P-0062 Second-Line Chemotherapy for Patients with Metastatic Gastric Cancer: a Retrospective Analysis

Abstract

IntroductionGastric cancer is the fourth most common cancer and the second most common cause of cancer deaths in the world. Many patients (pts) present with locally advanced unresectable or metastatic disease when first diagnosed. Treatment with second-line chemotherapy remains controversial. The aim of this study is to evaluate the time to progression (TTP) after second-line chemotherapy of pts with metastatic gastric cancer. MethodsThis retrospective analysis was based on data obtained from 84 pts treated with a first-line chemotherapy regimen for metastatic gastric cancer in our oncology department (January 2005 to May 2010). The primary endpoint of this study was TTP measured from the beginning of second-line treatment to the date of progression, accessed by imaging and/or clinical criteria. The secondary endpoint was survival after second-line chemotherapy, measured from the beginning of second-line chemotherapy to the date of death or last follow-up visit. ResultsFrom the 84 pts who completed first-line chemotherapy, 38 (45%) were able to receive second-line chemotherapy; all others had died from disease progression or had a poor performance status. Of the 38 pts, 26 (68%) were male and 12 (32%) female, with a median age of 64 years (range 46-80 years), 24% of the pts had histology compatible with mucinous adenocarcinoma (ADC). 27 pts had Eastern Cooperative Oncology Group performance status (ECOG PS) ≤2, and 11pts had unknown ECOG PS status. Chemotherapy regimens used for second-line treatment were: Taxanes 19 pts (50%), combination of oxaliplatin/5-FU (FOLFOX) 8 pts (21%), combination of irinotecan/5-FU (FOLFIRI) 7pts (18%), Irinotecan 3 pts (8%), and Mitomycin in 1 pts (3%). There were no treatment-related deaths. One patient (3%) had a complete response, 4 pts (11%) had partial response, and 14 pts (36%) had stable disease. The median TTP and survival after second-line chemotherapy were 2.73 months and 6 months, respectively. ConclusionDespite the patients with good performance status after first-line chemotherapy failure, the TTP and survival after second-line chemotherapy is relative short but consistent with the literature data.