J 2017

Prognostic Factor Analysis of Overall Survival in Gastric Cancer from Two Phase III Studies of Second-line Ramucirumab (REGARD and RAINBOW) Using Pooled Patient Data

FUCHS, C.S.; K. MURO; Jiří TOMÁŠEK; E. VAN CUTSEM; J.Y. CHO et. al.

Základní údaje

Originální název

Prognostic Factor Analysis of Overall Survival in Gastric Cancer from Two Phase III Studies of Second-line Ramucirumab (REGARD and RAINBOW) Using Pooled Patient Data

Autoři

FUCHS, C.S.; K. MURO; Jiří TOMÁŠEK; E. VAN CUTSEM; J.Y. CHO; S.C. OH; H. SAFRAN; G. BODOKY; I. CHAU; Y. SHIMADA; S.E. AL-BATRAN; R. PASSALACQUA; A. OHTSU; M. EMIG; D. FERRY; K. CHANDRAWANSA; Y. HSU; A. SASHEGYI; A.M. LIEPA a H. WILKE

Vydání

JOURNAL OF GASTRIC CANCER, SEOUL, KOREAN GASTRIC CANCER ASSOC, 2017, 2093-582X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Korejská republika

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.400

Kód RIV

RIV/00216224:14110/17:00099924

Organizační jednotka

Lékařská fakulta

UT WoS

000413196500004

EID Scopus

2-s2.0-85022006266

Klíčová slova anglicky

Prognosis; Stomach neoplasms; Gastroesophageal junction; Survival

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 22. 3. 2018 17:32, Soňa Böhmová

Anotace

V originále

Purpose: To identify baseline prognostic factors for survival in patients with disease progression, during or after chemotherapy for the treatment of advanced gastric or gastroesophageal junction (GEJ) cancer. Materials and Methods: We pooled data from patients randomized between 2009 and 2012 in 2 phase III, global double-blind studies of ramucirumab for the treatment of advanced gastric or GEJ adenocarcinoma following disease progression on first-line platinum-and/or fluoropyrimidine-containing therapy (REGARD and RAINBOW). Forty-one key baseline clinical and laboratory factors common in both studies were examined. Model building started with covariate screening using univariate Cox models (significance level=0.05). A stepwise multivariable Cox model identified the final prognostic factors (entry+exit significance level=0.01). Cox models were stratified by treatment and geographic region. The process was repeated to identify baseline prognostic quality of life (QoL) parameters. Results: Of 1,020 randomized patients, 953 (93%) patients without any missing covariates were included in the analysis. We identified 12 independent prognostic factors of poor survival: 1) peritoneal metastases; 2) Eastern Cooperative Oncology Group (ECOG) performance score 1; 3) the presence of a primary tumor; 4) time to progression since prior therapy <6 months; 5) poor/unknown tumor differentiation; abnormally low blood levels of 6) albumin, 7) sodium, and/or 8) lymphocytes; and abnormally high blood levels of 9) neutrophils, 10) aspartate aminotransferase (AST), 11) alkaline phosphatase (ALP), and/or 12) lactate dehydrogenase (LDH). Factors were used to devise a 4-tier prognostic index (median overall survival [OS] by risk [months]: high=3.4, moderate=6.4, medium=9.9, and low=14.5; Harrell's C-index=0.66; 95% confidence interval [CI], 0.64-0.68). Addition of QoL to the model identified patient-reported appetite loss as an independent prognostic factor. Conclusions: The identified prognostic factors and the reported prognostic index may help clinical decision-making, patient stratification, and planning of future clinical studies.