TY - JOUR
T1 - Comparing treatment and outcomes in advanced esophageal, gastroesophageal junction, and gastric adenocarcinomas
T2 - a population-based study
AU - Pape, Marieke
AU - Vissers, Pauline A. J.
AU - Dijksterhuis, Willemieke P. M.
AU - Bertwistle, David
AU - McDonald, Laura
AU - Mostert, Bianca
AU - Derks, Sarah
AU - Oving, Irma M.
AU - Verhoeven, Rob H. A.
AU - van Laarhoven, Hanneke W. M.
N1 - Funding Information: The authors thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry. The authors thank all the participating hospitals in the Netherlands. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Bristol Myers Squibb (CA209-77E). The funder has financed part of the data collection and two employees of the funder have contributed as co-authors on the article. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Bristol Myers Squibb (CA209-77E). The funder has financed part of the data collection and two employees of the funder have contributed as co-authors on the article. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: © The Author(s), 2023.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Background: Treatment of advanced or metastatic esophageal adenocarcinoma (EAC) follows the guidelines for gastroesophageal junction adenocarcinoma (GEJC) and gastric adenocarcinoma (GAC), but patients with EAC are often excluded from clinical studies of GEJC/GAC. Objectives: Here we describe treatment and survival of patients with advanced EAC, GEJC, and GAC to provide population-based evidence on distinctions and similarities between these populations. Design: Retrospective cohort study of patients with unresectable advanced (cT4b) or metastatic (cM1) EAC, GEJC, or GAC (2015–2020) were selected from the Netherlands Cancer Registry. Methods: Overall survival (OS) was assessed using Kaplan–Meier methods, log-rank tests, and multivariable Cox regression. Results: In all, 7391 patients were included (EAC: n = 3346, GEJC: n = 1246, and GAC: n = 2798). Patients with EAC were more often males and more often had ⩾2 metastatic locations. First-line systemic therapy was received by 42%, 47%, and 36% of patients with EAC, GEJC, and GAC, respectively. Median OS was 5.0, 5.1, and 4.0 months for all patients with EAC, GEJC, and GAC, respectively (p < 0.001). Median OS from start of first-line therapy of patients with human epidermal growth factor receptor 2 (HER2)-negative adenocarcinomas was 7.6, 7.8, and 7.5 months (p = 0.12) and of patients with HER2-positive carcinoma receiving first-line trastuzumab-containing therapy was 11.0, 13.3, and 9.5 months (p = 0.37) in EAC, GEJC, and GAC, respectively. After multivariable adjustment, no difference in OS for patients with EAC, GEJC, and GAC was observed. Conclusion: Despite differences in clinical characteristics and treatment strategies, survival between patients with advanced EAC, GEJC, and GAC was similar. We advocate that EAC patients should not be excluded from clinical trials for patients with molecularly similar GEJC/GAC.
AB - Background: Treatment of advanced or metastatic esophageal adenocarcinoma (EAC) follows the guidelines for gastroesophageal junction adenocarcinoma (GEJC) and gastric adenocarcinoma (GAC), but patients with EAC are often excluded from clinical studies of GEJC/GAC. Objectives: Here we describe treatment and survival of patients with advanced EAC, GEJC, and GAC to provide population-based evidence on distinctions and similarities between these populations. Design: Retrospective cohort study of patients with unresectable advanced (cT4b) or metastatic (cM1) EAC, GEJC, or GAC (2015–2020) were selected from the Netherlands Cancer Registry. Methods: Overall survival (OS) was assessed using Kaplan–Meier methods, log-rank tests, and multivariable Cox regression. Results: In all, 7391 patients were included (EAC: n = 3346, GEJC: n = 1246, and GAC: n = 2798). Patients with EAC were more often males and more often had ⩾2 metastatic locations. First-line systemic therapy was received by 42%, 47%, and 36% of patients with EAC, GEJC, and GAC, respectively. Median OS was 5.0, 5.1, and 4.0 months for all patients with EAC, GEJC, and GAC, respectively (p < 0.001). Median OS from start of first-line therapy of patients with human epidermal growth factor receptor 2 (HER2)-negative adenocarcinomas was 7.6, 7.8, and 7.5 months (p = 0.12) and of patients with HER2-positive carcinoma receiving first-line trastuzumab-containing therapy was 11.0, 13.3, and 9.5 months (p = 0.37) in EAC, GEJC, and GAC, respectively. After multivariable adjustment, no difference in OS for patients with EAC, GEJC, and GAC was observed. Conclusion: Despite differences in clinical characteristics and treatment strategies, survival between patients with advanced EAC, GEJC, and GAC was similar. We advocate that EAC patients should not be excluded from clinical trials for patients with molecularly similar GEJC/GAC.
KW - esophageal adenocarcinoma
KW - gastric adenocarcinoma
KW - gastroesophageal junction adenocarcinoma
KW - overall survival
KW - systemic therapy
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150906620&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36970109
UR - http://www.scopus.com/inward/record.url?scp=85150906620&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/17588359231162576
DO - https://doi.org/10.1177/17588359231162576
M3 - Article
C2 - 36970109
SN - 1758-8340
VL - 15
JO - Therapeutic advances in medical oncology
JF - Therapeutic advances in medical oncology
ER -