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Lordick F, Al-Batran SE, Arnold D, Borner M, Bruns CJ, Eisterer W, Faber G, Gockel I, Köberle D, Lorenzen S, Möhler M, Pritzkuleit R, Stahl M, Thuss-Patience P, Wöll E, Zander T, Maschmeyer G. German, Austrian, and Swiss guidelines for systemic treatment of gastric cancer. Gastric Cancer 2024; 27:6-18. [PMID: 37847333 PMCID: PMC10761449 DOI: 10.1007/s10120-023-01424-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/07/2023] [Indexed: 10/18/2023]
Abstract
The updated edition of the German, Austrian and Swiss Guidelines for Systemic Treatment of Gastric Cancer was completed in August 2023, incorporating new evidence that emerged after publication of the previous edition. It consists of a text-based "Diagnosis" part and a "Therapy" part including recommendations and treatment algorithms. The treatment part includes a comprehensive description regarding perioperative and palliative systemic therapy for gastric cancer and summarizes recommended standard of care for surgery and endoscopic resection. The guidelines are based on a literature search and evaluation by a multidisciplinary panel of experts nominated by the hematology and oncology scientific societies of the three involved countries.
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Affiliation(s)
- Florian Lordick
- Department of Medicine II (Oncology, Gastroenterology, Hepatology, and Pulmonology), University of Leipzig Medical Center, Liebigstr. 22, 04103, Leipzig, Germany.
| | - Salah-Eddin Al-Batran
- Frankfurt, Institut Für Klinisch-Onkologische Forschung (IKF), UCT-Universitäres Centrum Für Tumorerkrankungen, Frankfurt, Germany
| | - Dirk Arnold
- Asklepios Tumorzentrum Hamburg, Asklepios Klinik Altona, Hamburg, Germany
| | | | | | - Wolfgang Eisterer
- Allgemein Öffentliches Klinikum, Klagenfurt am Wörthersee, Klagenfurt, Austria
| | | | - Ines Gockel
- Department of Medicine II (Oncology, Gastroenterology, Hepatology, and Pulmonology), University of Leipzig Medical Center, Liebigstr. 22, 04103, Leipzig, Germany
| | | | | | | | | | - Michael Stahl
- Evang. Huyssens-Stiftung Kliniken Essen-Mitte, Essen, Germany
| | | | | | | | - Georg Maschmeyer
- Deutsche Gesellschaft Für Hämatologie und Medizinische Onkologie, Berlin, Germany
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2
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Riccò B, Martinelli G, Bardasi C, Dominici M, Spallanzani A, Salati M. Optimizing the Continuum of Care in Gastric Cancer. Onco Targets Ther 2023; 16:995-1012. [PMID: 38021446 PMCID: PMC10680466 DOI: 10.2147/ott.s365505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Gastric cancer (GC) still ranks as the fifth most common malignancy and the fourth leading cause of cancer-related death worldwide. Despite the recent progress in the therapeutic algorithm of the advanced disease with the advent of immune checkpoint inhibitors (ICIs) and next-generation HER2-directed therapies, survival rates remain poor, with a median survival hardly exceeding 12 months. Furthermore, only 40% of patients remain eligible for second- and later-line treatments due to the aggressiveness of the disease and the rapid deterioration of performance status (PS). Thus, current research is focusing either on the identification of novel treatment options or the development of personalized strategies to optimize the continuum of care and ultimately improve patients' outcome. In this article, we provide an overview of the current treatment landscape for advanced GC with a particular emphasis on later-line treatments and outline novel perspectives on the horizon.
