Evidence map›Paper›PMID 34655175›Full record

Trial reportCancer medicine2021

Clinical implications of using both fluoropyrimidine and paclitaxel in patients with severe peritoneal metastasis of gastric cancer: A post hoc study of JCOG1108/WJOG7312G.

Hiroyuki Arai, Eisuke Inoue, Kensei Yamaguchi, Narikazu Boku, Hiroki Hara, Tomohiro Nishina, Masahiro Tsuda, Kohei Shitara, Katsunori Shinozaki, Shinichiro Nakamura and 5 more

Open access · goldAbstract readClinical Trial, Phase IIClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Catheter based intraperitoneal chemotherapy using taxane for peritoneal metastases from gastric cancer: from bench to bedside-a narrative review.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 14 institutions in 2 countries.

Hiroyuki AraiDepartment of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.ORCID 0000-0002-1886-7070
Eisuke InoueShowa University Research Administration Center, Showa University, Tokyo, Japan.
Kensei YamaguchiDepartment of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Narikazu BokuDepartment of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Hiroki HaraDepartment of Gastroenterology, Saitama Cancer Center, Saitama, Japan.
Tomohiro NishinaDepartment of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Masahiro TsudaDepartment of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan.
Kohei ShitaraGastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Katsunori ShinozakiDivision of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Shinichiro NakamuraWest Japan Oncology Group (WJOG) Data Center Division, Yokohama, Japan.
Ichinosuke HyodoDepartment of Gastroenterology, University of Tsukuba, Tsukuba, Japan.
Kei MuroDepartment of Clinical Oncology, Aichi Cancer Center, Nagoya, Japan.ORCID 0000-0002-5572-743X
Mitsuru SasakoDepartment of Surgery, Yodogawa Christian Hospital, Osaka, Japan.
Masanori TerashimaDivision of Gastric Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.
Takako E NakajimaDepartment of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.
National Cancer Center Hospital East · JPAichi Cancer Center · JPHiroshima Prefectural Hospital · JPHyogo Prefectural Cancer Center · JPJapan Clinical Cancer Research Organization · JPSaitama Cancer Center · JPShikoku Cancer Center · JPShizuoka Cancer Center · JPShowa University Hospital · JPSt. Marianna University School of Medicine · JPThe Cancer Institute Hospital · JPUniversity of Southern California · USUniversity of Tsukuba · JPYodogawa Christian Hospital · JP

Funding

Japan Agency for Medical Research and Development (AMED) JP16ck0106139Japan Agency for Medical Research and Development (AMED) JP18ck0106351Ministry of Health, Labour and Welfare of Japan H26-144National Cancer Research and Development Fund 26-A-4National Cancer Research and Development Fund 29-A-3
6 · The paper itself

Abstract

backgroundIn the JCOG1108/WJOG7312G trial, a combination (FLTAX) of 5-fluorouracil (FU) /leucovorin (FL) and paclitaxel (PTX) did not show superiority in overall survival (OS) to FL in untreated patients with severe peritoneal metastasis of gastric cancer (GC-SPM), some of whom received second-line chemotherapy with PTX after FL. This post hoc study aimed to investigate the clinical implications of using both FU and PTX either sequentially or in combination for patients with GC-SPM.

methodsA total of 94 patients were enrolled and categorized into the following three subgroups: patients treated with (1) FL followed by PTX (FL/PTX, N = 25), (2) FL followed by best supportive care (BSC) (FL/BSC, N = 21), and (3) FLTAX (N = 48). OS was compared between the subgroups. By comparing baseline factors between the FL/PTX and FL/BSC subgroups, factors preventing the sequential use of PTX (SUP) were explored using logistic regression model. The efficacy of FL and FLTAX was compared according to the presence of risk factors preventing SUP.

resultsThe FL/PTX subgroup showed better and equivalent OS compared to the FL/BSC (median 7.8 vs. 2.0 months, p < 0.01) and FLTAX (median 7.8 vs. 8.0, p = 0.49) subgroups, respectively. Glasgow Prognostic Score 2 and initially unresectable disease were identified as risk factors preventing SUP. Absence of both risks predicted SUP with a sensitivity of 13% and a specificity of 100%, whereas absence of any risks predicted SUP with a sensitivity of 67% and a specificity of 62%. FLTAX showed better OS than FL in patients with one or two of these risks but worse OS in those with none.

conclusionsAlthough sequential use of FU and PTX showed equivalent survival to FLTAX in patients with GC-SPM, FLTAX might be preferable given the difficulty in selecting patients likely to receive sequential use at the initiation of first-line chemotherapy.

Indexed as

AgedAntineoplastic Combined Chemotherapy ProtocolsDrug Administration ScheduleFemaleFluorouracilHumansKaplan-Meier EstimateMaleMiddle AgedPaclitaxelPeritoneal NeoplasmsRisk AssessmentRisk FactorsStomach NeoplasmsSurvival AnalysisFluorouracilPaclitaxelFLTAXgastric cancerinadequate oral intakemassive ascitessevere peritoneal metastasis

Identifiers

PMID34655175
PMCPMC8559492
OpenAlexW3207921413

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.