title: Second-line treatment of advanced gastric cancer with oxaliplatin plus raltitrexed.
abstract: BACKGROUND
  Treatment with oxaliplatin plus raltitrexed has demonstrated an encouraging therapeutic index in patients with advanced colorectal cancer and malignant pleural mesothelioma. The aim of this multi-institutional study was to determine the antitumor potential of this combination in patients with metastatic gastric cancer failing prior palliative first-line chemotherapy, and to reconfirm its favorable toxicity profile.
  
  
  METHODS
  21 patients with metastatic gastric cancer, who progressed while on or within 6 months after discontinuing palliative first-line chemotherapy, participated in this study. They received raltitrexed 3,0 mg/m(2) and oxaliplatin 130 mg/m(2) both given intravenously on day 1 every 3 weeks.
  
  
  RESULTS
  One patient achieved a partial response, 6 had stable disease, and 14 patients progressed. Median progression-free and overall survival from the onset of salvage chemotherapy was 2.0 and 4.5 months, respectively. Hematologic adverse reactions, specifically neutropenia and anemia were common, though generally mild to moderate with only 3 patients experiencing grade 3/4 toxicity. The most frequent non-hematologic adverse events included nausea/emesis, asthenia, and transient elevation of liver functional parameters, again with grade 3 symptoms occurring only in a minority of patients.
  
  
  CONCLUSIONS
  Despite reproducibility of a favorable toxicity profile of oxaliplatin + raltitrexed, our data suggest that this combination regimen has no substantial antitumor activity in patients with progressive, chemotherapeutically pretreated metastatic gastric cancer.
authors.affiliation: Division of Oncology, Department of Internal Medicine I, Vienna University Medical School, Austria.
authors.forename: K E
authors.initials: KE
authors.lastname: Schmid
authors.forename: G V
authors.initials: GV
authors.lastname: Kornek
authors.forename: B
authors.initials: B
authors.lastname: Schüll
authors.forename: M
authors.initials: M
authors.lastname: Raderer
authors.forename: A
authors.initials: A
authors.lastname: Lenauer
authors.forename: D
authors.initials: D
authors.lastname: Depisch
authors.forename: F
authors.initials: F
authors.lastname: Lang
authors.forename: W
authors.initials: W
authors.lastname: Scheithauer
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D010166:Palliative Care; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects; D019233:Retreatment; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D009944:Organoplatinum Compounds; D011799:Quinazolines; D013876:Thiophenes; D000077150:Oxaliplatin; C068874:raltitrexed