Adjuvant and post-recurrent treatment patterns in patients with resectable gastric cancer in Japan: a retrospective database cohort study

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 27; no. 4; pp. 827 - 839
• Main Authors: Yoshikawa, Takaki, Kikko, Yorifumi, Makino, Reina, Kimijima, Yuya, Nishiyama, Eiji, Matsuda, Yuko, Casaes Teixeira, Bruno, Tejada, Mariella, Carroll, Robert, Hironaka, Shuichi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01-07-2024; Springer Nature B.V
• Subjects: Abdominal Surgery; Adjuvant therapy; Adjuvants; Adult; Adults; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; Cancer therapies; Chemotherapy; Chemotherapy, Adjuvant; Cisplatin; Cohort Studies; Databases, Factual; Drug Combinations; Female; Gastric cancer; Gastroenterology; Humans; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - pathology; Oncology; Original; Original Article; Oxaliplatin; Oxaliplatin - administration & dosage; Oxaliplatin - therapeutic use; Oxonic Acid - administration & dosage; Oxonic Acid - therapeutic use; Paclitaxel; Patients; Pyridines; Retrospective Studies; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach Neoplasms - therapy; Surgical Oncology; Tegafur; Tegafur - administration & dosage; Tegafur - therapeutic use; Trastuzumab; Young Adult; Japan; Retrospective studies; Chemotherapy, adjuvant; Practice patterns, physicians; Stomach neoplasms; Cohort studies
• ISSN: 1436-3291; 1436-3305; 1436-3305
• DOI: 10.1007/s10120-024-01501-w

Background
This study examined temporal shifts in adjuvant therapy patterns in Japanese patients with resectable gastric cancer (GC) and treatment patterns of first-line and subsequent therapy among those with recurrent disease.
Methods
This retrospective analysis of hospital-based administrative claims data (April 1, 2008 to March 31, 2022) included adults (aged ≥ 20 years) with GC who started adjuvant therapy on or after October 1, 2008 (adjuvant cohort) and patients in the adjuvant cohort with disease recurrence (recurrent cohort), further defined by the time to recurrence (≤ 180 or > 180 days after adjuvant therapy).
Results
In the adjuvant cohort (n = 17,062), the most common regimen during October 2008–May 2016 was tegafur/gimeracil/oteracil potassium (S-1; 95.7%). As new standard adjuvant regimen options were established, adjuvant S-1 use decreased to 65.0% and fluoropyrimidine plus oxaliplatin or docetaxel plus S-1 use increased to 15.0% and 20.0%, respectively, in September 2019–March 2022. In the recurrent cohort with no history of trastuzumab/trastuzumab deruxtecan treatment (n = 1257), the most common first-line regimens were paclitaxel plus ramucirumab (34.0%), capecitabine plus oxaliplatin (CapeOX; 17.0%), and nab-paclitaxel plus ramucirumab (10.1%) in patients with early recurrence, and S-1 plus oxaliplatin (26.3%), S-1 plus cisplatin (15.3%), CapeOX (14.0%), S-1 (13.2%), and paclitaxel plus ramucirumab (10.8%) in those with late recurrence.
Conclusions
This study demonstrated temporal shifts in adjuvant treatment patterns that followed the establishment of novel regimens, and confirmed that post-recurrent treatment patterns were consistent with the Japanese Gastric Cancer Association guideline recommendations.