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Poster display session

915 - Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in advanced gastric cancer: AGAMENON study data


09 Sep 2017


Poster display session


Cytotoxic Therapy;  Gastric Cancer




Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369


I. MACIAS1, A. Carmona-Bayonas2, M. Ferrer3, R. Hernandez4, A. Custodio5, A. Lacalle6, J.E. Lorenzo Barreto7, I. Echavarria Diaz-Guardamino8, L. Visa9, E. Buxo Orra10, M. Mangas Izquierdo11, A. Azkarate12, A. Diaz13, A. Viudez14, M. Sanchez Canovas15, A. Ramchandani Vaswani16, F. Longo17, E. Martinez de Castro18, J. Gallego Plazas19, P. Jimenez Fonseca20

Author affiliations

  • 1 Medical Oncology, Hospital de Sabadell Corporacis Parc Tauli, 8208 - Sabadell/ES
  • 2 Medical Oncology, Hospital Universitario Moral Meseguer, 30008 - Murcia/ES
  • 3 Oncology, Hospital de Sabadell Corporacis Parc Tauli, 8208 - Sabadell/ES
  • 4 Medical Oncology, Hospital Universitario de Canarias, Santa Cruz/ES
  • 5 Medical Oncology, Hospital Universitario la Paz, 28046 - Madrid/ES
  • 6 Medical Oncology, Complejo hospitalario de Navarra, Pamplona/ES
  • 7 Medical Oncology, Hospital Universitario de Canarias, 38320 - San Cristobal de la Laguna/ES
  • 8 Medical Oncology, Hospital General Universitario Gregorio Marañón, 28007 - Madrid/ES
  • 9 Medical Oncology, Hospital del Mar, 8003 - Barcelona/ES
  • 10 Medical Oncology, Hospital Clínic de Barcelona, 8036 - Barcelona/ES
  • 11 Medical Oncology, Hospital de Galdakao-Usansolo, 48960 - Galdakao/ES
  • 12 Medical Oncology, Hospital Universitario Son Espases, Palma de Mallorca/ES
  • 13 Medical Oncology, Hospital Universitario 12 de Octubre, Madrid/ES
  • 14 Medical Oncology, Complejo hospitalario de Navarra, 31008 - Pamplona/ES
  • 15 Medical Oncology, Hospital Universitario Moral Meseguer, Murcia/ES
  • 16 Medical Oncology, Hospital Universitario Insular de Gran Canarias, 35016 - Las Palmas/ES
  • 17 Medical Oncology, Hospital Universitario Ramón y Cajal, 28031 - Madrid/ES
  • 18 Medical Oncology, Hospital Universitario Marques de Valdecilla, 39008 - Santander/ES
  • 19 Medical Oncology, Hospital General Universitario de Elche, 3203 - Elche/ES
  • 20 Medical Oncology, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES


Abstract 915


Although anthracycline-based triplets are one of the most widely used regimens for the treatment of advanced gastric cancer (AGC), the incremental benefit associated with the inclusion of anthracyclines in therapeutic combinations is unknown. The aim of this study is to evaluate the efficacy and tolerance of epirubicin triplets vs platinum-fluoropyrimidine doublets in a national AGC registry.


We recruited patients with AGC treated at 28 Spanish centers with polychemotherapy, without trastuzumab, from 2008 to 2016. The effect of anthracycline-based triplets was assessed by propensity score matching (PSM) and Cox proportional hazards (PH) regression.


1002 patients (doublets, n = 653, triplets with anthracyclines, n = 349) were included. In the multivariate Cox PH regression model, there was no significant increase in OS in favor of anthracycline-based triplets: HR 0.90 (95% CI, 0.78-1.05), p = 0.20035. After PSM, the sample contains 325 pairs with similar baseline characteristics. There was also no increase of OS with this method: 10.5 (95% CI, 9.7-12.3) vs. 9.9 (95% CI, 9.2-11.4) months, HR 0.91 (CI 95%, 0.76-1.083), (stratified log-rank test, p = 0.226), for doublets without anthracyclines vs anthracycline-based triplets. Objective responses were higher with triplets: 32.9% vs. 24.0% (p = 0.014) without significant differences in PFS: HR 0.95 (CI 95%, 0.80-1.13), stratified log-rank test, p = 0.873. Triplets were associated with higher hematological toxicity, and increased toxicity-related admissions by 86%. The addition of epirubicin is viable, but 23.7% discontinued treatment because of adverse effects or patient decision.


Anthracycline triplets increased the antitumor effect (objective responses) of the treatment. However, they were not associated with an incremental benefit in PFS or OS and instead had a higher toxicity.

Clinical trial identification

Legal entity responsible for the study

Paula Jimenez Fonseca




All authors have declared no conflicts of interest.

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