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Affiliation(s)
- Beatrice Riccò
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Giulio Martinelli
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Camilla Bardasi
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Massimo Dominici
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Andrea Spallanzani
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Massimiliano Salati
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
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3
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Shitara K, George B, Taieb J, Sundar R, Fakih MG, Makris L, Benhadji KA, Ghidini M. Effects of prior therapies on outcomes with trifluridine/tipiracil in patients with metastatic gastric/gastroesophageal junction cancer in a randomized phase III trial (TAGS). J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04813-z. [PMID: 37213030 PMCID: PMC10374776 DOI: 10.1007/s00432-023-04813-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND In the phase III TAGS trial, trifluridine/tipiracil showed survival benefit versus placebo in patients with metastatic gastric/gastroesophageal junction cancer and ≥ 2 prior chemotherapies. This post hoc exploratory analysis assessed the impact of prior therapy type on outcomes. METHODS Based on prior treatment, patients in TAGS (N = 507) were categorized into overlapping subgroups: ramucirumab ± other agents (n = 169), no ramucirumab (n = 338), paclitaxel but no ramucirumab (n = 136), ramucirumab + paclitaxel sequentially or in combination (n = 154), neither paclitaxel nor ramucirumab (n = 202), irinotecan (n = 281), and no irinotecan (n = 226). Overall and progression-free survival, time to Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2, and safety were assessed. RESULTS Baseline characteristics and prior therapy patterns were generally well balanced between trifluridine/tipiracil and placebo arms across subgroups. Trifluridine/tipiracil was associated with survival benefits versus placebo regardless of prior treatment: across subgroups, median overall survival was 4.6-6.1 versus 3.0-3.8 months (hazard ratios, 0.47-0.88), median progression-free survival was 1.9-2.3 versus 1.7-1.8 months (hazard ratios, 0.49-0.67), and median time to ECOG PS ≥ 2 was 4.0-4.7 versus 1.9-2.5 months (hazard ratios, 0.56-0.88). Among trifluridine/tipiracil-randomized patients, median overall and progression-free survival trended longer in those who had not received ramucirumab, paclitaxel and ramucirumab, or irinotecan (6.0-6.1 and 2.1-2.3 months, respectively) than in those who previously received these agents (4.6-5.7 and 1.9 months). The trifluridine/tipiracil safety profile was consistent across subgroups, with similar overall incidences of grade ≥ 3 adverse events. Minor variations in hematologic toxicities were noted. CONCLUSIONS In TAGS, third- or later-line trifluridine/tipiracil treatment demonstrated overall and progression-free survival and functioning benefits versus placebo and a consistent safety profile in patients with metastatic gastric/gastroesophageal junction cancer, regardless of prior treatment type. CLINICAL TRIALS REGISTRATION clinicaltrials.gov NCT02500043.
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Affiliation(s)
- Kohei Shitara
- National Cancer Center Hospital East, Kashiwa-Shi, Chiba, 277-8577, Japan.
- Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Ben George
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Julien Taieb
- Hôpital Européen Georges Pompidou, Université Paris-Cité, SIRIC CARPEM, Paris, France
| | - Raghav Sundar
- National University Health System, Singapore, Singapore
| | - Marwan G Fakih
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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4
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Pape M, Vissers PAJ, Dijksterhuis WPM, Bertwistle D, McDonald L, Mostert B, Derks S, Oving IM, Verhoeven RHA, van Laarhoven HWM. Comparing treatment and outcomes in advanced esophageal,
gastroesophageal junction, and gastric adenocarcinomas: a population-based
study. Ther Adv Med Oncol 2023; 15:17588359231162576. [PMID: 36970109 PMCID: PMC10031599 DOI: 10.1177/17588359231162576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/20/2023] [Indexed: 03/24/2023] Open
Abstract
Background: Treatment of advanced or metastatic esophageal adenocarcinoma (EAC) follows
the guidelines for gastroesophageal junction adenocarcinoma (GEJC) and
gastric adenocarcinoma (GAC), but patients with EAC are often excluded from
clinical studies of GEJC/GAC. Objectives: Here we describe treatment and survival of patients with advanced EAC, GEJC,
and GAC to provide population-based evidence on distinctions and
similarities between these populations. Design: Retrospective cohort study of patients with unresectable advanced (cT4b) or
metastatic (cM1) EAC, GEJC, or GAC (2015–2020) were selected from the
Netherlands Cancer Registry. Methods: Overall survival (OS) was assessed using Kaplan–Meier methods, log-rank
tests, and multivariable Cox regression. Results: In all, 7391 patients were included (EAC: n = 3346, GEJC:
n = 1246, and GAC: n = 2798). Patients
with EAC were more often males and more often had ⩾2 metastatic locations.
