Stomach cancer, a new treatment available that prolongs the life of the sick

from Vera Martinella

Official green light also in Italy for a third line of therapy: an oral drug useful for patients who had no other options. Aggressive disease, still late diagnosed today

A new option that extends the survival of patients with metastatic gastric cancer. An oral chemotherapy, therefore in tablets, which patients can take at home, to be administered as a third line of treatment: that is, in those cases where the neoplasm progresses after the first and second lines of treatment and in which, until now, there were no other options available. now officially available also in Italy, after receiving the approval of the Italian Medicines Agency (Aifa), the trifluridine / tipiracil combination, recommended by European guidelines as standard of care in this subgroup of patients.

Third standard line

With stomach cancer they get sick approx 13 thousand Italians every year. Only one third of patients alive five years after diagnosis – he explains Carmine Pinto, president of the Federation of groups of Italian oncological cooperatives (FICOG) and director of the medical oncology of the Comprehensive Cancer Center of the AUSL-IRCCS of Reggio Emilia -. He mostly blames the fact that the disease is discovered late, when it is already in an advanced stage, because only then does it begin to show the first symptoms. And an aggressive neoplasm. The new indication of trifluridine / tipiracil therefore represents good news for patients, who now have a new therapeutic possibility in the third standard line of advanced disease, as is already the case for first and second line therapies, and as indicated by the Italian and European guidelines. We therefore have the possibility also in this oncological pathology of a treatment sequence. Specifically, the chemotherapy combination has obtained reimbursement from Aifa for the monotherapy treatment of adult patients suffering from metastatic gastric carcinoma, previously treated or not suitable for treatment with other available therapies. The approval came based on the results of the Phase 3 TAGS clinical trial which showed an improvement in median survival of up to 5.3 months, with a 30% reduction in the risk of deathtogether guaranteeing the maintenance of patients’ quality of life.

We need a specialized center

Until now, the therapeutic options available for the treatment of patients with metastatic gastric cancer have been limited to “off label” chemotherapy regimens (outside the ordinary rules) which not only do not offer any significant clinical benefit, but can potentially worsen the quality of life of the patient due to side effects – explains Pinto -. The oral combination trifluridine / tipiracil the only one to have demonstrated an increase in life expectancy and better management of symptoms related to disease progression. In addition to innovative drugs, to better treat those who fall ill with this neoplasm, it is crucial to be treated in a specialized center, where the various doctors discuss each other in order to choose the most suitable therapies in the individual case, because in this way the possibilities of survive and live better. Gastric cancer is a highly complex clinical diseaseespecially if the disease is in an advanced stage or in a relapse and requires optimal management of the diagnostic-therapeutic path – he underlines Claudia Santangelo, president of the patient association Living without a stomach (yes) -. The management of these patients, in particular with advanced stage carcinoma, in fact requires a multidisciplinary approach (medical oncologist, surgeon, pathologist, radiologist, radiotherapist, nutritionist, physiotherapist, psychologist) that allows a global management of patients and the disease, improving survival and quality of life. Surgery is the main treatment (when the stomach is removed, in whole or in part, the digestive tract can be reconnected by various methods), but since the disease is often diagnosed at an advanced stage it is not possible to intervene in the first place and one proceeds first with the drugs.

It is important not to lose weight

It is equally important to pay attention, from the beginning of the therapeutic process, to the nutritional aspect to avoid that the patient loses too much weight and, therefore, has problems in continuing the treatments or undergoes serious consequences that worsen the quality and the life expectation. In these last years greater attention to nutritional aspects it has improved the possibility for patients to access multiple lines of therapies with its positive impact on survival – says Pinto -. In fact, guaranteeing adequate nutritional support from the early stages of the disease allows many more patients with advanced disease to access a second (40% of cases) and even a third line (15%) of treatment. therefore indispensable in this oncological pathology a “global” patient care strategy, which can provide both symptom and survival benefits. We know that a well-nourished patient is a patient who will be able to undergo more adequate treatment. As a patient association we mainly ask for three things: cancer networks, equality of treatment in every Italian region and specialized treatment centers equipped with multidisciplinary and multiprofessional units adds Santangelo.

Symptoms not to be underestimated

Stomach cancer can be cured, if it is identified in the beginning and surgically removed, so It is important to pay attention to some symptoms which must be suspicious when they persist for many weeks. Unfortunately today only 7% of cases are diagnosed in the early stages. Attention should be paid to a number of signs that may be non-specific or indicate non-serious problems, but it is better to speak to a doctor in case of: persistent digestive disturbances, loss of appetite, difficulty swallowing, weight loss, feeling full after meals, feeling sick and being sick, heartburn (burning behind the breastbone), blood in the stool or black stools, chronic fatigue. Not to neglect these alarm bells must be especially those most at risk of getting sick: people suffering from atrophic gastritis (inflammation of the stomach) or a chronic infection caused byHelicobacter pyloriresponsible for ulcer and gastritis.

May 23, 2022 (change May 23, 2022 | 19:08)

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