title: Docetaxel and irinotecan as second-line therapy for advanced oesophagogastric cancer.
abstract: BACKGROUND
  Systemic chemotherapy improves survival in oesophagogastric cancer however no standard second-line regimen exists due to a paucity of randomised data. Docetaxel combined with irinotecan (DI) provides a suitable option due to the lack of cross-reactivity with first-line therapeutics and a tolerable toxicity profile.
  
  
  METHODS
  We retrospectively reviewed a cohort of patients with advanced oesophagogastric cancer in two institutions treated with the combination of docetaxel 35 mg/m(2) plus irinotecan 60 mg/m(2) day 1 and day 8 every 21 days, following progression with first-line platinum-based therapy.
  
  
  RESULTS
  Between January 2000 and September 2009, 41 eligible patients were identified. Median age was 58 years, male:female 25:16, adenocarcinoma:squamous cell carcinoma 37:4, oesophageal:oesophagogastric junction:gastric 7:10:24. Locally advanced:metastatic disease 6:35. Previous radical surgery:radiotherapy:both 6:4:7. 27/41 had progressed within 90 days of receiving platinum-based therapy. Median number of chemotherapy cycles: 3 (range 1-12). Eight patients required dose reductions due to DI toxicity. 10/28 evaluable patients had a response, median progression-free survival (PFS) was 11 weeks (95% confidence intervals (CI): 9-13 weeks) with median overall survival 24 weeks (95%CI: 12-35 weeks). No significant prognostic factors were identified.
  
  
  CONCLUSIONS
  Weekly docetaxel combined with irinotecan has acceptable safety and modest efficacy in the second-line treatment of advanced oesophagogastric cancer. Further prospective evaluation of this regimen is warranted.
authors.affiliation: The Royal Marsden Hospital, London and Surrey, UK.
authors.forename: Eliza
authors.initials: E
authors.lastname: Hawkes
authors.forename: Alicia F C
authors.initials: AF
authors.lastname: Okines
authors.forename: Demetris
authors.initials: D
authors.lastname: Papamichael
authors.forename: Sheela
authors.initials: S
authors.lastname: Rao
authors.forename: Sue
authors.initials: S
authors.lastname: Ashley
authors.forename: Haris
authors.initials: H
authors.lastname: Charalambous
authors.forename: Alona
authors.initials: A
authors.lastname: Koukouma
authors.forename: Ian
authors.initials: I
authors.lastname: Chau
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015331:Cohort Studies; D018450:Disease Progression; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy*; D043823:Taxoids / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D000077146:Irinotecan; D002166:Camptothecin