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Second-line chemotherapy effective in advanced gastric cancer
Second-line chemotherapy reduces mortality risk compared with best supportive care among patients with advanced gastric cancer, results of a meta-analysis suggest.
Patients with relapsed or refractory gastric cancer after first-line chemotherapy undergo salvage chemotherapy, yet no evidence supported this approach until recent phase 3 trials suggested it prolonged OS, according to background information included in the study.
Researchers conducted the current investigation to assess whether second-line salvage chemotherapy improved outcomes compared with best supportive care.
The investigators reviewed the Cochrane, Medline and Embase databases, as well as abstracts and virtual meeting presentations from ASCO annual meetings between 2004 and 2013, to identify studies that could help make such a determination.
The relevant studies — which included two randomized phase 3 trials and one ASCO abstract — included a combined 410 patients. They showed salvage chemotherapy was associated with a significant reduction in risk for death (HR=0.64; 95% CI, 0.52-0.79).
When researchers limited their analysis to patients who underwent docetaxel chemotherapy (n=150) or irinotecan chemotherapy (n=81), the reduction in risk for death remained significant. They calculated HRs of 0.71 (95% CI, 0.56-0.90) for docetaxel and 0.55 (95% CI, 0.40-0.77) for irinotecan).
Disclosure: See the full study for the researchers’ relevant financial disclosures.