title: Second-line chemotherapy of advanced disseminated gastric cancer after cisplatin, infusional 5-fluorouracil, folinic acid (PLF): benefit dependent on progression-free interval after first-line therapy.
abstract: BACKGROUND
  The role of second-line chemotherapy in gastric cancer is not yet established. We analyzed patients receiving second-line treatment after chemotherapy with cisplatin, infusional 5-fluorouracil, folinic acid (PLF).
  
  
  METHODS
  27 patients took part in this retrospective analysis. The second-line chemotherapy consisted of different regimens depending on the recommendations of the attending physician based on response to and toxicity of first-line treatment.
  
  
  RESULTS
  In 3 of 27 patients, partial response was achieved (11%, 95%-confidence interval 0-23%). The progression-free survival and overall survival was 3.1 (2.1-4.3) and 5.1 (3.8-6.6) months, respectively. Progression-free intervals (PFI) of more than 7 months after first-line therapy were a predictor for patients who may benefit from the treatment (median survival from the start of second-line therapy: 10.6 (6.6-13.1) months).
  
  
  CONCLUSIONS
  Second-line chemotherapy after cisplatin / 5-FU rarely induced tumor response, and progression-free survival as well as overall survival remained short. Based on our data, we hypothesize that the PFI after first-line treatment may be a selection criterion for patients suitable for second-line chemotherapy.
authors.affiliation: Klinik für internistische Onkologie und Hämatologie mit Zentrum für Palliativmedizin, Kliniken Essen-Mitte, Germany. m.stahl@kliniken-essen-mitte.de
authors.forename: Michael
authors.initials: M
authors.lastname: Stahl
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Wolf
authors.initials: W
authors.lastname: Köster
authors.forename: Hansjochen
authors.initials: H
authors.lastname: Wilke
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007263:Infusions, Parenteral; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016879:Salvage Therapy / Q000706:statistics & numerical data; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil