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Poster display session

3967 - Treatment of advanced gastric cancer based on Lauren’s histological: Real-World Data from the AGAMEMON National Cancer Registry

Date

09 Sep 2017

Session

Poster display session

Topics

Gastric Cancer

Presenters

Alberto Carmona-Bayonas

Citation

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

Authors

A. Carmona-Bayonas1, P. Jiménez-Fonseca2, R. Hernández3, A. Custodio4, J.M. Cano5, A. Lacalle6, I. Echavarria Diaz-Guardamino7, I. MACIAS8, M. Mangas Izquierdo9, L. Visa10, E. Buxo Orra11, A. Azkarate12, A. Ramchandani Vaswani13, E. Martínez de Castro14, A. Fernández Montes15, F. Longo16, R. Sánchez Bayona17, M.L. Limón18, A. Martín Carnicero19, J. Gallego Plazas20

Author affiliations

  • 1 Medical Oncology Department, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 2 Medical Oncology, Hospital Universitario Central de Asturias, Oviedo/ES
  • 3 Medical Oncology, Hospital Universitario de Canarias, Tenerife/ES
  • 4 Medical Oncology, Hospital Universitario La Paz, Madrid/ES
  • 5 Medical Oncology, Hospital General de Ciudad Real, Ciudad Real/ES
  • 6 Medical Oncology, Complejo Hospitalario de Navarra, Pamplona/ES
  • 7 Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid/ES
  • 8 Medical Oncology, Hospital de Sabadell Corporacis Parc Tauli, 8208 - Sabadell/ES
  • 9 Medical Oncology, Hospital Galdakao-Usansolo, 48960 - Galdakao/ES
  • 10 Medical Oncology, Hospital del Mar, 8003 - Barcelona/ES
  • 11 Medical Oncology, Hospital de Sant Pau, Barcelona/ES
  • 12 Medical Oncology, Hospital Universitario Son Espases, Palma de Mallorca/ES
  • 13 Medical Oncology, Hospital Universitario Insular de Gran Canarias, 35016 - Las Palmas/ES
  • 14 Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander/ES
  • 15 Medical Oncology, Complejo Hospitalario de Orense, Orense/ES
  • 16 Medical Oncology, Hospital Universitario Ramón y Cajal, 28031 - Madrid/ES
  • 17 Medical Oncology, Clínica Universidad de Navarra, Pamplona/ES
  • 18 Medical Oncology, Hospital Universitario Virgen del Rocío, Seville/ES
  • 19 Medical Oncology, Hospital San Millán-San Pedro, Logroño/ES
  • 20 Medical Oncology, Hospital Universitario de Elche, Elche/ES
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Resources

Abstract 3967

Background

The choice of first-line chemotherapy in advanced HER2-negative gastric cancer (AGC) is based on the center's preferences and adverse effects profile. There is neither a standard accepted regimen nor predictive factors for drug response in clinical practice other than HER2 status. The objective is to evaluate whether Lauren's classification influences the efficacy of different chemotherapies and the survival of patients.

Methods

The data come from a national registry of AGC in which 31 Spanish centers participate. Eligibility criteria include the diagnosis of a stomach or gastroesophageal junction adenocarcinoma, HER2 negativity, and the use of two or three drug chemotherapy combinations. We used Cox proportional hazards (PH) regression with treatment-by-histology interaction tests to estimate the therapeutic effects.

Results

The registry contains 1215 HER2-negative tumors that could be analyzed for survival endpoints and 675 evaluable for overall response rate (ORR). Overall, the study failed to confirm a decrease in the ORR in the presence of diffuse component (Mantel-Haenszel, common odds ratio of 0.744 (CI 95%, 0.538-1.030), P = 0.088, nor heterogeneity of response according to histology. However, in the intestinal type, docetaxel-based or anthracycline-based regimens were more active than oxaliplatin-fluoropyrimidine regimens (ORR 62% and 60% vs. 45%, P 

Conclusions

In this registry, tumor subtypes based on Lauren's classification predicted survival, and responded differently to chemotherapy. Future clinical trials should stratify estimates of effects based on histology.

Clinical trial identification

Legal entity responsible for the study

The investigators

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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