E. Fountzilas , J. Souglakos , J. Alafis , K. Dadouli , A. Koumarianou , N. Tsoukalas , A. Nikolaidi , D. Mauri , M. Karagianni , A. Anna , A. Psyrri , G. Rigakos , A. Avgerinos , M. Theochari , D. Pectasides , G. Oikonomopoulos , A. Vagionas , P. Papakostas , A. Christopoulou , G. Fountzilas , Z. Saridaki
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引用次数: 0
摘要
背景在胃癌患者中，紫杉醇/拉莫单抗相对于其他治疗方案的优越性尚未确定。我们的目的是评估紫杉醇/拉莫单抗二线治疗是否优于其他疗法。患者和方法我们收集了希腊合作肿瘤组织（Hellenic Cooperative Oncology Group，HeCOG）下属肿瘤内科治疗的胃癌、胃食管交界处腺癌或食管远端腺癌晚期患者的回顾性真实世界数据。所有患者均接受过至少 2 个月的二线治疗。结果从2015年3月到2023年3月，共有179名患者接受了二线治疗（中位年龄61.3岁）。其中，77人（43%）接受了紫杉醇/拉穆单抗治疗，21人（11.7%）接受了伊立替康/5-氟尿嘧啶（5-FU）/亮菌甲素治疗，16人（8.9%）接受了多西他赛治疗，65人（36.3%）接受了其他治疗。紫杉醇/拉穆单抗的疗效按组织学亚型进行评估：弥漫型、肠型和混合型。对于弥漫组织学，调整后的PFS1危险比（aHR）为1.03[95%置信区间（CI）0.50-2.16]，总生存期（OS）为1.71（95% CI 0.79-3.68）。就肠道组织学而言，PFS1的aHR为0.53（95% CI 0.28-1.01），OS的aHR为0.44（95% CI 0.22-0.88），表明OS获益具有统计学意义。混合组织学在 PFS1（aHR 1.00，95% CI 0.23-4.37）或 OS（aHR 1.10，95% CI 0.32-3.82）方面无明显差异。结论与其他方案相比，紫杉醇/拉莫单抗二线治疗与晚期肠型胃癌患者的OS具有独立相关性。确定晚期胃癌最有效的治疗方法仍是一项挑战。
Real-world efficacy and toxicity data of paclitaxel and ramucirumab compared with other treatment regimens in patients with advanced gastric cancer
Background
The superiority of paclitaxel/ramucirumab over alternative therapeutic regimens in patients with gastric cancer has yet to be defined. Our aim was to evaluate whether second-line treatment with paclitaxel/ramucirumab is superior compared with other therapies.
Patients and methods
Retrospective real-world data from patients with advanced adenocarcinoma of the stomach, gastroesophageal junction, or distal esophagus, treated at Departments of Medical Oncology, affiliated with the Hellenic Cooperative Oncology Group (HeCOG), were collected. All patients had received at least 2 months of second-line treatment. The primary endpoint was progression-free survival 1 (PFS1).
Results
From March 2015 to March 2023, 179 patients received second-line treatment (median age 61.3 years). Of those, 77 (43%) received paclitaxel/ramucirumab, 21 (11.7%) irinotecan/5-fluorouracil (5-FU)/leucovorin, 16 (8.9%) docetaxel, and 65 (36.3%) other treatments. The efficacy of paclitaxel/ramucirumab was assessed by histological subtype: diffuse, intestinal, and mixed. For diffuse histology, the adjusted hazard ratio (aHR) for PFS1 was 1.03 [95% confidence interval (CI) 0.50-2.16] and for overall survival (OS) was 1.71 (95% CI 0.79-3.68). For intestinal histology, the aHR for PFS1 was 0.53 (95% CI 0.28-1.01) and for OS was 0.44 (95% CI 0.22-0.88), indicating a statistically significant OS benefit. Mixed histology showed no significant differences in PFS1 (aHR 1.00, 95% CI 0.23-4.37) or OS (aHR 1.10, 95% CI 0.32-3.82). Toxicity, dose reduction, and discontinuation rates were similar between paclitaxel/ramucirumab and other regimens.
Conclusions
Second-line treatment with paclitaxel/ramucirumab was independently associated with OS compared with other regimens in patients with advanced intestinal-type gastric cancer. Identification of the most effective treatment for advanced gastric cancer remains a challenge.
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