, Musalli S, Rizvi S, Sahmoud T, Ohtsu A (2012) Phase III trial of everolimus (EVE) in previously treated patients with advanced gastric cancer (AGC): GRANITE-1. Gastrointestinal cancer symposium LBA3
go back to reference Waddell TS, Chau I, Barbachano Y, de Castro DG, Wotherspoon A (2012) A randomized multicenter trial of epirubicin, oxaliplatin, and capecitabine (EOC) plus panitumumab in advanced esophagogastric cancer (REAL3). J Clin Oncol 30 (suppl; abstr LBA4000) Waddell TS, Chau I, Barbachano Y, de Castro DG, Wotherspoon A (2012) A randomized multicenter trial of epirubicin, oxaliplatin, and capecitabine (EOC) plus panitumumab in advanced esophagogastric cancer (REAL3). J Clin Oncol 30 (suppl; abstr LBA4000)
Metadata
Title
Progression-free survival and post-progression survival in patients with advanced gastric cancer treated with first-line chemotherapy
Publication date
01-08-2013
Published in
Journal of Cancer Research and Clinical Oncology / Issue 8/2013
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-013-1452-y

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