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Published in: Gastric Cancer 2/2013

Open Access 01-04-2013 | Original Article

Efficacy and safety of capecitabine plus cisplatin in Japanese patients with advanced or metastatic gastric cancer: subset analyses of the AVAGAST study and the ToGA study

Authors: Kensei Yamaguchi, Akira Sawaki, Toshihiko Doi, Taroh Satoh, Yasuhide Yamada, Yasushi Omuro, Tomohiro Nishina, Narikazu Boku, Keisho Chin, Yasuo Hamamoto, Hiroya Takiuchi, Yoshito Komatsu, Shigehira Saji, Wasaburo Koizumi, Yoshinori Miyata, Atsushi Sato, Eishi Baba, Takao Tamura, Takashi Abe, Atsushi Ohtsu

Published in: Gastric Cancer | Issue 2/2013

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Abstract

Background

Capecitabine plus cisplatin (XP) is recognized as one of the global standard first-line chemotherapy regimens for patients with metastatic gastric cancer (mGC). Recent multinational phase III trials in mGC have been conducted with XP as the control arm, although no data on XP in Japanese patients with mGC have been published to date. The AVAGAST (XP ± bevacizumab in mGC) and ToGA (XP ± trastuzumab in human epidermal growth factor receptor 2 [HER2]-positive mGC) studies were the first two global studies including Japanese mGC patients. The aim of this analysis was to investigate the efficacy and safety of XP in Japanese mGC patients, using AVAGAST and ToGA subgroup data.

Methods

Efficacy and safety analyses were carried out in Japanese patients with mGC receiving XP alone, based on results from the AVAGAST and ToGA studies. There were differences in the target populations between the two studies; for example, the ToGA study limited patients to those with HER2-positive tumors; therefore, efficacy was evaluated separately.

Results

Ninety-four Japanese patients in the AVAGAST study and 50 in the ToGA study received XP alone. Median overall and progression-free survivals were 14.2 and 5.7 months, respectively, in the AVAGAST study, and 17.7 and 5.6 months, respectively, in the ToGA study. Overall response rates were 49.2 % in the AVAGAST and 58.5 % in the ToGA study. Adverse events were generally mild; the most common grade 3/4 events were neutropenia, anemia, anorexia, and nausea.

