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 Cytotoxic agents
Oesophageal Cancer
Gastric Cancer
Therapy
Biological therapy
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.