First-line systemic therapy was received by 42%, 47%, and 36% of patients
with EAC, GEJC, and GAC, respectively. Median OS was 5.0, 5.1, and
4.0 months for all patients with EAC, GEJC, and GAC, respectively
(p < 0.001). Median OS from start of first-line
therapy of patients with human epidermal growth factor receptor 2
(HER2)-negative adenocarcinomas was 7.6, 7.8, and 7.5 months
(p = 0.12) and of patients with HER2-positive carcinoma
receiving first-line trastuzumab-containing therapy was 11.0, 13.3, and
9.5 months (p = 0.37) in EAC, GEJC, and GAC, respectively.
After multivariable adjustment, no difference in OS for patients with EAC,
GEJC, and GAC was observed. Conclusion: Despite differences in clinical characteristics and treatment strategies,
survival between patients with advanced EAC, GEJC, and GAC was similar. We
advocate that EAC patients should not be excluded from clinical trials for
patients with molecularly similar GEJC/GAC.
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Affiliation(s)
- Marieke Pape
- Department of Research & Development,
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the
Netherlands
- Amsterdam UMC location University of Amsterdam,
Medical Oncology, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and
Quality of Life, Amsterdam, the Netherlands
| | - Pauline A. J. Vissers
- Department of Research & Development,
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the
Netherlands
- Department of Surgery, Radboud University
Medical Centre, Nijmegen, the Netherlands
| | - Willemieke P. M. Dijksterhuis
- Department of Research & Development,
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the
Netherlands
- Amsterdam UMC location University of Amsterdam,
Medical Oncology, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and
Quality of Life, Amsterdam, the Netherlands
| | - David Bertwistle
- Worldwide Health Economics & Outcomes
Research, Bristol-Myers Squibb, Uxbridge, UK
| | - Laura McDonald
- Worldwide Health Economics & Outcomes
Research, Bristol-Myers Squibb, Uxbridge, UK
| | - Bianca Mostert
- Department of Medical Oncology, Erasmus MC
Cancer Institute, Rotterdam, the Netherlands
| | - Sarah Derks
- Amsterdam UMC location Vrije Universiteit
Amsterdam, Medical Oncology, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Biology and
Immunology, Amsterdam, the Netherlands
- Oncode Institute, Utrecht, The
Netherlands
| | - Irma M. Oving
- Department of Medical Oncology,
Ziekenhuisgroep Twente, Almelo, the Netherlands
| | - Rob H. A. Verhoeven
- Department of Research & Development,
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the
Netherlands
- Amsterdam UMC location University of
Amsterdam, Medical Oncology, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and
Quality of Life, Amsterdam, the Netherlands
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5
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A phase 1b study of the allosteric extracellular FGFR2 inhibitor alofanib in patients with pretreated advanced gastric cancer. Invest New Drugs 2023; 41:324-332. [PMID: 36907947 DOI: 10.1007/s10637-023-01340-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/13/2023] [Indexed: 03/14/2023]
Abstract
Alofanib is a small-molecule allosteric extracellular FGFR2 inhibitor. We report safety and preliminary efficacy from the first-in-human phase 1b study of alofanib in heavily pretreated patients with advanced gastric cancer. The standard dose-escalation design 3+3 aimed to establish the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D). Alofanib was administered daily intravenously 5 days on, 2 days off. There were five dose levels (50-350 mg/m2). All patients received alofanib until disease progression or unacceptable toxicity. 21 patients were enrolled. Patients were predominantly male (71%), 67% had 2 and more metastatic sites, including liver metastases (43%), 19% had ECOG PS 2, and were heavily pretreated (86% had previous 2 and more treatment lines). During dose escalation, no dose-limiting toxicities were observed, and MTD was not defined. 15 (71.4%) patients had at least one adverse event associated with the treatment (TRAE). Grade 3 or higher TRAEs were observed in 6 patients (28.6%). The most common TRAEs included reactions immediately after administration, diarrhea, thrombocytopenia, arthralgia, and headache. The median progression-free survival and overall survival was 3.63 (95% CI 1.58-5.68) and 7.0 (95% CI 3.82-10.18) months, respectively. The 6- and 12-month overall survival rates were 57.1% and 33.3%. Disease control rate was 68% with one durable partial response. The MTD has not been reached and dose of 350 mg/m2, 5 days on, 2 days off has been declared as RP2D. Alofanib showed acceptable tolerability and preliminary signs of clinical activity in the late-line treatment of metastatic gastric cancer. (ClinicalTrials.gov identifier: NCT04071184).
