Early tumor shrinkage and depth of response in patients with advanced gastric cancer: a retrospective analysis of a randomized phase III study of first-line S-1 plus oxaliplatin vs. S-1 plus cisplatin - PubMed
. 2019 Jan;22(1):138-146.
doi: 10.1007/s10120-018-0845-7. Epub 2018 Jun 9.
Mizutomo Azuma 2 , Kazuhiro Nishikawa 3 , Masahiro Gotoh 4 , Hideaki Bando 5 , Naotoshi Sugimoto 6 , Kenji Amagai 7 , Keisho Chin 8 , Yasumasa Niwa 9 , Akihito Tsuji 10 , Hiroshi Imamura 11 , Masahiro Tsuda 12 , Hirofumi Yasui 13 , Hirofumi Fujii 14 , Kensei Yamaguchi 15 , Hisateru Yasui 16 , Shuichi Hironaka 17 , Ken Shimada 18 , Hiroto Miwa 19 , Terukazu Mitome 20 , Hiroki Kageyama 20 , Ichinosuke Hyodo 21
Affiliations
- PMID: 29948386
- DOI: 10.1007/s10120-018-0845-7
Early tumor shrinkage and depth of response in patients with advanced gastric cancer: a retrospective analysis of a randomized phase III study of first-line S-1 plus oxaliplatin vs. S-1 plus cisplatin
Tomohiro Nishina et al. Gastric Cancer. 2019 Jan.
Abstract
Background: We investigated early tumor shrinkage (ETS) and depth of response (DpR) using data from the G-SOX study comparing S-1 plus oxaliplatin with S-1 plus cisplatin as the first-line treatment for advanced gastric cancer (AGC).
Methods: ETS was determined as % decrease in the sum of the longest diameters of the target lesions at the first evaluation of week 6 compared to baseline. DpR was the maximum % shrinkage during the study treatment. The impact of ETS (cutoff value 20%) and DpR (continuous value) on progression-free survival (PFS) and overall survival (OS) were assessed by the log-rank test and Cox regression analysis including prognostic factors obtained in the G-SOX study; ECOG performance status, baseline sum of tumor diameters, disease status (recurrent/unresectable), and histology (diffuse/intestinal).
Results: Among 685 patients enrolled in the G-SOX study, 632 patients who had the first tumor evaluation were analyzed. Patients with ETS ≥ 20% had longer PFS (median 4.5 vs. 2.8 months, p < 0.0001) and OS (median 14.8 vs. 10.5 months, p < 0.0001) than those with ETS < 20%. Adjusted hazard ratios of ETS < 20 vs. ≥ 20% were 0.606 (95% confidence interval (CI) 0.506-0.725) for PFS and 0.589 (95% CI 0.492-0.704) for OS. DpR was also significantly associated with PFS and OS (both p < 0.0001). These results were similar between the SOX and CS groups.
Conclusions: In AGC patients receiving the first-line therapy, ETS and DpR might be predictors for PFS and OS.
Keywords: Chemotherapy; Depth of response; Early tumor shrinkage; Gastric cancer; Oxaliplatin.
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