Cancer Res Treat.  2021 Apr;53(2):436-444. 10.4143/crt.2020.725.

Trends in Chemotherapy Patterns and Survival of Patients with Advanced Gastric Cancer over a 16-Year Period: Impact of Anti-HER2–Targeted Agent in the Real-World Setting

• Koo DH
• Ryu MH
• Lee MY
• Chae H
• Kim EJ
• Moon MS
• Kang YK

• KMID: 2514925
• DOI: http://doi.org/10.4143/crt.2020.725

Abstract

Purpose
This study aimed to evaluate the survivals of patients with metastatic or recurrent gastric cancer (MRGC) over a period of 16 years and to investigate the recent changes in chemotherapy patterns.
Materials and Methods
A total of 5,384 patients who received chemotherapy for MRGC between 2000 and 2015 were analyzed. The analysis focused on a comparison of the first-line chemotherapy between four periods: 2000–2003 (period 1), 2004–2007 (period 2), 2008–2011 (period 3), and 2012–2015 (period 4).
Results
There were 880 patients (16%) in period 1, 1,573 (29%) in period 2, 1,435 (27%) in period 3, and 1,496 (28%) in period 4. Cytotoxic doublet-based therapy was the most commonly used (78%) first-line chemotherapy, and the combination of trastuzumab and doublet chemotherapy was provided to 288 patients. The OS rates at 12 and 24 months were steadily improved as follows: 39.2% and 14.6% in period 1, 43.5% and 17.6% in period 2, 50.3% and 20.6% in period 3, and 51.7% and 24.1% in period 4, respectively (p < 0.001). Among the patients who received the doublet-based chemotherapy, the median OS of those who received trastuzumab was 18.0 months (95% CI, 15.5–20.6), while that of those who received other doublet therapies was 11.2 months (95% CI, 10.8–11.6).
Conclusion
The OS was improved over time with advancements in chemotherapy, particularly the introduction of the anti-HER2–targeted agent, which contributed to the increase in the number of long-term survivors and established the superiority of OS for the treatment of MRGC.

Keyword

Stomach neoplasms; Prognosis; Treatment outcome; Trastuzumab

Figure

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  Fig. 1 Overall survival (A) and progression-free survival (B) curves according to the treatment period.

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  Fig. 2 Overall survival (A) and progression-free survival (B) curves according to the first-line chemotherapy.

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  Fig. 3 Overall survival (A, C, E) and progression-free survival (B, D, F) curves of the first-line regimens according to the risk group: (A, B) good (score 0–1), (C, D) moderate (score 2–3), and (E, F) poor (score 4 or more).

Reference

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