Role of chemotherapy for advanced/recurrent gastric cancer: An individual-patient-data meta-analysis

Koji Oba, Seiichiro Yamamoto, Kenichi Nakamura, Yung Jue Bang, Harry Bleiberg, Tomasz Burzykowski, Marc Buyse, Catherine Delbaldo, Stefan Michiels, Satoshi Morita, Yasuo Ohashi, Xavier Paoletti, Jean Pierre Pignon, Philippe Rougier, Junichi Sakamoto, Daniel Sargent, Mitsuru Sasako, Eric Van Cutsem, Nozomu Fuse, Kohei ShitaraAkira Tsuburaya, J. Ajani, N. Boku, C. Barone, M. Borner, O. Bouche, R. Bugat, C. Coombes, S. Cullinan, M. Dank, H. Douglass, B. Glimelius, R. Hawkins, S. Kanzler, W. Koizumi, T. W. Kim, F. Lordick, M. Moehler, Y. Nio, A. Ohtsu, C. Pozzo, P. Reichardt, A. Roth, C. Schumacher, P. Thuss-Patience, U. Vanhoefer, J. Wils, Y. Yamamura, The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group

Research output: Contribution to journalReview article

42 Citations (Scopus)

Abstract

We conducted an individual-patient-data meta-analysis of the efficacy of chemotherapy on overall survival (OS) and progression-free survival (PFS) in advanced/recurrent gastric cancer (AGC). Our primary research question was whether the experimental arms of the trials included in the meta-analysis showed a benefit as compared with their corresponding control arms. MEDLINE (up to 2010), Cochrane Central Register of Controlled Trials, National Institutes of Health (NIH) trial registry and proceedings of major oncologic and gastrointestinal cancer meetings were searched. Randomised controlled trials for AGC closed to patient accrual before the end of 2006 were eligible. As of December 2010, individual patient data were available from 22 trials (4245 patients, representing 47% of the targeted data) of 55 eligible trials. The overall comparison of experimental arms with the corresponding control arms showed statistically significant differences in terms of both OS and PFS. Hazard ratio was 0.88 (95% confidence interval 0.82-0.94, P < 0.0001) for OS and 0.81 (0.76-0.88, P < 0.0001) for PFS. The results of the sub-analysis of adding a given chemotherapeutic agent to any chemotherapy confirm the results of the overall analysis, with a hazard reduction of 11% for OS (P < 0.01) and 26% for PFS (P < 0.0001). This meta-analysis of individual patient data shows that the additions of experimental chemotherapeutic agents to pre-existing control or standard regimens have produced a modest improvement in OS and PFS. Median survival remained below 1 year for all investigated chemotherapy regimens and none emerged as a clear standard.

Original languageEnglish (US)
Pages (from-to)1565-1577
Number of pages13
JournalJAMA - Journal of the American Medical Association
Volume49
Issue number7
DOIs
StatePublished - May 5 2010

Fingerprint

Stomach Neoplasms
Meta-Analysis
Disease-Free Survival
Drug Therapy
Survival
Gastrointestinal Neoplasms
National Institutes of Health (U.S.)
MEDLINE
Registries
Randomized Controlled Trials
Confidence Intervals
Research

Keywords

  • Advanced gastric cancer
  • Chemotherapy
  • Individual patient data
  • Meta-analysis
  • Randomised trial
  • Recurrent gastric cancer

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Oba, K., Yamamoto, S., Nakamura, K., Bang, Y. J., Bleiberg, H., Burzykowski, T., ... The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group (2010). Role of chemotherapy for advanced/recurrent gastric cancer: An individual-patient-data meta-analysis. JAMA - Journal of the American Medical Association, 49(7), 1565-1577. https://doi.org/10.1016/j.ejca.2012.12.016

