SynthesisThe oncologist2021
Early Weight Loss as a Prognostic Factor in Patients with Advanced Gastric Cancer: Analyses from REGARD, RAINBOW, and RAINFALL Phase III Studies.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Body mass index, weight change, and cancer prognosis: a meta-analysis and systematic review of 73 cohort studies.ESMO open · 2024Pooled it
- Neoadjuvant Gastric Cancer Treatment and Associated Nutritional Critical Domains for the Optimization of Care Pathways: A Systematic Review.Nutrients · 2023Pooled it
- Body weight loss as a prognostic and predictive factor in previously treated patients with metastatic gastric cancer: post hoc analyses of the randomized phase III TAGS trial.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2023Trial
- Modifiable risk factors for weight loss after cancer treatment in Korean gastric cancer survivors.Journal of cancer survivorship : research and practice · 2026Article
- Impact of nutritional status on pathological response and recurrence-free survival in locally advanced oesophagogastric adenocarcinoma treated with perioperative FLOT therapy.ESMO gastrointestinal oncology · 2025Article
- The Impact of Peri-Operative Nutritional Status on Survival in Gastroesophageal Adenocarcinoma.Current oncology (Toronto, Ont.) · 2025Article
- The association between malnutrition risk and revised Edmonton Symptom Assessment System (ESAS-r) scores in an adult outpatient oncology population: a cross-sectional study.Journal of patient-reported outcomes · 2024Article
- Patient metabolic profile defined by liver and muscleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024Article
- Dietary intake of vitamin C and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024Article
- Physical Resilience as a Predictor of Lifespan and Late-Life Health in Genetically Heterogeneous Mice.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- German, Austrian, and Swiss guidelines for systemic treatment of gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024Article
- The Clinical Relevance of Selected Cytokines in Newly Diagnosed Multiple Myeloma Patients.Biomedicines · 2023Article
- Development and applicability of modified weight loss grading system in cancer: a real-world cohort study.Journal of cachexia, sarcopenia and muscle · 2023Article
- Gut microbiome and nutrition-related predictors of response to immunotherapy in cancer: making sense of the puzzle.BJC reports · 2023Review
- Body composition dynamics and impact on clinical outcome in gastric and gastro-esophageal junction cancer patients undergoing perioperative chemotherapy with the FLOT protocol.Journal of cancer research and clinical oncology · 2023Article
- Knowledge and Awareness About Gastric Cancer Among the General Population in Al-Baha City, Saudi Arabia.Cureus · 2023Article
- Clinical Management of Gastric Cancer Treatment Regimens.Current topics in microbiology and immunology · 2023Article
- Does immunotherapy change the treatment paradigm in metastatic gastric cancer?Medical oncology (Northwood, London, England) · 2022Review
- Nutritional Risk Index as a Prognostic Factor Predicts the Clinical Outcomes in Patients With Stage III Gastric Cancer.Frontiers in oncology · 2022Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWeight loss is common in advanced gastric and gastroesophageal junction adenocarcinoma (G/GEA); however, the prognostic implications of weight loss during the first cycle (C1) of chemotherapy remain poorly characterized. In this study, we investigated the impact of early weight loss during systemic treatment as a potential prognostic factor for overall survival (OS) in patients with advanced G/GEA. MATERIALS AND
methodsWe performed a post hoc analysis of three phase III studies of ramucirumab. Patients were categorized into two groups: weight loss of ≥3% and <3% based on weight change during C1 (3-4 weeks) of treatment. OS by weight groups was assessed for each study and as a pooled meta-analysis. The effect of C1 weight change on patient survival was evaluated using univariate and multivariate Cox models.
resultsA total of 1,464 patients with weight data at the end of C1 were analyzed: REGARD (n = 311), RAINBOW (n = 591), and RAINFALL (n = 562). For all three studies, there were fewer patients in the weight loss ≥3% than <3% group. OS was numerically shorter for patients with weight loss of ≥3% than for patients with weight loss of <3% during C1 irrespective of treatment arm. Similar treatment independent effects of early weight loss on OS were observed in the meta-analysis. Overall, early weight loss ≥3% was associated with shorter survival in patients receiving active drug as well as placebo/best supportive care.
conclusionThis large post hoc analysis demonstrated that weight loss of ≥3% during C1 was a negative prognostic factor for OS in patients with advanced G/GEA. IMPLICATIONS FOR PRACTICE: This comprehensive analysis examining early weight loss during systemic treatment as a predictor of survival outcomes in patients with advanced gastric and gastroesophageal junction adenocarcinoma (G/GEA) includes a large sample size, reliable on-treatment data reported in well-conducted phase III clinical trials, and global representation of cancer patients with advanced G/GEA. Understanding the impact of on-treatment weight loss is clinically relevant and may represent an opportunity for targeted interventions.
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