Second-line chemotherapy using taxane in patients with advanced gastric cancer who presented with severe peritoneal meta
- PDF / 875,894 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 174 Views
ORIGINAL ARTICLE
Second‑line chemotherapy using taxane in patients with advanced gastric cancer who presented with severe peritoneal metastasis: a multicenter retrospective study Hiroyuki Arai1 · Masahiro Kawahira2 · Hirofumi Yasui2 · Toshiki Masuishi3 · Kei Muro3 · Takako Eguchi Nakajima1,4 Received: 31 May 2020 / Accepted: 2 October 2020 © Japan Society of Clinical Oncology 2020
Abstract Background Individuals with advanced gastric cancer (AGC) who present with severe peritoneal metastasis (SPM) have poor prognosis. This study aimed to evaluate efficacy and safety of second-line treatment for patients with such condition. Methods This retrospective study included patients receiving taxane-based second-line chemotherapy at three Japanese institutions between 2010 and 2016. Patients with AGC who present with SPM were included if they had massive ascites and/or inadequate oral intake requiring intravenous nutritional support. Results In this study, 43 (40%) of 108 patients had an Eastern Cooperative Oncology Group Performance Status score ≥ 2, and the median serum albumin level of the patients was 3.3 g/dL. Ramucirumab was used in combination with paclitaxel in 21 patients. The median overall survival (OS) and progression-free survival (PFS) were 5.1 and 2.8 months, respectively. Inadequate oral intake was considered a negative prognostic factor of both OS and PFS in the multivariate analysis. Three treatment-related deaths were observed, which include those attributed to febrile neutropenia, gastrointestinal perforation, and pneumonitis. Common grade ≥ 3 adverse events were neutropenia (35%), leukopenia (30%), anemia (24%), and anorexia (16%). We observed febrile neutropenia in 8% and gastrointestinal perforation in 4% of patients, and such conditions were dominantly observed in patients with inadequate oral intake. Conclusion Taxane-based second-line chemotherapy was effective and safe for patients with AGC who present with SPM. Attention must be provided when treating patients with inadequate oral intake as they are likely to have short prognosis and serious toxicities. Keywords Gastric cancer · Severe peritoneal metastasis · Second-line chemotherapy · Massive ascites · Inadequate oral intake
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10147-020-01802-x) contains supplementary material, which is available to authorized users. * Takako Eguchi Nakajima [email protected]‑u.ac.jp 1
Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
2
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
3
Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
4
Kyoto University Hospital, Kyoto Innovation Center for Next Generation Clinical Trials and iPS Cell Therapy (Ki-CONNECT), Kyoto, Japan
Abbreviations AGC Advanced gastric cancer GC Gastric cancer SPM Severe peritoneal metastasis BSC Best supportive care OS Overall survival PFS Progression-free survival
Data Loading...
