Second-line treatment efficacy and toxicity in older vs. non-older patients with advanced gastric cancer: A multicentre real-world study

Valentina Fanotto, Lorenzo Fornaro, Roberto Bordonaro, Gerardo Rosati, Lorenza Rimassa, Samantha Di Donato, Daniele Santini, Gianluca Tomasello, Francesco Leone, Nicola Silvestris, Silvia Stragliotto, Mario Scartozzi, Riccardo Giampieri, Federico Nichetti, Lorenzo Antonuzzo, Saverio Cinieri, Antonio Avallone, Antonio Pellegrino, Davide Melisi, Enrico VasileLorenzo Gerratana, Giuseppe Aprile

Research output: Contribution to journalArticle

Abstract

Objectives: Although gastric cancer (GC) incidence rises with age, older patients are poorly represented in clinical trials, whose results are therefore difficult to translate into standard management of older patients. Purpose of this study was to compare clinico-pathological features and survival outcomes between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Materials and Methods: Clinico-pathological characteristics, basal values, and treatment data of older (≥70 years at second-line start) and non-older patients were compared using chi-square test or 2-tailed Fisher exact test. The Kaplan-Meier estimation was used to calculate progression-free survival (PFS) and overall survival (OS), which were examined by log-rank test. Results: Older patients represented 31.8% of the population (N = 868). Intestinal type was more frequent in older patients (P =.02). Poorly differentiated tumours were more often observed in non-older patients (P =.009). At stage IV diagnosis, the rate of liver metastases was higher in older patients (P =.02), while peritoneal spread was more represented in non-older patients (P =.002). Although older patients were more often treated with monotherapy (P =.001), they had similar PFS (HR 0.86, 95%CI 0.71–1.03, P =.102) and OS (HR 0.82, 95%CI 0.65–1.02, P =.08) compared to the non-older counterpart. No statistical differences were observed in treatment-related adverse events, hospital admissions, or further treatment lines between age groups. Conclusion: In our large cohort study, despite some differences in tumour characteristics and treatment intensity, no survival difference was found between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Incidence of adverse events was similar between age groups.

Original languageEnglish
JournalJournal of Geriatric Oncology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Stomach Neoplasms
Survival
Disease-Free Survival
Age Groups
Drug Therapy
Incidence
Chi-Square Distribution
Therapeutics
Neoplasms
Cohort Studies
Clinical Trials
Neoplasm Metastasis
Liver

Keywords

  • Advanced gastric cancer
  • Older patients
  • Second-line chemotherapy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Geriatrics and Gerontology

Cite this

Second-line treatment efficacy and toxicity in older vs. non-older patients with advanced gastric cancer : A multicentre real-world study. / Fanotto, Valentina; Fornaro, Lorenzo; Bordonaro, Roberto; Rosati, Gerardo; Rimassa, Lorenza; Di Donato, Samantha; Santini, Daniele; Tomasello, Gianluca; Leone, Francesco; Silvestris, Nicola; Stragliotto, Silvia; Scartozzi, Mario; Giampieri, Riccardo; Nichetti, Federico; Antonuzzo, Lorenzo; Cinieri, Saverio; Avallone, Antonio; Pellegrino, Antonio; Melisi, Davide; Vasile, Enrico; Gerratana, Lorenzo; Aprile, Giuseppe.

In: Journal of Geriatric Oncology, 01.01.2018.

Research output: Contribution to journalArticle

Fanotto, V, Fornaro, L, Bordonaro, R, Rosati, G, Rimassa, L, Di Donato, S, Santini, D, Tomasello, G, Leone, F, Silvestris, N, Stragliotto, S, Scartozzi, M, Giampieri, R, Nichetti, F, Antonuzzo, L, Cinieri, S, Avallone, A, Pellegrino, A, Melisi, D, Vasile, E, Gerratana, L & Aprile, G 2018, 'Second-line treatment efficacy and toxicity in older vs. non-older patients with advanced gastric cancer: A multicentre real-world study', Journal of Geriatric Oncology. https://doi.org/10.1016/j.jgo.2018.11.009
Fanotto, Valentina ; Fornaro, Lorenzo ; Bordonaro, Roberto ; Rosati, Gerardo ; Rimassa, Lorenza ; Di Donato, Samantha ; Santini, Daniele ; Tomasello, Gianluca ; Leone, Francesco ; Silvestris, Nicola ; Stragliotto, Silvia ; Scartozzi, Mario ; Giampieri, Riccardo ; Nichetti, Federico ; Antonuzzo, Lorenzo ; Cinieri, Saverio ; Avallone, Antonio ; Pellegrino, Antonio ; Melisi, Davide ; Vasile, Enrico ; Gerratana, Lorenzo ; Aprile, Giuseppe. / Second-line treatment efficacy and toxicity in older vs. non-older patients with advanced gastric cancer : A multicentre real-world study. In: Journal of Geriatric Oncology. 2018.
@article{33a85166bad54c62aca123b3ccd9aac8,
title = "Second-line treatment efficacy and toxicity in older vs. non-older patients with advanced gastric cancer: A multicentre real-world study",
abstract = "Objectives: Although gastric cancer (GC) incidence rises with age, older patients are poorly represented in clinical trials, whose results are therefore difficult to translate into standard management of older patients. Purpose of this study was to compare clinico-pathological features and survival outcomes between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Materials and Methods: Clinico-pathological characteristics, basal values, and treatment data of older (≥70 years at second-line start) and non-older patients were compared using chi-square test or 2-tailed Fisher exact test. The Kaplan-Meier estimation was used to calculate progression-free survival (PFS) and overall survival (OS), which were examined by log-rank test. Results: Older patients represented 31.8{\%} of the population (N = 868). Intestinal type was more frequent in older patients (P =.02). Poorly differentiated tumours were more often observed in non-older patients (P =.009). At stage IV diagnosis, the rate of liver metastases was higher in older patients (P =.02), while peritoneal spread was more represented in non-older patients (P =.002). Although older patients were more often treated with monotherapy (P =.001), they had similar PFS (HR 0.86, 95{\%}CI 0.71–1.03, P =.102) and OS (HR 0.82, 95{\%}CI 0.65–1.02, P =.08) compared to the non-older counterpart. No statistical differences were observed in treatment-related adverse events, hospital admissions, or further treatment lines between age groups. Conclusion: In our large cohort study, despite some differences in tumour characteristics and treatment intensity, no survival difference was found between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Incidence of adverse events was similar between age groups.",
keywords = "Advanced gastric cancer, Older patients, Second-line chemotherapy, Survival",
author = "Valentina Fanotto and Lorenzo Fornaro and Roberto Bordonaro and Gerardo Rosati and Lorenza Rimassa and {Di Donato}, Samantha and Daniele Santini and Gianluca Tomasello and Francesco Leone and Nicola Silvestris and Silvia Stragliotto and Mario Scartozzi and Riccardo Giampieri and Federico Nichetti and Lorenzo Antonuzzo and Saverio Cinieri and Antonio Avallone and Antonio Pellegrino and Davide Melisi and Enrico Vasile and Lorenzo Gerratana and Giuseppe Aprile",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jgo.2018.11.009",
language = "English",
journal = "Journal of Geriatric Oncology",
issn = "1879-4068",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Second-line treatment efficacy and toxicity in older vs. non-older patients with advanced gastric cancer

