دورية أكاديمية

Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry.

التفاصيل البيبلوغرافية
العنوان: Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry.
المؤلفون: Jiménez Fonseca, Paula1, Carmona-Bayonas, Alberto2, Hernández, Raquel3, Custodio, Ana4, Cano, Juana Maria5, Lacalle, Alejandra6, Echavarria, Isabel7, Macias, Ismael8, Mangas, Monserrat9, Visa, Laura10, Buxo, Elvira11, Álvarez Manceñido, Felipe12, Viudez, Antonio6, Pericay, Carles8, Azkarate, Aitor13, Ramchandani, Avinash14, López, Carlos15, Martinez de Castro, Eva15, Fernández Montes, Ana16, Longo, Federico17
المصدر: British Journal of Cancer. 9/5/2017, Vol. 117 Issue 6, p775-782. 8p. 2 Charts, 4 Graphs.
مصطلحات موضوعية: *ANTINEOPLASTIC agents, *ANTHRACYCLINES, *CELL receptors, *CISPLATIN, *COMPARATIVE studies, *HYDROCARBONS, *RESEARCH methodology, *MEDICAL cooperation, *PROGNOSIS, *RESEARCH, *STOMACH tumors, *EVALUATION research, *TREATMENT effectiveness, *ACQUISITION of data, *ODDS ratio
مصطلحات جغرافية: CHILE, SPAIN
مستخلص: Background: The choice of chemotherapy in HER2-negative gastric cancer is based on centre's preferences and adverse effects profile. No schedule is currently accepted as standard, nor are there any factors to predict response, other than HER2 status. We seek to evaluate whether Lauren type influences the efficacy of various chemotherapies and on patient overall survival (OS).Methods: We have conducted a multicenter study in 31 hospitals. The eligibility criteria include diagnosis of stomach or gastroesophageal junction adenocarcinoma, HER2 negativity, and chemotherapy containing 2-3 drugs. Cox proportional hazards regression adjusted for confounding factors, with tests of 'treatment-by-histology' interaction, was used to estimate treatment effect.Results: Our registry contains 1303 tumours analysable for OS end points and 730 evaluable for overall response rate (ORR). A decrease in ORR was detected in the presence of a diffuse component: odds ratio 0.719 (95% confidence interval (CI), 0.525-0.987), P=0.039. Anthracycline- or docetaxel-containing schedules increased ORR only in the intestinal type. The diffuse type displayed increased mortality with hazard ratio (HR) of 1.201 (95% CI, 1.054-1.368), P=0.0056. Patients receiving chemotherapy with docetaxel exhibited increased OS limited to the intestinal type: HR 0.65 (95% CI, 0.49-0.87), P=0.024, with no increment in OS for the subset having a diffuse component. With respect to progression-free survival (PFS), a significant interaction was seen in the effect of docetaxel-containing schedules, with better PFS limited to the intestinal type subgroup, in the comparison against any other schedule: HR 0.65 (95% CI, 0.50-0.85), P=0.015, and against anthracycline-based regimens: HR 0.64 (95% CI, 0.46-0.88), P=0.046.Conclusions: As a conclusion, in this registry, Lauren classification tumour subtypes predicted survival and responded differently to chemotherapy. Future clinical trials should stratify effect estimations based on histology. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
الوصف
تدمد:00070920
DOI:10.1038/bjc.2017.245