Impact of progression type on overall survival in patients with advanced gastric cancer based on randomized phase III study of S-1 plus oxaliplatin versus S-1 plus cisplatin.
BACKGROUND
The association between progression type and survival has been reported in breast cancer, but remains unclear in advanced gastric cancer (AGC). Here, this association was assessed using data obtained from an earlier randomized phase III study demonstrating the non-inferiority of S-1 plus oxaliplatin (SOX) to S-1 plus cisplatin (CS) on progression-free survival and overall survival (OS) in the first-line treatment of AGC.


METHODS
A Cox regression model including two time-dependent covariates, progression with new lesions and with no new lesions, was used to determine their effect on OS in each treatment group. When both types of progression were detected simultaneously, this was categorized as progression with new lesions.


RESULTS
Progression with and with no new lesions was identified in 91 and 167 patients, respectively, in the SOX group (333 patients) and 95 and 147 patients, respectively, in the CS group (330 patients). The association between progression type and OS was similar in both treatment groups; both progression types were strong poor prognostic factors, particularly progression with new lesions [hazard ratio (HR), 7.26; 95% confidence interval (CI), 4.89-10.80 in SOX and HR, 5.78; 95% CI, 4.13-8.08 in CS] compared to no new lesions (HR, 4.66; 95% CI, 3.21-6.77 in SOX and HR, 2.71; 95% CI, 1.95-3.75 in CS).


CONCLUSIONS
Progression accompanied by new lesions had a strong negative impact on OS in patients treated with S-1 and platinum for AGC.
Department of Surgery, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan. kazuno13@hotmail.co.jp.
Kazuhiro
K
Nishikawa
Gastrointestinal Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
Yasuhide
Y
Yamada
Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan.
Kenji
K
Ishido
Cancer Chemotherapy Center, Osaka Medical College Hospital, Takatsuki, Japan.
Masahiro
M
Gotoh
Division of Gastrointestinal Oncology and Digestive Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan.
Hideaki
H
Bando
Department of Clinical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Naotoshi
N
Sugimoto
Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Tomohiro
T
Nishina
Department of Gastroenterology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
Kenji
K
Amagai
Department of Gastroenterology, Cancer Institute Hospital of JFCR, Tokyo, Japan.
Keisho
K
Chin
Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan.
Yasumasa
Y
Niwa
Department of Medical Oncology, Kochi Health Sciences Center, Kochi, Japan.
Akihito
A
Tsuji
Department of Surgery, Sakai City Hospital, Sakai, Japan.
Hiroshi
H
Imamura
Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan.
Masahiro
M
Tsuda
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-Gun, Japan.
Hirofumi
H
Yasui
Division of Clinical Oncology, Jichi Medical University, Shimotsuke, Japan.
Hirofumi
H
Fujii
Division of Gastroenterology, Saitama Cancer Center, Kita-Adachi-Gun, Japan.
Kensei
K
Yamaguchi
Department of Medical Oncology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Hisateru
H
Yasui
Clinical Trial Promotion Department, Chiba Cancer Center, Chiba, Japan.
Shuichi
S
Hironaka
Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Ken
K
Shimada
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Hiroto
H
Miwa
Faculty of Engineering, Tokyo University of Science, Tokyo, Japan.
Chikuma
C
Hamada
Division of Gastroenterology, University of Tsukuba, Tsukuba, Japan.
Ichinosuke
I
Hyodo
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010094:Oxonic Acid / Q000008:administration & dosage; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage
D004338:Drug Combinations; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin
Gastric cancer; Overall survival; Progression type; Progression-free survival; S-1 plus oxaliplatin