Authors:
Address: Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhongzheng District, Taipei, 100, Taiwan.
Journal:

Publication:

abstract

BACKGROUND:

The standard of chemotherapy regimens for advanced or metastatic gastric cancer and the clinical outcome were heterogeneous in Asian versus non-Asian countries. This study aimed to explore predictors of safety and efficacy of chemotherapy for patients with advanced or metastatic gastric cancer.

METHODS:

Treatment group-based meta-analysis and meta-regression were performed to analyze results of randomized trials published since 2005 for advanced or metastatic gastric cancer patients who received systemic chemotherapy as first-line treatment. Data were extracted and synthesized according to the Cochrane guidelines.

RESULTS:

Twenty-five trials (8 Asian, 17 Western or international) with 56 treatment groups were analyzed. Asian trials reported a lower percentage of gastroesophageal junctional carcinoma, higher percentage of diffuse-type histology, and more frequent use of second-line chemotherapy. Meta-analysis revealed significant heterogeneity both in treatment safety (grade 3-4 neutropenia and diarrhea) and efficacy [6-month progression-free survival (PFS) and 1-year overall survival (OS)]. Meta-regression analyses indicate that Asian trials are associated with an 8.2% lower incidence of grade 3-4 neutropenia and 2.1% lower incidence of grade 3-4 diarrhea. A lower percentage of patients with gastroesophageal junction carcinoma and the use of combination regimens predicted better PFS. The use of second-line chemotherapy predicts better 1-year OS, which will increase by 10% for every 10% increase in patients who received second-line chemotherapy.

CONCLUSION:

Geographic region (Asian vs. non-Asian) is an independent predictor of safety in systemic therapy for gastric cancer.

Related Articles
Review The use of irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectal cancer: systematic review and economic evaluation.
Health Technol Assess. 2008
Review The use of irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectal cancer: systematic review and economic evaluation.
Hind D, Tappenden P, Tumur I, Eggington S, Sutcliffe P, Ryan A. Health Technol Assess. 2008 May; 12(15):iii-ix, xi-162.
Final Report on Carcinogens Background Document for Formaldehyde.
Rep Carcinog Backgr Doc. 2010
Final Report on Carcinogens Background Document for Formaldehyde.
National Toxicology Program. Rep Carcinog Backgr Doc. 2010 Jan; (10-5981):i-512.
Epidermal growth factor receptor targeted therapy in stages III and IV head and neck cancer.
Curr Oncol. 2010
Epidermal growth factor receptor targeted therapy in stages III and IV head and neck cancer.
Cripps C, Winquist E, Devries MC, Stys-Norman D, Gilbert R, Head and Neck Cancer Disease Site Group. Curr Oncol. 2010 Jun; 17(3):37-48.
Review Capecitabine for the treatment of advanced gastric cancer.
Health Technol Assess. 2010
Review Capecitabine for the treatment of advanced gastric cancer.
Norman G, Soares M, Peura P, Rice S, Suh D, Wright K, Sculpher M, Eastwood A. Health Technol Assess. 2010 Oct; 14(Suppl. 2):11-7.
Magnitude of risks and benefits of the addition of bevacizumab to chemotherapy for advanced breast cancer patients: Meta-regression analysis of randomized trials.
J Exp Clin Cancer Res. 2011
Magnitude of risks and benefits of the addition of bevacizumab to chemotherapy for advanced breast cancer patients: Meta-regression analysis of randomized trials.
Cuppone F, Bria E, Vaccaro V, Puglisi F, Fabi A, Sperduti I, Carlini P, Milella M, Nisticò C, Russillo M, et al. J Exp Clin Cancer Res. 2011 May 12; 30:54. Epub 2011 May 12.

To top • Home

---

Show map | Diseases | Vaccination | Chronic disease | Medicine | Pregnancy | Heat & Sunburn | Cold | Security | Useful tips | Faq | News

TraveldoctorOnline 2001 • Disclaimer • webmaster