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Outcomes of multiple salvage chemotherapy for advanced gastric cancer: implications for clinical practice and trial design

 Yong Wha Moon  ;  Sun Young Rha  ;  Hei-Cheul Jeung  ;  Chan Kim  ;  Min Hee Hong  ;  Hyun Chang  ;  Jae Kyung Roh  ;  Sung Hoon Noh  ;  Byung Soo Kim  ;  Hyun Cheol Chung 
 Cancer Chemotherapy and Pharmacology, Vol.66(4) : 797-805, 2010 
Journal Title
 Cancer Chemotherapy and Pharmacology 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use* ; Endpoint Determination ; Female ; Humans ; Male ; Middle Aged ; Palliative Care ; Prognosis ; Research Design ; Retrospective Studies ; Salvage Therapy* ; Stomach Neoplasms/drug therapy* ; Survival Analysis ; Treatment Outcome ; Young Adult
Gastric cancer ; Sequential ; Salvage chemotherapy ; Progression-free survival
PURPOSE: We analyzed the natural history of advanced gastric cancer with sequential salvage chemotherapy following first-line treatment. METHODS: We studied 532 patients with unresectable gastric adenocarcinoma who were treated at Yonsei Cancer Center (2000-2008). The patients were managed with multiple sequential salvage chemotherapy as allowed by performance status and toxicity profiles. The tumor response was assessed every two cycles. RESULTS: Four hundred sixty patients received palliative chemotherapy and 72 received supportive care only. The median overall survival was 12.0 months for all patients, 12.1 months for the chemotherapy group, and 2.5 months for the supportive care group (P < 0.001). In the chemotherapy group, 87% received first-line chemotherapy, 47% second-line, 23% third-line, 9% fourth-line, and 3% fifth-line. Response rates were 24.8, 12.6, 10.9, 2.6, and 0% and disease control rates were 76.3, 60.1, 54.2, 54.2, and 53.3% for first- to fifth-line treatment, respectively. The median progression-free survival was 5.5, 3.4, 2.5, 1.9, and 2.0 months and overall survival was 12.1, 7.9, 5.5, 5.0, and 6.8 months. Performance status and metastatic pattern were consistent prognostic factors throughout salvage treatment. CONCLUSIONS: Clinical trials may be feasible in second- or third-line salvage chemotherapy for gastric cancer. Future clinical trials in these settings should take into account the low response rate, short progression-free survival, and the prognostic factors for optimal trial design
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chan(김찬)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Moon, Yong Wha(문용화)
Chang, Hyun(장현)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
Hong, Min Hee(홍민희) ORCID logo https://orcid.org/0000-0003-3490-2195
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