Is there a preferred platinum and fluoropyrimidine regimen for advanced HER2-negative esophagogastric adenocarcinoma? Insights from 1293 patients in AGAMENON-SEOM registry

被引：0

作者：

Arias-Martinez, Aranzazu ^{[1
]}

de Castro, Eva Martinez ^{[2
]}

Gallego, Javier ^{[3
]}

Arrazubi, Virginia ^{[4
]}

Custodio, Ana ^{[5
]}

Fernandez Montes, Ana ^{[6
]}

Diez, Marc ^{[7
]}

Hernandez, Raquel ^{[8
]}

Limon, Maria Luisa ^{[9
]}

Cano, Juana Maria ^{[10
]}

Vidal-Tocino, Rosario ^{[11
]}

Macias, Ismael ^{[12
]}

Visa, Laura ^{[13
]}

Martin Richard, Marta ^{[14
]}

Sauri, Tamara ^{[15
]}

Hierro, Cinta ^{[16
]}

Gil, Mireia ^{[17
]}

Cerda, Paula ^{[18
]}

Martinez Moreno, Elia ^{[19
]}

Martinez Lago, Nieves ^{[20
]}

Merida-Garcia, Antonio Jose ^{[21
]}

Gomez Gonzalez, Lucia ^{[22
]}

Garcia Navalon, Francisco Javier ^{[23
]}

Ruiz Martin, Maribel ^{[24
]}

Marin, Gema ^{[25
]}

Lopez-Lopez, Flora ^{[26
]}

Ruperez Blanco, Ana Belen ^{[27
]}

Fernandez, Alejandro Francisco ^{[28
]}

Jimenez-Fonseca, Paula ^{[29
]}

Carmona-Bayonas, Alberto ^{[30
]}

Alvarez-Mancenido, Felipe ^{[31
]}

机构：

[1] Univ Granada, Doctoral Program Pharm, Granada, Spain

[2] Hosp Univ Marques de Valdecilla, Med Oncol Dept, IDIVAL, Santander, Spain

[3] Univ Elche, Dept Med Oncol, Gen Hosp, Elche 03203, Spain

[4] Hosp Univ Navarra, Med Oncol Dept, Pamplona, Spain

[5] Hosp Univ La Paz, Med Oncol Dept, CIBERONC, CB16-12-00398, Madrid, Spain

[6] Complejo Hosp Univ Orense, Med Oncol Dept, Orense, Spain

[7] Hosp Univ Vall dHebron VHIO, Med Oncol Dept, Barcelona, Spain

[8] Hosp Univ Canarias, Med Oncol Dept, Tenerife, Spain

[9] Hosp Univ Virgen del Rocio, Med Oncol Dept, Seville, Spain

[10] Hosp Gen Univ Ciudad Real, Med Oncol Dept, Ciudad Real, Spain

[11] Complejo Asistencial Univ Salamanca IBSAL, Med Oncol Dept, Salamanca, Spain

[12] Hosp Univ Parc Tauli, Med Oncol Dept, Sabadell, Spain

[13] Hosp Univ El Mar, Med Oncol Dept, Barcelona, Spain

[14] Inst Catalan Oncol ICO, Med Oncol Dept, Barcelona, Spain

[15] Hosp Clin Barcelona, Med Oncol Dept, Barcelona, Spain

[16] Inst Catalan Oncol ICO Badalona, Med Oncol Dept, Badalona Appl Res Grp Oncol B ARGO, Barcelona, Spain

[17] Consorcio Hosp Gen Univ Valencia, Med Oncol Dept, Valencia, Spain

[18] Hosp Univ Santa Creu & St Pau, Dept Biochem, Barcelona, Spain

[19] Hosp Univ Fuenlabrada, Med Oncol Dept, Madrid, Spain

[20] Complejo Hosp Univ Ferrol, Med Oncol Dept, Ferrol, Spain

[21] Med Oncol Dept, Complejo Asistencial Zamora, Zamora, Spain

[22] Hosp Gen Univ Alicante, Med Oncol Dept, Alicante, Spain

[23] Hosp Univ Son Llatzer, Med Oncol Dept, Mallorca, Spain

[24] Complejo Asistencial Univ Palencia, Med Oncol Dept, Palencia, Spain

[25] Hosp Univ Virgen de la Arrixaca, Med Oncol Dept, Murcia, Spain

[26] Hosp Univ Sureste, Med Oncol Dept, Madrid, Spain

[27] Hosp Univ Toledo, Dept Pathol, Toledo, Spain

[28] Complejo Hosp Univ Pontevedra, Med Oncol Dept, Pontevedra, Spain

[29] Hosp Univ Cent Asturias, Med Oncol Dept, ISPA, Oviedo, Spain

[30] Univ Murcia, Hosp Univ Morales Meseguer, Hematol & Med Oncol Dept, IMIB, Murcia, Spain

[31] Hosp Univ Cent Asturias, Pharm Dept, Oviedo, Spain

来源：

CLINICAL & TRANSLATIONAL ONCOLOGY | 2024年 / 26卷 / 07期

关键词：

Advanced esophagogastric cancer; Chemotherapy; Cisplatin; Fluoropyrimidine; Oxaliplatin; Survival; ADVANCED GASTRIC-CANCER; RANDOMIZED PHASE-III; GASTROESOPHAGEAL JUNCTION; PLUS CHEMOTHERAPY; 1ST-LINE THERAPY; DOUBLE-BLIND; OPEN-LABEL; CISPLATIN; FLUOROURACIL; TRIAL;

D O I：

10.1007/s12094-024-03388-6

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background The optimal chemotherapy backbone for HER2-negative advanced esophagogastric cancer, either in combination with targeted therapies or as a comparator in clinical trials, is uncertain. The subtle yet crucial differences in platinum-based regimens' safety and synergy with combination treatments need consideration. Methods We analyzed cases from the AGAMENON-SEOM Spanish registry of HER2-negative advanced esophagogastric adenocarcinoma treated with platinum and fluoropyrimidine from 2008 to 2021. This study focused exclusively on patients receiving one of the four regimens: FOLFOX (5-FU and oxaliplatin), CAPOX (capecitabine and oxaliplatin), CP (capecitabine and cisplatin) and FP (5-FU and cisplatin). The aim was to determine the most effective and tolerable platinum and fluoropyrimidine-based chemotherapy regimen and to identify any prognostic factors. Results Among 1293 patients, 36% received either FOLFOX (n = 468) or CAPOX (n = 466), 20% CP (n = 252), and 8% FP (n = 107). FOLFOX significantly increased PFS (progression free survival) compared to CP, with a hazard ratio of 0.73 (95% CI 0.58-0.92, p = 0.009). The duration of treatment was similar across all groups. Survival outcomes among regimens were similar, but analysis revealed worse ECOG-PS (Eastern Cooperative Oncology Group-Performance Status), > 2 metastatic sites, bone metastases, hypoalbuminemia, higher NLR (neutrophil-to-lymphocyte ratio), and CP regimen as predictors of poor PFS. Fatigue was common in all treatments, with the highest incidence in FOLFOX (77%), followed by FP (72%), CAPOX (68%), and CP (60%). Other notable toxicities included neuropathy (FOLFOX 69%, CAPOX 62%), neutropenia (FOLFOX 52%, FP 55%), hand-foot syndrome in CP (46%), and thromboembolic events (FP 12%, CP 11%). Conclusions FOLFOX shown better PFS than CP. Adverse effects varied: neuropathy was more common with oxaliplatin, while thromboembolism was more frequent with cisplatin.

引用

页码：1674 / 1686

页数：13

共 23 条

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