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.

3.00
Hdl Handle:
http://hdl.handle.net/10541/87564
Title:
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, Robert E; Iveson, T; Nicolson, M; Harper, P; Seymour, M; Hickish, T
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.
Affiliation:
Department of Medicine, Royal Marsden Hospital, London.
Citation:
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. 2009, 20 (5):885-91 Ann. Oncol.
Journal:
Annals of Oncology
Issue Date:
May-2009
URI:
http://hdl.handle.net/10541/87564
DOI:
10.1093/annonc/mdn716
PubMed ID:
19164454
Type:
Article
Language:
en
ISSN:
1569-8041
Appears in Collections:
All Paterson Institute for Cancer Research; Medical Oncology

Full metadata record

DC FieldValue Language
dc.contributor.authorChau, Ien
dc.contributor.authorNorman, A Ren
dc.contributor.authorCunningham, Den
dc.contributor.authorOates, Jen
dc.contributor.authorHawkins, Robert Een
dc.contributor.authorIveson, Ten
dc.contributor.authorNicolson, Men
dc.contributor.authorHarper, Pen
dc.contributor.authorSeymour, Men
dc.contributor.authorHickish, Ten
dc.date.accessioned2009-12-08T12:18:24Z-
dc.date.available2009-12-08T12:18:24Z-
dc.date.issued2009-05-
dc.identifier.citationThe 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. 2009, 20 (5):885-91 Ann. Oncol.en
dc.identifier.issn1569-8041-
dc.identifier.pmid19164454-
dc.identifier.doi10.1093/annonc/mdn716-
dc.identifier.urihttp://hdl.handle.net/10541/87564-
dc.description.abstractBACKGROUND: 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.en
dc.language.isoenen
dc.subjectOesophageal Canceren
dc.subjectOesophageal Junctionen
dc.subjectStomach Canceren
dc.subject.meshAdenocarcinoma-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAntimetabolites, Antineoplastic-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshAustralia-
dc.subject.meshCisplatin-
dc.subject.meshDeoxycytidine-
dc.subject.meshEsophageal Neoplasms-
dc.subject.meshEsophagogastric Junction-
dc.subject.meshFemale-
dc.subject.meshFluorouracil-
dc.subject.meshGreat Britain-
dc.subject.meshHumans-
dc.subject.meshKaplan-Meiers Estimate-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMulticenter Studies as Topic-
dc.subject.meshProportional Hazards Models-
dc.subject.meshRandomized Controlled Trials as Topic-
dc.subject.meshRisk Assessment-
dc.subject.meshStomach Neoplasms-
dc.subject.meshTime Factors-
dc.subject.meshTreatment Outcome-
dc.subject.meshYoung Adult-
dc.titleThe 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.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medicine, Royal Marsden Hospital, London.en
dc.identifier.journalAnnals of Oncologyen

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