Salvage chemotherapy with biweekly irinotecan, plus 5-fluorouracil and leucovorin in patients with advanced gastric cancer previously treated with fluoropyrimidine, platinum, and taxane.
OBJECTIVE
We retrospectively assessed the combination of biweekly irinotecan with 5-fluorouracil (5-FU), and leucovorin (LV) as salvage chemotherapy in patients with advanced gastric cancer (AGC) previously treated with fluoropyrimidine (F), platinum (P), and taxane (T).


METHODS
Between October 2003 and February 2006, all 131 patients with AGC were treated with irinotecan (150 mg/m(2) on day 1), along with either FOLFIRI-1 (ie, LV (20 mg/m(2) bolus) before 5-FU (1000 mg/m(2) continuous infusion over 6-hour) on days 1-2), or FOLFIRI-2 (ie, LV (20 mg/m(2) bolus) before 5-FU (400 mg/m(2) bolus) followed by 22-hour continuous infusion of 600 mg/m(2) on days 1-2), or FOLFIRI-3 (ie, 5-FU (400 mg/m(2) bolus) followed by 46-hour continuous infusion of 2400 mg/m(2) 5-FU and 100 mg/m(2) LV). Cycles were repeated every 2 weeks.


RESULTS
The median age of the patients was 52 years (range, 19-70 years). Patients received a median of 4 cycles of chemotherapy (range, 1-21 cycles). Of the 97 patients with measurable disease, 1 (1.0%) achieved a complete response, and 11 (11.3%) achieved partial responses, making the overall response rate 12.3%. The median time to progression (TTP) was 2.2 months (95% CI, 1.9-2.6 months) and the median overall survival (OS) was 6.2 months (95% CI, 5.6-6.9 months). Good performance status (P = 0.046), fewer metastatic sites (P < 0.001), and longer time to progression of previous chemotherapy (P = 0.006) were independent prognostic factors affecting OS. OS was longer with the FOLFIRI-1 regimen but not with statistical significance (P = 0.064). The treatments were generally well tolerated.


CONCLUSIONS
In actual clinical practice, biweekly irinotecan with 5-FU and LV had modest activity and tolerability in AGC patients previously treated with F, P, and T.
Sym
Sun Jin
SJ
Division of Oncology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ryu
Min-Hee
MH
Lee
Jae-Lyun
JL
Chang
Heung Moon
HM
Kim
Tae Won
TW
Lee
Sung Sook
SS
Lee
Jung Shin
JS
Kang
Yoon-Koo
YK
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016019:Survival Analysis
D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin