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      Factors, Including Clinical Trial Eligibility, Associated with Induction of Third-Line Treatment for Advanced Gastric Cancer

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          Abstract

          Introduction: Third-line chemotherapy has been suggested to improve survival in patients with gastric cancer. This study aimed to identify factors associated with the induction of third-line chemotherapy for advanced gastric cancer, focusing on patient eligibility for clinical trial. Methods: We retrospectively analyzed 335 patients treated for unresectable or recurrent gastric cancer between April 2009 and May 2020. The patients were grouped into those that met the key eligibility criteria for clinical trial (136 patients, 40.6%) and those that did not (199 patients, 59.4%) before receiving first-line chemotherapy. Results: The overall survival (OS) was 16.8 months (95% CI: 14.0–19.6) and 9.3 months (95% CI: 7.8–11.0) in the eligible and ineligible group, respectively. Multivariate analyses to identify the risk factors associated with the induction of third-line chemotherapy revealed ineligibility of clinical trial (OR 1.95; 95% CI: 1.15–3.31), number of metastatic sites (OR 1.99; 95% CI: 1.23–3.22), low albumin concentration (OR 2.24; 95% CI: 1.14–4.38), and a lack of complete or partial response to first-line treatment (OR 1.85; 95% CI: 1.05–3.26). Indeed, in responders to first-line treatment for ineligible patients, the median OS was 17.7 months (95% CI: 10.6–27.9), respectively. Conclusions: Treatment outcomes were different for those eligible for clinical trials and those who were not. However, this study suggested that patients who responded to first-line treatment have more favorable prognosis when treated with salvage chemotherapy, even if they were deemed ineligible for clinical trials.

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          Author and article information

          Journal
          OCL
          Oncology
          10.1159/issn.0030-2414
          Oncology
          Oncology
          S. Karger AG
          0030-2414
          1423-0232
          2023
          January 2023
          14 September 2022
          : 101
          : 1
          : 59-68
          Affiliations
          [_a] aThird Department of Internal Medicine, University of Toyama, Toyama, Japan
          [_b] bDepartment of Clinical Oncology, University of Miyazaki Hospital, Miyazaki, Japan
          [_c] cDepartment of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
          [_d] dDepartment of Gastroenterology, Takaoka Municipal Hospital, Takaoka, Japan
          Author information
          https://orcid.org/0000-0001-8369-8536
          https://orcid.org/0000-0002-5270-7003
          https://orcid.org/0000-0002-7243-1083
          https://orcid.org/0000-0003-4031-3012
          https://orcid.org/0000-0003-0625-1911
          Article
          526577 Oncology 2023;101:59–68
          10.1159/000526577
          36103845
          28af7d24-a0e6-4a40-8a45-956f074bb317
          © 2022 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 13 May 2022
          : 27 July 2022
          Page count
          Figures: 3, Tables: 3, Pages: 10
          Funding
          No funding was received for this study.
          Categories
          Research Article

          Medicine
          Gastric cancer,Eligibility,Clinical trial,Chemotherapy
          Medicine
          Gastric cancer, Eligibility, Clinical trial, Chemotherapy

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