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6
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Ferrario L, Asperti F, Aprile G, Giuliani J. HTA and Gastric Cancer: Evaluating Alternatives in Third- and Fourth-Line Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2107. [PMID: 36767474 PMCID: PMC9915553 DOI: 10.3390/ijerph20032107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Metastatic gastric cancer (mGC) represents an economic and societal burden worldwide. The present study has two aims. Firstly, it evaluates the benefits and the added value of the introduction of trifluridine/tipiracil (FTD/TPI) in the Italian clinical practice, defining the comparative efficacy and safety profiles with respect to the other available treatment options (represented by the best supportive care (BSC) and FOLFIRI (5-FU, irinotecan, and leucovorin) regimens). Secondly, it assesses the potential economic and organizational advantages for hospitals and patients, focusing on third- and fourth-line treatments. For the achievement of the above objective, a health technology assessment study was conducted in 2021, assuming the NHS perspective within a 3-month time horizon. The literature reported a better efficacy of FTD/TPI with respect to both BSC and FOLFIRI regimens. From an economic perspective, despite the additional economic resources that would be required, the investment could positively impact the overall survival rate for the patients treated with the FTD/TPI strategy. However, the innovative molecule would lead to a decrease in hospital accesses devoted to chemotherapy infusion, ranging from a minimum of 34% to a maximum of 44%, strictly dependent on FTD/TPI penetration rate, with a consequent opportunity to take on a greater number of oncological patients requiring drug administration for the treatment of any other cancer diseases. According to experts' opinions, lower perceptions of FTD/TPI emerged concerning equity aspects, whereas it would improve both individuals' and caregivers' quality of life. In conclusion, the results have demonstrated the strategic relevance related to the introduction of FTD/TPI regarding the coverage of an important unmet medical need of patients with metastatic gastric cancer who were refractory to at least two prior therapies, with important advantages for patients and hospitals, thus optimizing the clinical pathway of such frail patients.
