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External validity of docetaxel triplet trials in advanced gastric cancer: are there patients who still benefit?
- Source :
- Scientia, Gastric Cancer, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname, r-FISABIO. Repositorio Institucional de Producción Científica, r-FISABIO: Repositorio Institucional de Producción Científica, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
- Publication Year :
- 2021
- Publisher :
- Springer, 2021.
-
Abstract
- Background The purpose of our study was to develop an online calculator to estimate the effect of docetaxel triplets (DPF) in first line of advanced gastric cancer (AGC), and to assess the external validity of docetaxel trials in individual patients. Methods The study includes patients with HER2(-) AGC treated with platin and fluoropyrimidine (PF) or with DPF in first line. Treatment effect and interactions were assessed using Bayesian accelerated failure time models. Result The series comprises 1376 patients; 238 treated with DPF and 1138 with PF between 2008 and 2019. DPF was associated with increased progression-free survival (PFS) and overall survival (OS) with time ratio (TR) 1.27 (95% credible interval [CrI], 1.15–1.40), and TR 1.19 (95% CrI, 1.09–1.27), respectively. Serious adverse events were more common with DPF, particularly hematological effects (32% vs 22%). Younger participants received greater DPF dose density without achieving greater disease control, while severe toxicity was likewise higher. DPF yielded superior OS in Lauren intestinal (TR 1.27, 95% CrI, 1.08–1.11) vs diffuse subtype (TR 1.17, 95% CrI, 1.09–1.24) and the probability of increasing OS > 15% was 90% vs 67% in each subtype, respectively. The effect dwindles over time, which can be attributed to pathological changes and clinical practice changes. Conclusion Our study confirms the effect of DPF is highly dependent on several clinical–pathological variables, with discreet and gradually declining benefit over platinum doublets in later years, at the expense of increased toxicity. These results may help to underpin the idea that external validity of AGC trials should be revised regularly.
- Subjects :
- Male
Oncology
Cancer Research
Survival
medicine.medical_treatment
Platinum Compounds
Docetaxel
Other subheadings::Other subheadings::/drug therapy [Other subheadings]
técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::teorema de Bayes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]
0302 clinical medicine
Surgical oncology
Antineoplastic Combined Chemotherapy Protocols
Prospective Studies
Registries
030212 general & internal medicine
Aged, 80 and over
Clinical Trials as Topic
Gastroenterology
General Medicine
Middle Aged
Advanced gastric cancer
Progression-Free Survival
Survival Rate
técnicas de investigación::métodos epidemiológicos::estadística como asunto::análisis de supervivencia::supervivencia libre de progresión [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]
Treatment Outcome
Estómac - Càncer - Tractament
030220 oncology & carcinogenesis
Toxicity
Female
Original Article
Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Stomach Neoplasms [DISEASES]
medicine.drug
Adult
medicine.medical_specialty
neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias gástricas [ENFERMEDADES]
animal structures
Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores]
External validity
Young Adult
03 medical and health sciences
Stomach Neoplasms
Anàlisi de supervivència (Biometria)
Internal medicine
Product Surveillance, Postmarketing
medicine
Humans
Chemotherapy
Adverse effect
Aged
business.industry
Bayes Theorem
Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Bayes Theorem [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]
Pyrimidines
Estadística bayesiana
Bayesian model
Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis::Progression-Free Survival [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]
Gastric cancer
business
Abdominal surgery
Subjects
Details
- Language :
- English
- ISSN :
- 14363291
- Database :
- OpenAIRE
- Journal :
- Scientia, Gastric Cancer, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname, r-FISABIO. Repositorio Institucional de Producción Científica, r-FISABIO: Repositorio Institucional de Producción Científica, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
- Accession number :
- edsair.doi.dedup.....82837869875d5aad20b11f5093a89906