Role of chemotherapy for advanced/recurrent gastric cancer : An individual-patient-data meta-analysis. / Oba, Koji; Yamamoto, Seiichiro; Nakamura, Kenichi; Bang, Yung Jue; Bleiberg, Harry; Burzykowski, Tomasz; Buyse, Marc; Delbaldo, Catherine; Michiels, Stefan; Morita, Satoshi; Ohashi, Yasuo; Paoletti, Xavier; Pignon, Jean Pierre; Rougier, Philippe; Sakamoto, Junichi; Sargent, Daniel; Sasako, Mitsuru; Van Cutsem, Eric; Fuse, Nozomu; Shitara, Kohei; Tsuburaya, Akira; Ajani, J.; Boku, N.; Barone, C.; Borner, M.; Bouche, O.; Bugat, R.; Coombes, C.; Cullinan, S.; Dank, M.; Douglass, H.; Glimelius, B.; Hawkins, R.; Kanzler, S.; Koizumi, W.; Kim, T. W.; Lordick, F.; Moehler, M.; Nio, Y.; Ohtsu, A.; Pozzo, C.; Reichardt, P.; Roth, A.; Schumacher, C.; Thuss-Patience, P.; Vanhoefer, U.; Wils, J.; Yamamura, Y.; The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group.

In: JAMA - Journal of the American Medical Association, Vol. 49, No. 7, 05.05.2010, p. 1565-1577.

Research output: Contribution to journalReview article

Oba, K, Yamamoto, S, Nakamura, K, Bang, YJ, Bleiberg, H, Burzykowski, T, Buyse, M, Delbaldo, C, Michiels, S, Morita, S, Ohashi, Y, Paoletti, X, Pignon, JP, Rougier, P, Sakamoto, J, Sargent, D, Sasako, M, Van Cutsem, E, Fuse, N, Shitara, K, Tsuburaya, A, Ajani, J, Boku, N, Barone, C, Borner, M, Bouche, O, Bugat, R, Coombes, C, Cullinan, S, Dank, M, Douglass, H, Glimelius, B, Hawkins, R, Kanzler, S, Koizumi, W, Kim, TW, Lordick, F, Moehler, M, Nio, Y, Ohtsu, A, Pozzo, C, Reichardt, P, Roth, A, Schumacher, C, Thuss-Patience, P, Vanhoefer, U, Wils, J, Yamamura, Y & The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group 2010, 'Role of chemotherapy for advanced/recurrent gastric cancer: An individual-patient-data meta-analysis', JAMA - Journal of the American Medical Association, vol. 49, no. 7, pp. 1565-1577. https://doi.org/10.1016/j.ejca.2012.12.016
Oba, Koji ; Yamamoto, Seiichiro ; Nakamura, Kenichi ; Bang, Yung Jue ; Bleiberg, Harry ; Burzykowski, Tomasz ; Buyse, Marc ; Delbaldo, Catherine ; Michiels, Stefan ; Morita, Satoshi ; Ohashi, Yasuo ; Paoletti, Xavier ; Pignon, Jean Pierre ; Rougier, Philippe ; Sakamoto, Junichi ; Sargent, Daniel ; Sasako, Mitsuru ; Van Cutsem, Eric ; Fuse, Nozomu ; Shitara, Kohei ; Tsuburaya, Akira ; Ajani, J. ; Boku, N. ; Barone, C. ; Borner, M. ; Bouche, O. ; Bugat, R. ; Coombes, C. ; Cullinan, S. ; Dank, M. ; Douglass, H. ; Glimelius, B. ; Hawkins, R. ; Kanzler, S. ; Koizumi, W. ; Kim, T. W. ; Lordick, F. ; Moehler, M. ; Nio, Y. ; Ohtsu, A. ; Pozzo, C. ; Reichardt, P. ; Roth, A. ; Schumacher, C. ; Thuss-Patience, P. ; Vanhoefer, U. ; Wils, J. ; Yamamura, Y. ; The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group. / Role of chemotherapy for advanced/recurrent gastric cancer : An individual-patient-data meta-analysis. In: JAMA - Journal of the American Medical Association. 2010 ; Vol. 49, No. 7. pp. 1565-1577.
@article{6bb12c024bef4af4ab94b728eeed654d,
