title: Retention of platinum sensitivity till late stages of tumour progression may imply improved prognosis of oesophageal and gastric cancers.
abstract: BACKGROUND
  We report on the outcomes of patients with metastatic oesophago-gastric (OG) cancer progressing after first-line platinum-based chemotherapy (PBCT) who received a re-challenge schedule of PBCT (r-PBCT) as second-line therapy.
  
  
  METHODS
  Patients with metastatic OG cancer treated with first-line PBCT (n = 138) between January 2009 and June 2013 were selected for the purpose of the study. Treatment-related outcomes were assessed including response rates, progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  43 (32%) patients progressed (group A: platinum resistant (PR)) and 95 (68%) patients showed a response (group B: platinum sensitive (PS)) or had stable disease after first-line PBCT. Approximately 20% (9/43) of the patients in group A received second-line chemotherapy compared to 50% (38/80) in group B. Most patients (39/47) received r-PBCT, and the remaining patients (8/47) were treated with irinotecan-based chemotherapy. More than 50% (20/39) of the patients achieved disease control, with median PFS and OS of 3 months (95% confidence interval (CI) = 2.0-4.0 months) and 5.7 months (95% CI = 4.7-6.7 months) after commencement of r-PBCT. The actuarial median OS of patients responding to second-line or second and third lines of r-PBCT was 26.7 and 30.1 months, respectively.
  
  
  CONCLUSIONS
  In platinum responders, r-PBCT appears to be an appropriate second-line option with survival outcomes comparable to those of other agents.
authors: Castle Hill Hospital, Cottingham, UK.
authors: Mohan
authors: M
authors: Hingorani
authors: Sanjay
authors: S
authors: Dixit
authors: Rajarshi
authors: R
authors: Roy
authors: Anthony
authors: A
authors: Maraveyas
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D019008:Drug Resistance, Neoplasm; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017671:Platinum Compounds / Q000008:administration & dosage*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017671:Platinum Compounds