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. 2023 Mar;12(5):5341-5351.
doi: 10.1002/cam4.5354. Epub 2022 Nov 16.

Daily practices in chemotherapy for advanced gastric or gastroesophageal junction adenocarcinoma: METESTOMAC French prospective cohort

Sylvain Manfredi  1 , Marie Dior  2 , Olivier Bouche  3 , Emilie Barbier  4 , Vincent Hautefeuille  5 , Marielle Guillet  6 , Justine Turpin  7 , Vincent Bourgeois  8 , Dall Osto Helene  9 , Romain Desgrippes  10 , Franck Audemar  11 , Yann Molin  12 , Christophe Locher  13 , Thierry Chatellier  14 , Thierry Lecomte  15 , Nathalie Baize  16 , Cedric Lecaille  17 , Dominique Spaeth  18 , Gael Goujon  19 , Come Lepage  20 , David Tougeron  21 ; Metestomac Investigators/Collaborators
Affiliations

Daily practices in chemotherapy for advanced gastric or gastroesophageal junction adenocarcinoma: METESTOMAC French prospective cohort

Sylvain Manfredi et al. Cancer Med. 2023 Mar.

Abstract

Background: Around 50% of gastric cancers are diagnosed at an advanced stage. Several chemotherapy regimens are now internationally validated. Few data are available on the routine daily management of advanced gastric or gastroesophageal junction cancers. We aimed to describe chemotherapy practices, tolerance, and efficacy overall survival (OS) and Progression free survival (PFS) in a prospective French cohort.

Methods: Patients starting palliative chemotherapy were prospectively enrolled in 49 French centres. The primary objective was to report and describe patients' characteristics and treatment strategies. Secondary objectives were OS, PFS, objective response rate, adverse events rate, performance status deterioration during the chemotherapy.

Results: A total of 182 patients were included; 179 were analysed. Most patients received platinium-based chemotherapy as the first treatment and FOLFIRI as second; 62.0% of patients received a second line, and 32.4% a third line. More than two thirds of Her2-positive patients were first treated with trastuzumab. The FOLFIRI regimen was the most frequently used second-line therapy. Median OS was 13.3 months, similar whatever the chemotherapy or combinations used in the first line. One- and 2-year OS increased with the number of chemotherapy lines received, from respectively 24.7% and 5.7% (1 line), to 46.9% and 12.4% (2 lines) and 88.1% and 29.9% (3 or more lines) (p < 0.0001).

Conclusion: Our study showed that treatment strategies in France are based on a succession of doublets, making it possible to offer a second and third line of treatment more often. This treatment strategy must be taken into account for future trials with immunotherapy combinations.

Keywords: cohort; gastric cancer; real life; strategy.

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Conflict of interest statement

None for all the authors.

Figures

FIGURE 1
FIGURE 1
AEs grade ≥3 according to chemotherapy scheme (%)
FIGURE 2
FIGURE 2
ECOG status evolution for each chemotherapy line
FIGURE 3
FIGURE 3
Overall survival (OS)
FIGURE 4
FIGURE 4
progression free survival (PFS)
See this image and copyright information in PMC

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