title = "Role of chemotherapy for advanced/recurrent gastric cancer: An individual-patient-data meta-analysis",
abstract = "We conducted an individual-patient-data meta-analysis of the efficacy of chemotherapy on overall survival (OS) and progression-free survival (PFS) in advanced/recurrent gastric cancer (AGC). Our primary research question was whether the experimental arms of the trials included in the meta-analysis showed a benefit as compared with their corresponding control arms. MEDLINE (up to 2010), Cochrane Central Register of Controlled Trials, National Institutes of Health (NIH) trial registry and proceedings of major oncologic and gastrointestinal cancer meetings were searched. Randomised controlled trials for AGC closed to patient accrual before the end of 2006 were eligible. As of December 2010, individual patient data were available from 22 trials (4245 patients, representing 47{\%} of the targeted data) of 55 eligible trials. The overall comparison of experimental arms with the corresponding control arms showed statistically significant differences in terms of both OS and PFS. Hazard ratio was 0.88 (95{\%} confidence interval 0.82-0.94, P < 0.0001) for OS and 0.81 (0.76-0.88, P < 0.0001) for PFS. The results of the sub-analysis of adding a given chemotherapeutic agent to any chemotherapy confirm the results of the overall analysis, with a hazard reduction of 11{\%} for OS (P < 0.01) and 26{\%} for PFS (P < 0.0001). This meta-analysis of individual patient data shows that the additions of experimental chemotherapeutic agents to pre-existing control or standard regimens have produced a modest improvement in OS and PFS. Median survival remained below 1 year for all investigated chemotherapy regimens and none emerged as a clear standard.",
keywords = "Advanced gastric cancer, Chemotherapy, Individual patient data, Meta-analysis, Randomised trial, Recurrent gastric cancer",
author = "Koji Oba and Seiichiro Yamamoto and Kenichi Nakamura and Bang, {Yung Jue} and Harry Bleiberg and Tomasz Burzykowski and Marc Buyse and Catherine Delbaldo and Stefan Michiels and Satoshi Morita and Yasuo Ohashi and Xavier Paoletti and Pignon, {Jean Pierre} and Philippe Rougier and Junichi Sakamoto and Daniel Sargent and Mitsuru Sasako and {Van Cutsem}, Eric and Nozomu Fuse and Kohei Shitara and Akira Tsuburaya and J. Ajani and N. Boku and C. Barone and M. Borner and O. Bouche and R. Bugat and C. Coombes and S. Cullinan and M. Dank and H. Douglass and B. Glimelius and R. Hawkins and S. Kanzler and W. Koizumi and Kim, {T. W.} and F. Lordick and M. Moehler and Y. Nio and A. Ohtsu and C. Pozzo and P. Reichardt and A. Roth and C. Schumacher and P. Thuss-Patience and U. Vanhoefer and J. Wils and Y. Yamamura and {The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group}",
year = "2010",
month = "5",
day = "5",
doi = "10.1016/j.ejca.2012.12.016",
language = "English (US)",
volume = "49",
pages = "1565--1577",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "7",