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Affiliation(s)
- Lucrezia Ferrario
- Centre for Health Economics, Social and Health Care Management, LIUC Business School, HD LAB—Healthcare Datascience, LAB LIUC University Carlo Cattaneo, 21053 Castellanza, Italy
| | - Federica Asperti
- Centre for Health Economics, Social and Health Care Management, LIUC Business School, HD LAB—Healthcare Datascience, LAB LIUC University Carlo Cattaneo, 21053 Castellanza, Italy
| | - Giuseppe Aprile
- Department of Oncology, ULSS 8 Berica Hospital, 36100 Vicenza, Italy
| | - Jacopo Giuliani
- Department of Oncology, ULSS 9 Scaligera, Mater Salutis Hospital, 37045 Legnago, Italy
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7
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Cascinu S, Di Bartolomeo M, Lonardi S, Beretta G, Fornaro L, De Vita F. The evolving strategies for the management of patients with metastatic gastric cancer: A narrative review and expert opinion. Front Med (Lausanne) 2022; 9:1002435. [PMID: 36590964 PMCID: PMC9799163 DOI: 10.3389/fmed.2022.1002435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Gastric cancer (GC) is recognized as one of the most common deadly malignancies worldwide and about 40-50% of patients present at diagnosis with an unresectable disease due to a locally advanced or already metastatic condition. Recently, therapeutic options for management of metastatic GC (mGC) have been approved allowing a potential improvement of patient cancer treatment response and also an establishment of a continuum of care for this aggressive disease. This report is the result of a literature review by an expert panel. The aim of this document is to provide evidence, wherever it is lacking, to provide expert opinion directed at strategic management of mGC, and in particular aspect at practical management where appropriate guidelines are not available. Treatment landscape with new therapeutic strategies for third line and beyond, role of imaging, prognostic factors, symptoms, and markers as well as the importance of multidisciplinary approach particularly the nutritional aspects are discussed.
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Affiliation(s)
- Stefano Cascinu
- Comprehensive Cancer Center, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy,*Correspondence: Stefano Cascinu,
| | - Maria Di Bartolomeo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Lonardi
- Medical Oncology Unit 3, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Lorenzo Fornaro
- Unit of Medical Oncology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Ferdinando De Vita
- Oncologia Medica - Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
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8
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Haque E, Esmail A, Muhsen I, Salah H, Abdelrahim M. Recent Trends and Advancements in the Diagnosis and Management of Gastric Cancer. Cancers (Basel) 2022; 14:5615. [PMID: 36428707 PMCID: PMC9688354 DOI: 10.3390/cancers14225615] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022] Open
Abstract
Gastric cancer is an enigmatic malignancy that has recently been shown to be increasing in incidence globally. There has been recent progress in emerging technologies for the diagnosis and treatment of the disease. Improvements in non-invasive diagnostic techniques with serological tests and biomarkers have led to decreased use of invasive procedures such as endoscopy. A multidisciplinary approach is used to treat gastric cancer, with recent significant advancements in systemic therapies used in combination with cytotoxic chemotherapies. New therapeutic targets have been identified and clinical trials are taking place to assess their efficacy and safety. In this review, we provide an overview of the current and emerging treatment strategies and diagnostic techniques for gastric cancer.
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Affiliation(s)
- Emaan Haque
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Abdullah Esmail
- Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston, TX 77030, USA
| | - Ibrahim Muhsen
- Section of Hematology and Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Haneen Salah
- Department of Pathology, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Maen Abdelrahim
- Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston, TX 77030, USA
- Cockrell Center for Advanced Therapeutic Phase I Program, Houston Methodist Research Institute, Houston, TX 77030, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY 10021, USA
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9
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Pavlakis N, Tincknell G, Lim LE, Muro K, Obermannova R, Lorenzen S, Chua YJ, Jackson C, Karapetis CS, Price T, Chantrill L, Segelov E, Lordick F. European-Australasian consensus on the management of advanced gastric and gastro-oesophageal junction cancer: current practice and new directions. Ther Adv Med Oncol 2022; 14:17588359221118874. [PMID: 36051471 PMCID: PMC9425884 DOI: 10.1177/17588359221118874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Gastric carcinoma and gastro-oesophageal junction (GC/GEJ) carcinoma remain a significant global problem, with patients presenting with symptoms often found to have advanced or metastatic disease. Treatment options for these patients have broadened in recent years with new chemotherapy agents, agents targeting angiogenic pathways and the development of immune checkpoint inhibitors (ICIs). Most initial advances have occurred in the refractory setting, where it is important to balance treatment benefits versus toxicity and patient quality of life. In the first-line treatment of advanced/metastatic GC/GEJ, platinum- and fluoropyrimidine-based chemotherapy protocols remain the backbone of therapy (with or without HER2-targeted therapy), with the FOLFIRI regimen offering an alternative in patients deemed unsuitable for a platinum agent. Microsatellite instability-high or mismatch repair-deficient cancers have been shown to benefit most from ICIs. In unselected patients previously treated with doublet or triplet platinum- and fluoropyrimidine-based chemotherapy and second-line chemotherapy with irinotecan or taxanes have formed the backbone of therapy with or without the addition of the vascular endothelial growth factor receptor-2 inhibitor ramucirumab in addition to paclitaxel. Beyond this, efficacy has been demonstrated with oral trifluridine/tipiracil and with single-agent nivolumab, in selected refractory patients. In this review, we highlight the positive evidence from key trials that have led to our current practice algorithm, with particular focus on the refractory advanced disease setting, discussing the areas of active research and highlighting the factors, including biomarkers and the influence of ethnicity, that contribute to therapeutic decision-making.
