Correlation Between the Effects of First-Line Chemotherapy and Survival Time from Second-Line Chemotherapy in Patients with Advanced Gastric Cancer

ABSTRACT Background In advanced gastric cancer (AGC), several prognostic factors for survival time in first-line chemotherapy (1st-CTX) have been reported. However, there are few reports about the relationship between the effects of 1st-CTX and survival time from the start of 2nd-CTX (2nd-MST). Objectives To evaluate between the effects of S-1 + CDDP (SP) therapy as 1st-CTX and 2nd-MST in patients with AGC. Patients and methods The subjects were 32 patients who were treated with SP therapy as 1st-CTX between October 2002 and December 2010 at our institute. The main selection criteria were as follows: with measurable lesions, treated with Irinotecan (CPT-11) or weekly Paclitaxel (wTXL) as 2nd-CTX. Univariate and multivariate analyses were carried out to examine the correlation between 2nd-MST and the efficacy of SP therapy (progression free survival: 1st-PFS, best tumor response rate: best-RR, time to best response) and other prognostic factors. Results The median survival time (1st-MST) and 1st-PFS was 425 and 206 days, respectively. The RR in SP therapy was 66% (PR 21 patients). Best-RR was 30–40/41–50/51–60/61–70/ > 71, %:4/4/3/8/2 patients, respectively. The median to best response time was 73 days. The patient characteristics at the start of 2nd-CTX were as follows: the median age; 63 years, PS; 0/1/2: 9/13/10, histology; intestinal type/diffuse type; 19/13, number of organs with metastases; 1/2/ > 3: 6/16/10, lymph node metastases; yes/no: 20/12, peritoneal dissemination; yes/no: 15/17, 2nd-CTX; CPT/wTXL: 18/14. The 2nd-MST was 173 days. The following factors were correlated with longer 2nd-MST by univariate analyses; age ( Conclusions The effect of SP therapy as 1st-CTX is not prognostic factor of 2nd-MST.