651P - Factors associated with second line paclitaxel efficacy in non-Asian patients (pts) with advanced oesophagogastric (OG) cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Gastric Cancer
Presenter Noelia Tarazona
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors N. Tarazona1, E. Smyth1, C. Peckitt2, I. Chau1, D. Watkins1, S. Rao1, N. Starling1, D. Cunningham1
  • 1Gastrointestinal & Lymphoma Unit, The Royal Marsden NHS Foundation Trust, SM2 5PT - Royal Marsden Hospital, Sutton/GB
  • 2Gastrointestinal & Lymphoma Unit, THE ROYAL Marsden NHS Foundation Trust, SM2 5PT - Royal Marsden Hospital, Sutton/GB

Abstract

Aim

Paclitaxel has demonstrated efficacy and an acceptable toxicity profile in Asian pts with refractory advanced gastric cancer. However regional distinctions are aparent in OG cancer biology and chemotherapy pharmacogenetics. Our aims were to investigate whether the benefits of paclitaxel in a European setting were comparable to those described for Asian pts, and to determine whether any clinical factors were associated pt outcomes.

Methods

For this retrospective observational study all pts with a diagnosis of advanced OG adenocarcinoma treated with 2nd/3rd line weekly paclitaxel from 01/06/2011 to 21/02/2014 were identified from the electronic patient record at the Royal Marsden Hospital. Chart review was performed to obtain patient demographics, sites of metastases, resection status, response/duration of response to prior chemotherapy, ECOG PS, haemaglobin, albumin, alkaline phosphatase (ALP), neutrophil/lymphocyte ratio, CEA, CA19.9, Royal Marsden prognostic store, radiological response and dates of progression, death or last follow up. Overall and progression free survival (OS/PFS) were estimated using the Kaplan-Meier method. Multivariable Cox regression analysis was used to investigate the association of clinical and laboratory parameters and survival.

Results

57 pts were identified. All pts had progressed following a prior platinum/fluoropyrimidine regimen. Pts were 74% male; median age 64y; 66% PS 0-1; 23% prior resection; 91% 2nd line; 44% progressed ≤ 6 months (m) after 1st line chemotherapy. Median number of cycles 3 (range 1-8). Median follow up 13.6m. Response rate (RR) 18.4% in evaluable pts. OS and PFS were 5.8m (95% CI: 4.8 – 6.8m) and 2.6m (95% CI: 1.9 – 3.2m). In multivariate analyses PS ≥2 [HR 2.28 (95% CI 1.15 – 4.53), p = 0.018], and ALP ≥100 U/L [HR 2.01 (95% CI 1.06 – 3.80), p= 0.033] were independent prognostic factors of poor OS.

Conclusions

The efficacy of salvage paclitaxel for pts with advanced OG cancer was comparable in this European population to that demonstrated Asian studies. ECOG PS ≥ 2 and ALP ≥ 100 U/L at treatment initiation are associated with poor survival; for such pts the risk/benefit ratio of therapy should be carefully considered.

Disclosure

All authors have declared no conflicts of interest.