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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

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
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
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
gastric adenocarcinoma, oesophagus, oesophago-gastric junction
0923-7534
885-891
Chau, I.
ff7dfc68-c4ae-4fb9-b035-8b646d32e451
Norman, A.R.
9d5636c7-72da-4a29-80f1-e3d79c501639
Cunningham, D.
02b4fd3a-f452-4419-96a7-f98f609f098d
Oates, J.
813bc998-fd2e-4f29-bae2-8881beabba0e
Hawkins, R.
359a61bf-7393-4b1d-a1c1-cecc85ee8107
Iveson, T.
867cb6c5-ea9a-4521-a4cc-4cd4d2503b3a
Nicolson, M.
293bfbb1-f76e-408e-a6e3-615dffb59acd
Harper, P.
93a9f992-d1de-4748-b77a-00917cf3e879
Seymour, M.
79cb91bf-b3e6-4222-82cf-c0072be29613
Hickish, T.
d17bf903-3f13-4b46-9389-f0f458083442
Chau, I.
ff7dfc68-c4ae-4fb9-b035-8b646d32e451
Norman, A.R.
9d5636c7-72da-4a29-80f1-e3d79c501639
Cunningham, D.
02b4fd3a-f452-4419-96a7-f98f609f098d
Oates, J.
813bc998-fd2e-4f29-bae2-8881beabba0e
Hawkins, R.
359a61bf-7393-4b1d-a1c1-cecc85ee8107
Iveson, T.
867cb6c5-ea9a-4521-a4cc-4cd4d2503b3a
Nicolson, M.
293bfbb1-f76e-408e-a6e3-615dffb59acd
Harper, P.
93a9f992-d1de-4748-b77a-00917cf3e879
Seymour, M.
79cb91bf-b3e6-4222-82cf-c0072be29613
Hickish, T.
d17bf903-3f13-4b46-9389-f0f458083442

Chau, I., Norman, A.R., Cunningham, D., Oates, J., Hawkins, R., Iveson, T., Nicolson, M., Harper, P., Seymour, M. and Hickish, T. (2009) 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. Annals of Oncology, 20 (5), 885-891. (doi:10.1093/annonc/mdn716).

Record type: Article

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

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Published date: May 2009
Keywords: gastric adenocarcinoma, oesophagus, oesophago-gastric junction
Organisations: Cancer Sciences

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Local EPrints ID: 79354
URI: https://eprints.soton.ac.uk/id/eprint/79354
ISSN: 0923-7534
PURE UUID: bf22e943-471c-44f8-b3fa-4a748df979bb

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Date deposited: 15 Mar 2010
Last modified: 18 Jul 2017 23:18

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Contributors

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

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