}

TY - JOUR

T1 - Role of chemotherapy for advanced/recurrent gastric cancer

T2 - An individual-patient-data meta-analysis

AU - Oba, Koji

AU - Yamamoto, Seiichiro

AU - Nakamura, Kenichi

AU - Bang, Yung Jue

AU - Bleiberg, Harry

AU - Burzykowski, Tomasz

AU - Buyse, Marc

AU - Delbaldo, Catherine

AU - Michiels, Stefan

AU - Morita, Satoshi

AU - Ohashi, Yasuo

AU - Paoletti, Xavier

AU - Pignon, Jean Pierre

AU - Rougier, Philippe

AU - Sakamoto, Junichi

AU - Sargent, Daniel

AU - Sasako, Mitsuru

AU - Van Cutsem, Eric

AU - Fuse, Nozomu

AU - Shitara, Kohei

AU - Tsuburaya, Akira

AU - Ajani, J.

AU - Boku, N.

AU - Barone, C.

AU - Borner, M.

AU - Bouche, O.

AU - Bugat, R.

AU - Coombes, C.

AU - Cullinan, S.

AU - Dank, M.

AU - Douglass, H.

AU - Glimelius, B.

AU - Hawkins, R.

AU - Kanzler, S.

AU - Koizumi, W.

AU - Kim, T. W.

AU - Lordick, F.

AU - Moehler, M.

AU - Nio, Y.

AU - Ohtsu, A.

AU - Pozzo, C.

AU - Reichardt, P.

AU - Roth, A.

AU - Schumacher, C.

AU - Thuss-Patience, P.

AU - Vanhoefer, U.

AU - Wils, J.

AU - Yamamura, Y.

AU - The GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group

PY - 2010/5/5

Y1 - 2010/5/5

N2 - We conducted an individual-patient-data meta-analysis of the efficacy of chemotherapy on overall survival (OS) and progression-free survival (PFS) in advanced/recurrent gastric cancer (AGC). Our primary research question was whether the experimental arms of the trials included in the meta-analysis showed a benefit as compared with their corresponding control arms. MEDLINE (up to 2010), Cochrane Central Register of Controlled Trials, National Institutes of Health (NIH) trial registry and proceedings of major oncologic and gastrointestinal cancer meetings were searched. Randomised controlled trials for AGC closed to patient accrual before the end of 2006 were eligible. As of December 2010, individual patient data were available from 22 trials (4245 patients, representing 47% of the targeted data) of 55 eligible trials. The overall comparison of experimental arms with the corresponding control arms showed statistically significant differences in terms of both OS and PFS. Hazard ratio was 0.88 (95% confidence interval 0.82-0.94, P < 0.0001) for OS and 0.81 (0.76-0.88, P < 0.0001) for PFS. The results of the sub-analysis of adding a given chemotherapeutic agent to any chemotherapy confirm the results of the overall analysis, with a hazard reduction of 11% for OS (P < 0.01) and 26% for PFS (P < 0.0001). This meta-analysis of individual patient data shows that the additions of experimental chemotherapeutic agents to pre-existing control or standard regimens have produced a modest improvement in OS and PFS. Median survival remained below 1 year for all investigated chemotherapy regimens and none emerged as a clear standard.

AB - We conducted an individual-patient-data meta-analysis of the efficacy of chemotherapy on overall survival (OS) and progression-free survival (PFS) in advanced/recurrent gastric cancer (AGC). Our primary research question was whether the experimental arms of the trials included in the meta-analysis showed a benefit as compared with their corresponding control arms. MEDLINE (up to 2010), Cochrane Central Register of Controlled Trials, National Institutes of Health (NIH) trial registry and proceedings of major oncologic and gastrointestinal cancer meetings were searched. Randomised controlled trials for AGC closed to patient accrual before the end of 2006 were eligible. As of December 2010, individual patient data were available from 22 trials (4245 patients, representing 47% of the targeted data) of 55 eligible trials. The overall comparison of experimental arms with the corresponding control arms showed statistically significant differences in terms of both OS and PFS. Hazard ratio was 0.88 (95% confidence interval 0.82-0.94, P < 0.0001) for OS and 0.81 (0.76-0.88, P < 0.0001) for PFS. The results of the sub-analysis of adding a given chemotherapeutic agent to any chemotherapy confirm the results of the overall analysis, with a hazard reduction of 11% for OS (P < 0.01) and 26% for PFS (P < 0.0001). This meta-analysis of individual patient data shows that the additions of experimental chemotherapeutic agents to pre-existing control or standard regimens have produced a modest improvement in OS and PFS. Median survival remained below 1 year for all investigated chemotherapy regimens and none emerged as a clear standard.

KW - Advanced gastric cancer

KW - Chemotherapy

KW - Individual patient data

KW - Meta-analysis

KW - Randomised trial

KW - Recurrent gastric cancer

UR - http://www.scopus.com/inward/record.url?scp=85007305846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007305846&partnerID=8YFLogxK

U2 - 10.1016/j.ejca.2012.12.016

DO - 10.1016/j.ejca.2012.12.016

M3 - Review article

AN - SCOPUS:85007305846

VL - 49

SP - 1565

EP - 1577

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 7

ER -