684P - First-line chemotherapy for patients with gastroesophageal adenocarcinoma in the community setting: A multicenter cohort of 418 patients

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Gastric Cancer
Presenter Marcelo Garrido
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors M. Garrido1, M.A. Vicente Conesa2, A. Carmona-Bayonas3, L. Faez4, A. Custodio5, C. López6, L. Visa7, J. Gallego Plazas8, S. Fernandez Arrojo9, A. Ramchandani10, C. Murias11, M. Múgica12, V. Iranzo13, E. Buxo7, N. Hindi14, F. Erpel15, E. Pineda7, E. Jofré1, C. Giraldo16, P. Jimenez Fonseca17
  • 1Hemato-oncología, Centro Del Cáncer, Universidad Catolica de Chile, 7550000 - Santiago de chile/CL
  • 2Medical Oncology/hematology, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 3Medical Oncology - Haematology, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 4Medical Oncology, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 5Medical Oncology, Hospital Universitario La Paz, 29034 - Madrid/ES
  • 6Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander/ES
  • 7Department Medical Oncology, Hospital Clinic Barcelona, 08036 - Barcelona/ES
  • 8Medical Oncology, Hospital Universitario de Elche, 03202 - Elche/ES
  • 9Medical Oncology, Hospital Universitario Central de Asturias., oviedo/ES
  • 10Medical Oncology, Hospital de Las Palmas, Las Palmas/ES
  • 11Medical Oncology, Hospital Universitario de Canarias., tenerife/ES
  • 12Medical Oncology, Hospital Universitario Marqués de Valdecilla, santander/ES
  • 13Medical Oncology, Hospital General Universitario de Valencia, valencia/ES
  • 14Oncología Médica, Hospital Universitario La Paz, Madrid/ES
  • 15Internal Medicine, Universidad Catolica de Chile, 7550000 - Santiago de chile/CL
  • 16Oncologia Medica, Hospital Sotero del Rio, Santiago de chile/CL
  • 17Servicio De Oncologia Medica, Hospital Universitario Central de Asturias, ES-33006 - Oviedo/ES

Abstract

Aim

To display the first-line chemotherapy used in clinical practice and its efficacy and toxicity profile.

Efficacy and toxicity grade 3-4 (%) Anthracycline-based CT (N= 94) 22% Docetaxel-based CT (N= 46) 11% Oxaliplatin-based CT (N= 113) 27% Cisplatin-based CT (N= 143) 34%
Response Rate (95% CI), % 32 (21-40) 47 (21-59) 62 (48-69) 51 (43-65)
Median progression-free survival (95% CI), months 6.3 (5.3-7.2) 7.1 (4.7-9.6) 7.1 (6.1-8.2) 8.2 (5.9-10.5)
Median overall survival (95% CI), months 9.0 (7.5-10.6) 11.4 (8.4-14.5) 9.6 (7.8-11.3) 11.3 (9.2-13.5)
1-year survival 52.1% 52.2% 51.3% 49.7%
Anemia 7 4 3 13
Neutropenia 32 26 13 25
Febrile neutropenia 12 7 3 4
Thrombocytopenia 5 4 5 6
Vomiting 7 4 3 13
Diarrhea 9 7 8 5
Stomatitis 4 3 2 5
Fatigue 14 3 5 12
Hand-foot symdrome 1 3 0 4
Neuropathy 11 1 4 1
Alopecia 68 52 1 1
Thromboembolism 4 7 3 5
Hospitalization due toxicity 32 20 21 11
Death with 60 days 4 3 1 3

Methods

We analyzed the clinical outcome of the 418 patients (pts) with metastatic gastroesophageal cancer (AGC) consecutively treated with combined chemotherapy between 2004-2013.

Results

Median age: 61 yo (18-85); ECOG: 0-1: 84%; localization: stomach 72%, distal esophagus and esophagogastric junction 28%; metastases localization: nodes (51%), liver (48%), peritoneum (46%), ascites (21%), lung (15%), bone (10%); histological grade: G1-2 49%; Lauren type: intestinal: 61%. Surgery was performed in 35%. Efficacy and toxicity with chemotherapy (CT) in first-line is shown in table for anthracycline-, oxaliplatin-, cisplatin- and docetaxel-based regimens. The most common CT schedules were cisplatin and capecitabine in 120 pts (28,6%), epirubicin, oxaliplatin and capecitabine 73 pts (17,4%), oxaliplatin and 5FU 64 pts (15,3%). 114 pts (27,2%) were treated with a three-drug combination. 195 of all pts (47,2%) received a second-line chemotherapy, 80 pts (34,9%) with irinotecan, 43 pts (18,8%) with docetaxel.

Conclusions

No scheme has shown advantages on efficacy or toxicity to help determine the best treatment options as first-line therapy for patients in a community setting.

Disclosure

All authors have declared no conflicts of interest.