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

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 ou...

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Bibliographic Details
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
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Description
Summary: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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0205853