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

Autor: Arias-Martinez A; Doctoral Program in Pharmacy, Universidad de Granada, Barrio Verxeles n°13 2°, CP 27850, Granada, Viveiro, Spain. arantxa.91.am@gmail.com., Martínez de Castro E; Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Gallego J; Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain., Arrazubi V; Medical Oncology Department, Hospital Universitario de Navarra, IdiSNA, Pamplona, Spain., Custodio A; Medical Oncology Department, Hospital Universitario La Paz, CIBERONC, CB16/12/00398, Madrid, Spain., Fernández Montes A; Medical Oncology Department, Complejo Hospitalario Universitario de Orense, Orense, Spain., Diez M; Medical Oncology Department, Hospital Universitario Vall d'Hebron, VHIO, Barcelona, Spain., Hernandez R; Medical Oncology Department, Hospital Universitario de Canarias, Tenerife, Spain., Limón ML; Medical Oncology Department, Hospital Universitario Virgen del Rocío, Seville, Spain., Cano JM; Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Vidal-Tocino R; Medical Oncology Department, Complejo Asistencial Universitario de Salamanca - IBSAL, Salamanca, Spain., Macias I; Medical Oncology Department, Hospital Universitario Parc Tauli, Sabadell, Spain., Visa L; Medical Oncology Department, Hospital Universitario El Mar, Barcelona, Spain., Martin Richard M; Medical Oncology Department, Instituto Catalán de Oncología (ICO), L'Hospitalet de Llobregat, Barcelona, Spain., Sauri T; Medical Oncology Department, Hospital Clinic, Barcelona, Spain., Hierro C; Medical Oncology Department, Instituto Catalán de Oncología (ICO)-Badalona, Barcelona; Badalona-Applied Research Group in Oncology (B-ARGO), Badalona, Spain., Gil M; Medical Oncology Department, Hospital General Universitario de Valencia-Ciberonc CB16/12/0035, Valencia, Spain., Cerda P; Medical Oncology Department, Hospital Universitario Santa Creu y Sant Pau, Barcelona, Spain., Martínez Moreno E; Medical Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain., Martínez Lago N; Medical Oncology Department, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain., Mérida-García AJ; Medical Oncology Department, Complejo Asistencial de Zamora, Zamora, Spain., Gómez González L; Medical Oncology Department, Hospital General Universitario de Alicante, Alicante, Spain., García Navalón FJ; Medical Oncology Department, Hospital Universitario de Son Llatzer, Mallorca, Spain., Ruiz Martín M; Medical Oncology Department, Complejo Asistencial Universitario de Palencia, Palencia, Spain., Marín G; Medical Oncology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain., López-López F; Medical Oncology Department, Hospital Universitario del Sureste, Madrid, Spain., Ruperez Blanco AB; Medical Oncology Department, Hospital Universitario de Toledo, Toledo, Spain., Fernández AF; Medical Oncology Department, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain., Jimenez-Fonseca P; Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain., Carmona-Bayonas A; Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain., Alvarez-Manceñido F; Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2024 Jul; Vol. 26 (7), pp. 1674-1686. Date of Electronic Publication: 2024 Feb 15.
DOI: 10.1007/s12094-024-03388-6
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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