694P - Progression-free survival and postprogression survival in patients with advanced gastric cancer treated with first-line chemotherapy

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Cytotoxic agents
Gastric Cancer
Biological therapy
Presenter Kohei Shitara
Authors K. Shitara1, K. Matsuo2, K. Muro3, A. Ohtsu4
  • 1Gastroenterology & Gastrointestinal Oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP
  • 2Aichi Cancer Center Research Institute, Aichi Cancer Cehter, Nagoya/JP
  • 3Clinical Oncology, Aichi Cancer Center Hospital, JP-464-8681 - Nagoya/JP
  • 4Research Center For Innovative Oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP



Progression-free survival (PFS) has been reported to be moderately correlated to overall survival (OS) in patients with advanced gastric cancer (AGC) who received first-line chemotherapy (Shitara, K et al. Invest New Drug 2011; Shitara K and Burzykowski T. On behalf of GASTRIC. ASCO 2011). Impact of post progression survival (PPS) on OS of patients with AGC has not yet been reported in detail.


We retrospectively analyzed AGC patients who received first-line chemotherapy including fluoropyrimidine plus platinum with confirmed disease progression. We partitioned OS into PFS and PPS and analyzed the correlation between OS and either PFS or PPS by Spearman rank correlation coefficient (r). Subgroup analyses were performed according to treatment setting (clinical trial or practice) and presence of measurable lesion. Multivariate analysis was also conducted to evaluate prognostic factors for PPS.


Between April 2005 to May 2011, 291 AGC patients met inclusion criteria. One-hundred five patients (36%) included in clinical trials and 246 patients (85%) received second-line chemotherapy. Median PFS, PPS, and OS were 5.3 months, 8.1 months. 14.8 months, respectively. PFS and OS showed a correlation with r of 0.75 (95% CI, 0.69- 0.81). PPS and OS also showed a correlation with r of 0.87 (95% CI, 0.84- 0.91). Correlations tend to be higher between PSS and OS than that of PFS and OS in subset of patients in clinical trials (r = 0.84 vs. r = 0.72) or patients with measurable lesion (r = 0.87 vs. r = 0.72). According to the multivariate analysis, performance status at progression and second-line chemotherapy were significantly associated with length of PPS.


Our results indicate that both PFS and PSS is correlated with OS in first-line chemotherapy for advanced AGC, thus suggest the importance of reporting detailed patients characteristic and treatment course after disease progression in clinical trials of first-line chemotherapy for AGC.


All authors have declared no conflicts of interest.