Second-line Docetaxel 'Markedly' Prolongs Overall Survival in Relapsed Esophago-Gastric Cancer

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(ChemotherapyAdvisor) – Second-line docetaxel “markedly” improves overall survival without degrading quality of life among patients with relapsed esophago-gastric cancer, according to data from a randomized phase 3 clinical trial presented at the 10th annual Gastrointestinal Cancers Symposium being held January 24-26 in San Francisco, CA.

“Docetaxel should be a standard second-line treatment for esophago-gastric adenocarcinoma,” reported co-author Hugo Ford, MD, of Addenbrooke's Hospital in Cambridge, England. “It is likely to be the standard arm against which future treatments are compared.”

The UK-based phase 3 trial included 168 patients with locally advanced or metastatic adenocarcinoma of the esophagus, stomach, or esophago-gastric junction, whose cancers had progressed within 6 months of initial chemotherapy. Patients were randomly assigned to receive either docetaxel or active symptom control involving radiotherapy, steroids, and/or supportive medication, Dr. Ford reported.

“The median overall survival among patients who received docetaxel was 5.2 months, roughly 50% longer than the 3.6 months among those who received active symptom control,” he reported. “The survival benefit was evident across the different tumor sites and stages of cancer and did not differ by patient age or gender. The greatest benefit was observed in patients with performance status 0 (asymptomatic or fully active).”

Preliminary analysis of overall and disease-specific quality of life indicated “that patients receiving second-line therapy with docetaxel have improved pain scores and no loss in global quality of life,” he noted.

The quality-of-life findings are particularly important given the relatively short survival times involved, he said.

Esophago-gastric cancer, which affects 1.5 million people, is “common and usually incurable,” Dr. Ford said. “Certainly in Western populations, it is normally incurable at the time of diagnosis. We know that chemotherapy improves survival (times) and in fact, in advanced disease it has also been shown to improve quality of life.”

All patients diagnosed with advanced esophago-gastric cancer and “up to 70% of patients with early disease” will progress following initial chemotherapy, Dr. Ford noted. “For such patients, the average survival time is only 3 to 4 months.”

The 2013 Gastrointestinal Cancers Symposium is co-sponsored by the American Gastroenterological Association (AGA) Institute, the American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO) and the Society of Surgical Oncology (SSO).


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