T2 - A multicentre real-world study

AU - Fanotto, Valentina

AU - Fornaro, Lorenzo

AU - Bordonaro, Roberto

AU - Rosati, Gerardo

AU - Rimassa, Lorenza

AU - Di Donato, Samantha

AU - Santini, Daniele

AU - Tomasello, Gianluca

AU - Leone, Francesco

AU - Silvestris, Nicola

AU - Stragliotto, Silvia

AU - Scartozzi, Mario

AU - Giampieri, Riccardo

AU - Nichetti, Federico

AU - Antonuzzo, Lorenzo

AU - Cinieri, Saverio

AU - Avallone, Antonio

AU - Pellegrino, Antonio

AU - Melisi, Davide

AU - Vasile, Enrico

AU - Gerratana, Lorenzo

AU - Aprile, Giuseppe

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: Although gastric cancer (GC) incidence rises with age, older patients are poorly represented in clinical trials, whose results are therefore difficult to translate into standard management of older patients. Purpose of this study was to compare clinico-pathological features and survival outcomes between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Materials and Methods: Clinico-pathological characteristics, basal values, and treatment data of older (≥70 years at second-line start) and non-older patients were compared using chi-square test or 2-tailed Fisher exact test. The Kaplan-Meier estimation was used to calculate progression-free survival (PFS) and overall survival (OS), which were examined by log-rank test. Results: Older patients represented 31.8% of the population (N = 868). Intestinal type was more frequent in older patients (P =.02). Poorly differentiated tumours were more often observed in non-older patients (P =.009). At stage IV diagnosis, the rate of liver metastases was higher in older patients (P =.02), while peritoneal spread was more represented in non-older patients (P =.002). Although older patients were more often treated with monotherapy (P =.001), they had similar PFS (HR 0.86, 95%CI 0.71–1.03, P =.102) and OS (HR 0.82, 95%CI 0.65–1.02, P =.08) compared to the non-older counterpart. No statistical differences were observed in treatment-related adverse events, hospital admissions, or further treatment lines between age groups. Conclusion: In our large cohort study, despite some differences in tumour characteristics and treatment intensity, no survival difference was found between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Incidence of adverse events was similar between age groups.

AB - Objectives: Although gastric cancer (GC) incidence rises with age, older patients are poorly represented in clinical trials, whose results are therefore difficult to translate into standard management of older patients. Purpose of this study was to compare clinico-pathological features and survival outcomes between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Materials and Methods: Clinico-pathological characteristics, basal values, and treatment data of older (≥70 years at second-line start) and non-older patients were compared using chi-square test or 2-tailed Fisher exact test. The Kaplan-Meier estimation was used to calculate progression-free survival (PFS) and overall survival (OS), which were examined by log-rank test. Results: Older patients represented 31.8% of the population (N = 868). Intestinal type was more frequent in older patients (P =.02). Poorly differentiated tumours were more often observed in non-older patients (P =.009). At stage IV diagnosis, the rate of liver metastases was higher in older patients (P =.02), while peritoneal spread was more represented in non-older patients (P =.002). Although older patients were more often treated with monotherapy (P =.001), they had similar PFS (HR 0.86, 95%CI 0.71–1.03, P =.102) and OS (HR 0.82, 95%CI 0.65–1.02, P =.08) compared to the non-older counterpart. No statistical differences were observed in treatment-related adverse events, hospital admissions, or further treatment lines between age groups. Conclusion: In our large cohort study, despite some differences in tumour characteristics and treatment intensity, no survival difference was found between older and non-older patients with advanced GC treated with at least two chemotherapy lines. Incidence of adverse events was similar between age groups.

KW - Advanced gastric cancer

KW - Older patients

KW - Second-line chemotherapy

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85058040620&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058040620&partnerID=8YFLogxK

U2 - 10.1016/j.jgo.2018.11.009

DO - 10.1016/j.jgo.2018.11.009

M3 - Article

AN - SCOPUS:85058040620

JO - Journal of Geriatric Oncology

JF - Journal of Geriatric Oncology

SN - 1879-4068

ER -