Correlation between tumor response to first-line chemotherapy and prognosis in advanced gastric cancer patients

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Abstract
Background: In advanced gastric cancer, the relationship between tumor response and prognosis is far from clear. Methods: We performed a pooled analysis on published data from 4593 patients in 25 randomized trials of first-line chemotherapy for advanced gastric cancer. A weighed analysis was used to investigate the correlation between objective response rate (RR) and time to progression (TTP) and overall survival time (OS). Results: A moderate correlation was found between RR and TTP and OS (r = 0.49 and r = 0.45, respectively) in all 25 trials. In treatment arms without new drugs including irinotecan, taxanes, or oxaliplatin, RR also was associated with TTP and OS (r = 0.56 and r = 0.47, respectively). However, no association between RR and OS was found, whereas there was a moderate correlation between RR and TTP (r = 0.41) in treatment arms using new drugs. Conclusions: Our results indicated that response to treatment was related to TTP and OS. The potential role of objective response as a surrogate in chemotherapy trials of advanced gastric cancer warrants further investigation, especially with regard to treatment with new drugs.

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