The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma - Individual patient data from 1775 patients in four randomised controlled trials

Authors: Chau, I., Norman, A.R., Cunningham, D., Oates, J., Hawkins, R., Iveson, T., Nicolson, M., Harper, P., Seymour, M. and Hickish, T.

Journal: Annals of Oncology

Volume: 20

Issue: 5

Pages: 885-891

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdn716

Abstract:

Background: It is unclear if differential chemotherapy effects exist on overall survival (OS), response rate (RR) and toxicity depending on primary tumour origin [oesophageal versus oesophago-gastric junction (OGJ) versus gastric adenocarcinoma]. Patients and methods: A total of 2110 patients were enrolled in four randomised controlled trials (RCTs) assessing fluoropyrimidine ± platinum-based chemotherapy. This analysis used individual patient data and restricted to patients with adenocarcinoma who received one or more dose of chemotherapy. Gastric origin was the control in comparisons of tumour origin. Results: Of the 2110 patients randomised, 1775 (84%) patients had adenocarcinoma with oesophageal (n = 485), OGJ (n = 457) and gastric (n = 833) origins. The median OS was 9.5 months in oesophageal, 9.3 months in OGJ and 8.7 months in gastric cancer (P = 0.68). RR was 44.1% in oesophageal, 41.1% in OGJ and 35.6% in gastric cancers (P = 0.11 and 0.27, respectively, compared with gastric cancer on multivariate analysis). Toxicity composite end point occurred in 46%, 47% and 45% in oesophageal, OGJ and gastric cancers, respectively (P = 0.85 and 0.62 compared with gastric). Conclusions: In our large multicentre RCT dataset, no significant differences were demonstrated on multivariate analyses in OS, RR and toxic effects among patients with advanced oesophageal, OGJ and gastric adenocarcinoma. Future RCTs should not exclude oesophageal adenocarcinoma. © The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Source: Scopus

The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma--individual patient data from 1775 patients in four randomised controlled trials.

Authors: Chau, I., Norman, A.R., Cunningham, D., Oates, J., Hawkins, R., Iveson, T., Nicolson, M., Harper, P., Seymour, M. and Hickish, T.

Journal: Ann Oncol

Volume: 20

Issue: 5

Pages: 885-891

eISSN: 1569-8041

DOI: 10.1093/annonc/mdn716

Abstract:

BACKGROUND: It is unclear if differential chemotherapy effects exist on overall survival (OS), response rate (RR) and toxicity depending on primary tumour origin [oesophageal versus oesophago-gastric junction (OGJ) versus gastric adenocarcinoma]. PATIENTS AND METHODS: A total of 2110 patients were enrolled in four randomised controlled trials (RCTs) assessing fluoropyrimidine +/- platinum-based chemotherapy. This analysis used individual patient data and restricted to patients with adenocarcinoma who received one or more dose of chemotherapy. Gastric origin was the control in comparisons of tumour origin. RESULTS: Of the 2110 patients randomised, 1775 (84%) patients had adenocarcinoma with oesophageal (n = 485), OGJ (n = 457) and gastric (n = 833) origins. The median OS was 9.5 months in oesophageal, 9.3 months in OGJ and 8.7 months in gastric cancer (P = 0.68). RR was 44.1% in oesophageal, 41.1% in OGJ and 35.6% in gastric cancers (P = 0.11 and 0.27, respectively, compared with gastric cancer on multivariate analysis). Toxicity composite end point occurred in 46%, 47% and 45% in oesophageal, OGJ and gastric cancers, respectively (P = 0.85 and 0.62 compared with gastric). CONCLUSIONS: In our large multicentre RCT dataset, no significant differences were demonstrated on multivariate analyses in OS, RR and toxic effects among patients with advanced oesophageal, OGJ and gastric adenocarcinoma. Future RCTs should not exclude oesophageal adenocarcinoma.

Source: PubMed

Preferred by: Tamas Hickish

The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma-025EFindividual patient data from 1775 patients in four randomised controlled trials

Authors: Chau, I., Norman, A.R., Cunningham, D., Oates, J., Hawkins, R., Iveson, T., Nicolson, M., Harper, P., Seymour, M. and Hickish, T.

Journal: ANNALS OF ONCOLOGY

Volume: 20

Issue: 5

Pages: 885-891

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdn716

Source: Web of Science (Lite)

The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma--individual patient data from 1775 patients in four randomised controlled trials.

Authors: Chau, I., Norman, A.R., Cunningham, D., Oates, J., Hawkins, R., Iveson, T., Nicolson, M., Harper, P., Seymour, M. and Hickish, T.

Journal: Annals of oncology : official journal of the European Society for Medical Oncology

Volume: 20

Issue: 5

Pages: 885-891

eISSN: 1569-8041

ISSN: 0923-7534

DOI: 10.1093/annonc/mdn716

Abstract:

Background

It is unclear if differential chemotherapy effects exist on overall survival (OS), response rate (RR) and toxicity depending on primary tumour origin [oesophageal versus oesophago-gastric junction (OGJ) versus gastric adenocarcinoma].

Patients and methods

A total of 2110 patients were enrolled in four randomised controlled trials (RCTs) assessing fluoropyrimidine +/- platinum-based chemotherapy. This analysis used individual patient data and restricted to patients with adenocarcinoma who received one or more dose of chemotherapy. Gastric origin was the control in comparisons of tumour origin.

Results

Of the 2110 patients randomised, 1775 (84%) patients had adenocarcinoma with oesophageal (n = 485), OGJ (n = 457) and gastric (n = 833) origins. The median OS was 9.5 months in oesophageal, 9.3 months in OGJ and 8.7 months in gastric cancer (P = 0.68). RR was 44.1% in oesophageal, 41.1% in OGJ and 35.6% in gastric cancers (P = 0.11 and 0.27, respectively, compared with gastric cancer on multivariate analysis). Toxicity composite end point occurred in 46%, 47% and 45% in oesophageal, OGJ and gastric cancers, respectively (P = 0.85 and 0.62 compared with gastric).

Conclusions

In our large multicentre RCT dataset, no significant differences were demonstrated on multivariate analyses in OS, RR and toxic effects among patients with advanced oesophageal, OGJ and gastric adenocarcinoma. Future RCTs should not exclude oesophageal adenocarcinoma.

Source: Europe PubMed Central