TY - JOUR
T1 - Regional differences in advanced gastric cancer
T2 - exploratory analyses of the AVAGAST placebo arm
AU - Sawaki, Akira
AU - Yamada, Yasuhide
AU - Yamaguchi, Kensei
AU - Nishina, Tomohiro
AU - Doi, Toshihiko
AU - Satoh, Taroh
AU - Chin, Keisho
AU - Boku, Narikazu
AU - Omuro, Yasushi
AU - Komatsu, Yoshito
AU - Hamamoto, Yasuo
AU - Koizumi, Wasaburo
AU - Saji, Shigehira
AU - Shah, Manish A.
AU - Van Cutsem, Eric
AU - Kang, Yoon Koo
AU - Iwasaki, Junko
AU - Kuriki, Hiroshi
AU - Ohtsuka, Wataru
AU - Ohtsu, Atsushi
N1 - Publisher Copyright:
© 2017, The Author(s).
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: AVAGAST was an international, randomized, placebo-controlled phase III study of chemotherapy with or without bevacizumab as first-line therapy for patients with advanced gastric cancer. We performed exploratory analyses to evaluate regional differences observed in the trial. Methods: Analyses were performed in the placebo plus chemotherapy arm (intention-to-treat population). Chemotherapy was cisplatin 80 mg/m2 for six cycles plus capecitabine (1000 mg/m2 orally bid days 1–14) or 5-fluorouracil (800 mg/m2/day continuous IV infusion days 1–5) every 3 weeks until disease progression or unacceptable toxicity. Results: Overall, 387 patients were assigned to placebo plus chemotherapy (eastern Europe/South America, n = 118; USA/western Europe, n = 81; Korea/other Asia, n = 94; Japan, n = 94). At baseline, poor performance status, liver metastases, and larger tumors were most frequent in eastern Europe/South America and least frequent in Japan. Patients received subsequent chemotherapy after disease progression as follows: eastern Europe/South America (14%); USA/western Europe (37%); Korea/other Asia (61%); and Japan (77%). Hazard ratios for overall survival versus USA/western Europe were 1.47 (95% CI, 1.09–1.99) for eastern Europe/South America, 0.91 (95% CI, 0.67–1.25) for Korea/other Asia, and 0.87 (95% CI, 0.64–1.19) for Japan. Conclusions: Regional differences in the healthcare environment may have contributed to the differences in overall survival observed in the AVAGAST study.
AB - Background: AVAGAST was an international, randomized, placebo-controlled phase III study of chemotherapy with or without bevacizumab as first-line therapy for patients with advanced gastric cancer. We performed exploratory analyses to evaluate regional differences observed in the trial. Methods: Analyses were performed in the placebo plus chemotherapy arm (intention-to-treat population). Chemotherapy was cisplatin 80 mg/m2 for six cycles plus capecitabine (1000 mg/m2 orally bid days 1–14) or 5-fluorouracil (800 mg/m2/day continuous IV infusion days 1–5) every 3 weeks until disease progression or unacceptable toxicity. Results: Overall, 387 patients were assigned to placebo plus chemotherapy (eastern Europe/South America, n = 118; USA/western Europe, n = 81; Korea/other Asia, n = 94; Japan, n = 94). At baseline, poor performance status, liver metastases, and larger tumors were most frequent in eastern Europe/South America and least frequent in Japan. Patients received subsequent chemotherapy after disease progression as follows: eastern Europe/South America (14%); USA/western Europe (37%); Korea/other Asia (61%); and Japan (77%). Hazard ratios for overall survival versus USA/western Europe were 1.47 (95% CI, 1.09–1.99) for eastern Europe/South America, 0.91 (95% CI, 0.67–1.25) for Korea/other Asia, and 0.87 (95% CI, 0.64–1.19) for Japan. Conclusions: Regional differences in the healthcare environment may have contributed to the differences in overall survival observed in the AVAGAST study.
KW - Geographic locations
KW - Stomach neoplasms
KW - Survival analysis
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U2 - 10.1007/s10120-017-0773-y
DO - 10.1007/s10120-017-0773-y
M3 - Article
C2 - 29058097
AN - SCOPUS:85031919769
SN - 1436-3291
VL - 21
SP - 429
EP - 438
JO - Gastric Cancer
JF - Gastric Cancer
IS - 3
ER -