Upon failure of first line treatment for advanced/ stage 4 stomach cancer, patients with good performance status will benefit from second line treatments.
Which agent(s), chemotherapy/ biologic or immunotherapy offer longest median OS in this setting?
- Docetaxel: median OS of 5.2 months (COUGAR-02) – 8.4 months (Lee, 2005)
- Paclitaxel: median OS of 7.8 months (CCOG 0302) – 9.5 months (WJOG 4007)
- nab-Paclitaxel: median OS of 9.2 months (J-0200 study)
- Irinotecan: median OS of 4 months (AIO study) – 8.4 months (WJOG 4007 trial)
- S-1: median OS of 6.3 months (S1 monotherapy study)
- FOLFIRI: median OS of 7.6 months (Kim, 2005) – 10.9 months (Kim, 2007)
- REGARD trial with Ramucirumab mono therapy: median OS 5.2 months
- RAINBOW trial with Ramucirumab + Paclitaxel: median OS of 9.6 months
- KEYNOTE-061 (Pembrolizumab): median OS 9.1 months
For some select few patients, if the patient performance status remains good, there are also data on third line palliative treatments.
- Docetaxel: medial survival 5.3 months
- Irinotecan: median OS 4 months – 6.6 months
- ONO-4538 study (Nivolumab): median OS 5.3 months
- Apatinib: median OS 6.5 months
- INTEGRATE trial (Regorafenib): median OS 5.8 months
That’s it. Just the important numbers of the treatments available. Immunotherapy is coming soon and there will be a lot more updates in the coming years to come.
So, far, immunotherapy results haven’t been as successful as in lung cancer.