Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combination chemotherapy for the treatment of advanced oesophago-gastric cancer
| Autor: | Y-K. Kang, David Cunningham, P. I. McCloud, Alicia Okines, A. R. Norman |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Esophageal Neoplasms Kaplan-Meier Estimate Deoxycytidine Disease-Free Survival Capecitabine Young Adult Stomach Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Progression-free survival Survival analysis Aged Randomized Controlled Trials as Topic Aged 80 and over Proportional hazards model business.industry Hazard ratio Combination chemotherapy Hematology Odds ratio Middle Aged Surgery Treatment Outcome Fluorouracil Female business medicine.drug |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 20(9) |
| ISSN: | 1569-8041 |
| Popis: | The REAL-2 and ML17032 trials demonstrated that the oral fluoropyrimidine, capecitabine, is noninferior to 5-fluorouracil (5-FU) for overall survival (OS) and progression-free survival (PFS), respectively, in advanced oesophago-gastric cancer.Individual patient data were collected on all patients randomised within the trials (n = 1318). Kaplan-Meier survival curves were generated and the log-rank test was used to compare OS and PFS between patients receiving 5-FU combinations and capecitabine combinations. Stepwise multivariate Cox regression analysis was used to calculate corrected hazard ratios (HRs) and 95% confidence intervals (CIs) for OS and PFS. Logistic regression was used for objective response rate. Forest plots with tests of heterogeneity were generated.OS was superior in the 654 patients treated with capecitabine combinations compared with the 664 patients treated with 5-FU combinations; HR 0.87 (95% CI 0.77-0.98, P = 0.02). Poor performance status, age60 and metastatic disease were independent predictors of poor survival. There was no significant difference in PFS between treatment groups on multivariate analysis. Assessable patients treated with capecitabine combinations were significantly more likely to have an objective response to treatment than those treated with 5-FU combinations; odds ratio 1.38 (95% CI 1.10-1.73, P = 0.006).OS is superior in patients treated with capecitabine combinations compared with 5-FU combinations in advanced oesophago-gastric cancer. |
| Databáze: | OpenAIRE |
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