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Affiliation(s)
- Nick Pavlakis
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaDepartment of Medical Oncology, Royal North Shore Hospital, Sydney University, Reserve Road, St Leonards, Sydney, NSW 2065, AustraliaGenesis Care, North Shore Health Hub, St Leonards, NSW, Australia
| | - Gary Tincknell
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaIllawarra Cancer Care Centre, Wollongong Hospital, Wollongong, NSW, Australia
| | - Lisi Elizabeth Lim
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaBallarat Regional Integrated Cancer Centre, Ballarat, VIC, Australia
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | | | - Sylvie Lorenzen
- Department of Hematology and Oncology, Technical University, Munich, Germany
| | - Yu Jo Chua
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaDepartment of Medical Oncology, Canberra Hospital
| | - Chris Jackson
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaDepartment of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Christos Stelios Karapetis
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaFlinders Medical Centre and Flinders University, Adelaide, SA, Australia
| | - Timothy Price
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaQueen Elizabeth Hospital, Adelaide, SA, Australia
| | - Lorraine Chantrill
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaIllawarra Cancer Care Centre, Wollongong Hospital, Wollongong, NSW, Australia
| | - Eva Segelov
- The Australasian Gastrointestinal Trials Group (AGITG), Camperdown, NSW, AustraliaDepartment of Medical Oncology, Monash Health and Monash University, Clayton, VIC, Australia
| | - Florian Lordick
- University Cancer Centre, Leipzig University Medical Centre, Germany
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10
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Fostea RM, Arkenau HT. Trifluridine/tipiracil in the treatment of gastric cancer. Future Oncol 2022; 18:1511-1517. [PMID: 35081748 DOI: 10.2217/fon-2021-0754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Trifluridine/tipiracil is a compound drug, approved in 2015 by the Food and Drug Administration, and in 2016 by the European Medicines Agency, for the treatment of chemorefractory metastatic colorectal cancers, after the phase 3 RECOURSE trial demonstrated significant benefit. Another phase 3 trial (TAGS) showed significant improvement of overall survival and progression-free survival in refractory gastric cancer and gastroesophageal junction cancer, leading to further approval from the FDA on February 2019, followed by Japan in August 2019 and the European Union in September 2019. As promising results have already been observed in the chemorefractory gastric and gastroesophageal-junction cancers, ongoing trials are assessing the use of trifluridine/tipiracil with other standard of care agents, aiming to further improve the survival rate of these patients.
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Affiliation(s)
- Raluca Maria Fostea
- Drug Development Unit, Sarah Cannon Research Institute UK, 93 Harley Street, Marylebone, W1G 6AD, London, United Kingdom
| | - Hendrik-Tobias Arkenau
- Drug Development Unit, Sarah Cannon Research Institute UK, 93 Harley Street, Marylebone, W1G 6AD, London, United Kingdom.,Cancer Institute, University College London, 72 Huntley Street, Bloomsbury, WC1E 6DD, London, United Kingdom
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