Summary
Background Cisplatin and fluoropyrimidine (CF) are standard first- line treatment in advanced gastric cancer, but no second-line treatment has yet been established. We present a phase II study in which we evaluated the efficacy and toxicity of the combination of Sorafenib (S), and Oxaliplatin as second-line therapy. Methods Patients with progressive gastric adenocarcinoma after CF- first-line, ECOG 0–2, and measurable disease were included. The primary objective was PFS. Treatment doses were Oxaliplatin 130 mg/m2/3 weeks and Sorafenib 800 mg/bid/d. Results We included 40 patients. CR was 2.5 % and SD was 47.2 %. Grade 3–4 toxic effects were neutropenia (9.8 %), thrombocytopenia (7.3 %), neurotoxicity (4.9 %) and diarrhea (4.9 %). Median PFS was 3 months (95 %CI: 2.3–4.1) and median OS was 6.5 months (95 % CI: 5.2–9.6). Time to progression (TTP) to first line therapy was a prognosis factor. Median OS was 9.7 months when time-to-progression during first-line chemotherapy was >6 months and 5.6 m when it was <6 months (p = 0.04). Conclusions Time-to-progression under a CF-based first-line therapy determines subgroups of GC patients with different prognosis. The combination of Oxaliplatin-Sorafenib in advanced GC patients previously treated with CF appears safe, but our results do not support the implementation of a phase III trial.
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Acknowledgments
We thank Carolyn Newey for English review of the work.
This study was performed within the Medical PhD. framework of the Universitat Autònoma de Barcelona.
X Garcia- Albeniz is a recipient of an “ASISA Fellowship”
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This study comply with the current laws of Spain.
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The authors declare that they have no conflict of interest
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Martin-Richard, M., Gallego, R., Pericay, C. et al. Multicenter phase II study of oxaliplatin and sorafenib in advanced gastric adenocarcinoma after failure of cisplatin and fluoropyrimidine treatment. A gemcad study. Invest New Drugs 31, 1573–1579 (2013). https://doi.org/10.1007/s10637-013-0020-2
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DOI: https://doi.org/10.1007/s10637-013-0020-2