Conclusions

XP is effective and well tolerated in Japanese patients with mGC, and could be one of the standard regimens for the first-line treatment in this cohort.
Literature
1.
go back to reference Ferlay J, Bray F, Parkin DM, Pisani P, editors. Gobocan 2000: cancer incidence and mortality worldwide (IARC Cancer Bases No. 5). Lyon: IARC Press; 2001. Ferlay J, Bray F, Parkin DM, Pisani P, editors. Gobocan 2000: cancer incidence and mortality worldwide (IARC Cancer Bases No. 5). Lyon: IARC Press; 2001.
2.
go back to reference Lau M, Le A, El-Serag HB. Noncardia gastric adenocarcinoma remains an important and deadly cancer in the United States: secular trends in incidence and survival. Am J Gastroenterol. 2006;101:2485–92.PubMedCrossRef Lau M, Le A, El-Serag HB. Noncardia gastric adenocarcinoma remains an important and deadly cancer in the United States: secular trends in incidence and survival. Am J Gastroenterol. 2006;101:2485–92.PubMedCrossRef
3.
go back to reference Parkin DM. Epidemiology of cancer: global patterns and trends. Toxicol Lett. 1998;102–103:227–34.PubMedCrossRef Parkin DM. Epidemiology of cancer: global patterns and trends. Toxicol Lett. 1998;102–103:227–34.PubMedCrossRef
5.
go back to reference Okines AF, Norman AR, McCloud P, Kang YK, Cunningham D. Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combination chemotherapy for the treatment of advanced oesophago-gastric cancer. Ann Oncol. 2009;20:1529–34.PubMedCrossRef Okines AF, Norman AR, McCloud P, Kang YK, Cunningham D. Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combination chemotherapy for the treatment of advanced oesophago-gastric cancer. Ann Oncol. 2009;20:1529–34.PubMedCrossRef
6.
go back to reference Japanese Gastric Cancer Association. Gastric cancer treatment guideline. 3rd ed. Tokyo: Kanahara-shuppan; 2010. Japanese Gastric Cancer Association. Gastric cancer treatment guideline. 3rd ed. Tokyo: Kanahara-shuppan; 2010.
7.
go back to reference Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A. et al. 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. 2010;376:687–97.PubMedCrossRef Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A. et al. 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. 2010;376:687–97.PubMedCrossRef
8.
go back to reference Ohtsu A, Shah MA, Van Cutsem E, Rha SY, Sawaki A, Park SR. et al. Bevacizumab in combination with chemotherapy as first-line therapy in advanced gastric cancer: a randomized, double-blind, placebo-controlled phase III study. J Clin Oncol. 2011; 29:3968–76PubMedCrossRef Ohtsu A, Shah MA, Van Cutsem E, Rha SY, Sawaki A, Park SR. et al. Bevacizumab in combination with chemotherapy as first-line therapy in advanced gastric cancer: a randomized, double-blind, placebo-controlled phase III study. J Clin Oncol. 2011; 29:3968–76PubMedCrossRef
9.
go back to reference Ohtsu A. Chemotherapy for metastatic gastric cancer: past, present, and future. J Gastroenterol. 2008;43:256–64.PubMedCrossRef Ohtsu A. Chemotherapy for metastatic gastric cancer: past, present, and future. J Gastroenterol. 2008;43:256–64.PubMedCrossRef
10.
go back to reference Ohtsu A, Yoshida S, Saijo N. Disparities in gastric cancer chemotherapy between the East and West. J Clin Oncol. 2006;24:2188–96.PubMedCrossRef Ohtsu A, Yoshida S, Saijo N. Disparities in gastric cancer chemotherapy between the East and West. J Clin Oncol. 2006;24:2188–96.PubMedCrossRef
11.
go back to reference Boku N, Yamamoto S, Fukuda H, Shirao K, Doi T, Sawaki A, et al. Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol. 2009;10:1063–69. Boku N, Yamamoto S, Fukuda H, Shirao K, Doi T, Sawaki A, et al. Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol. 2009;10:1063–69.
12.
go back to reference Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.PubMedCrossRef Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.PubMedCrossRef
13.
go back to reference Koizumi W, Okayasu I, Hyodo I, Sakamoto J, Kojima H. Prediction of the effect of capecitabine in gastric cancer by immunohistochemical staining of thymidine phosphorylase and dihydropyrimidine dehydrogenase. Anticancer Drugs. 2008;19:819–24.PubMedCrossRef Koizumi W, Okayasu I, Hyodo I, Sakamoto J, Kojima H. Prediction of the effect of capecitabine in gastric cancer by immunohistochemical staining of thymidine phosphorylase and dihydropyrimidine dehydrogenase. Anticancer Drugs. 2008;19:819–24.PubMedCrossRef
14.
go back to reference Koizumi W, Tanabe S, Azuma M, Ishido K, Nishimura K, Sasaki T, et al. Impacts of fluorouracil-metabolizing enzymes on the outcomes of patients treated with S-1 alone or S-1 plus cisplatin for first-line treatment of advanced gastric cancer. Int J Cancer. 2010;126:162–70.PubMedCrossRef Koizumi W, Tanabe S, Azuma M, Ishido K, Nishimura K, Sasaki T, et al. Impacts of fluorouracil-metabolizing enzymes on the outcomes of patients treated with S-1 alone or S-1 plus cisplatin for first-line treatment of advanced gastric cancer. Int J Cancer. 2010;126:162–70.PubMedCrossRef
Metadata
Title
Efficacy and safety of capecitabine plus cisplatin in Japanese patients with advanced or metastatic gastric cancer: subset analyses of the AVAGAST study and the ToGA study
Authors
Kensei Yamaguchi
Akira Sawaki
Toshihiko Doi
Taroh Satoh
Yasuhide Yamada
Yasushi Omuro
Tomohiro Nishina
Narikazu Boku
Keisho Chin
Yasuo Hamamoto
Hiroya Takiuchi
Yoshito Komatsu
Shigehira Saji
Wasaburo Koizumi
Yoshinori Miyata
Atsushi Sato
Eishi Baba
Takao Tamura
Takashi Abe
Atsushi Ohtsu
Publication date
01-04-2013
Publisher
Springer Japan
Published in
Gastric Cancer / Issue 2/2013
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-012-0167-0

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