A population-based outcomes study of patients with metastatic gastric cancer receiving second-line chemotherapy: A nationwide health insurance database study

• Published in: PloS one 2018-10, Vol.13 (10), p.e0205853
• Main Authors: Choi, In Sil, Kim, Jee Hyun, Lee, Ju Hyun, Suh, Koung Jin, Lee, Ji Yun, Kim, Ji-Won, Kim, Se-Hyun, Kim, Jin Won, Lee, Jeong-Ok, Kim, Yu Jung, Bang, Soo-Mee, Lee, Jong Seok, Lee, Keun-Wook
• Format: Article
• Language: English
• Subjects: 5-Fluorouracil; Adult; Aged; Aged, 80 and over; Analysis; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols; Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Cisplatin; Cisplatin - therapeutic use; Databases, Factual; Disease-Free Survival; Female; Fluorides - therapeutic use; Fluorouracil - therapeutic use; Gastric cancer; Health aspects; Health insurance; Hospitals; Humans; Insurance; Insurance, Health; Internal medicine; Irinotecan; Irinotecan - therapeutic use; Male; Medical diagnosis; Medical prognosis; Medicine; Medicine and Health Sciences; Metastases; Metastasis; Middle Aged; Neoplasm Metastasis; Outcome Assessment, Health Care; Oxaliplatin; Oxaliplatin - administration & dosage; Patient outcomes; Patients; Platinum; Population studies; Population-based studies; Prognosis; Pyrimidines - therapeutic use; Republic of Korea; Social Sciences; Stomach cancer; Stomach Neoplasms - drug therapy; Stomach Neoplasms - epidemiology; Stomach Neoplasms - pathology; Survival; Taxanes; Taxoids - therapeutic use
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0205853

The survival benefit of second-line chemotherapy in patients with metastatic gastric cancer (MGC) has recently been established. We conducted a nationwide population-based outcomes study of patients with MGC receiving second-line chemotherapy to better understand real-world treatment patterns and outcomes. Data were collected from the Health Insurance Review and Assessment Service database. We identified 509 newly diagnosed patients with MGC in 2010 who received second-line chemotherapy. These patients were divided into three groups for analyses: Group A comprised all patients who received second-line chemotherapy (N = 509); Group B comprised those who received fluoropyrimidine (Fp) plus platinum as first-line treatment, followed by irinotecan-based or taxane-based regimens as second-line chemotherapy (N = 284); and Group C comprised those who received Fp plus cisplatin as first-line treatment, followed by 5-fluorouracil (5-FU)/oxaliplatin, irinotecan-based, or taxane-based regimens as second-line chemotherapy (N = 184). Among patients who received first-line chemotherapy, 47.2% (509/1,078) continued to receive second-line chemotherapy. The most commonly used second-line chemotherapy regimens were 5-FU/irinotecan, 5-FU/oxaliplatin, and docetaxel. The median overall survival (OS) of all 509 patients was 5.2 months. The time from the start date of first-line chemotherapy to the start date of second-line chemotherapy > 6.1 months was an independent prognostic factor for improved OS. The type of chemotherapy regimen was not a significant factor affecting OS. The findings provide a better understanding of second-line treatment patterns and outcomes in patients with MGC and will help guide treatment decisions in real-world clinical practice.