title: Efficacy of irinotecan in combination with  5-fluorouracil (FOLFIRI) for metastatic gastric or  gastroesophageal junction adenocarcinomas (MGA)  treatment.
abstract: OBJECTIVE
  The most commonly used schedules are 5-FU in combination with CDDP with or without epirubicin (ECF) or docetaxel (TCF) in treatment of MGA patients (pts), independently of HER status. We evaluated the efficacy of FOLFIRI regimen in a large retrospective series of MGA pts.
  
  
  METHODS
  Two hundred and twelve pts from 13 French centers were treated with at least one cycle of FOLFIRI (irinotecan 180 mg/m2 intravenous (i.v.) over 90 minutes on day 1 with folinic acid (FA) 400mg/m2 i.v. over two hours followed by 5-FU 400mg/m2 i.v. bolus then 5- FU 2400 mg/m2 continuous infusion over 46 hours on day 1, repeated every 14 days). Primary tumour sites were 120 (58%) stomach and 92 (42%) gastroesophageal junction. FOLFIRI was administered as first-line in 137 (65%) pts and as later-line in 75 (35%) pts for MGA.
  
  
  RESULTS
  There was no difference between chemonaive and not chemonaive pts treated as firstline in terms of response rate 37% (95% CI: 25-50) vs 44% (95% CI: 21-69), median PFS, 6.7 (95% CI: 5.5-9.9) vs 5.3 months (95% CI: 3.6-6.9) (P = 0.25), and OS, 13.1 (95% CI: 11.7-18.7) vs 8.8 months (95% CI: 7.3—15.6) (P = 0.19), respectively. There was no difference between pts treated as second or later-line in terms of response rate 20% (95% CI: 8-39) vs 22% (95% CI: 6-48), median PFS, four months (95% CI: 2.8-5.4) vs 3.5 months (95% CI: 2.3-4.5) (P = 0.56), and OS, 10.4 months (95% CI: 5.4-14.4) vs 5.3 months (95% CI: 3.5-11.3) (P = 0.58), respectively. The global grade 3-4 toxicities were: diarrhea 11%, vomiting 9%, neutropenia 18%, febril neutropenia 4% (one toxic death).
  
  
  CONCLUSIONS
  This retrospective study confirms the activity and good tolerance of FOLFIRI regimen in MGA as first-line as well as later-line.
authors.affiliation: CRLC Val d'Aurelle, 208, rue des Apothicaires, 34298 Montpellier cedex 5, France. esamalin@valdorel.fnclcc.fr
authors.forename: E
authors.initials: E
authors.lastname: Samalin
authors.forename: P
authors.initials: P
authors.lastname: Afchain
authors.forename: S
authors.initials: S
authors.lastname: Thézenas
authors.forename: F
authors.initials: F
authors.lastname: Abbas
authors.forename: O
authors.initials: O
authors.lastname: Romano
authors.forename: R
authors.initials: R
authors.lastname: Guimbaud
authors.forename: Y
authors.initials: Y
authors.lastname: Bécouarn
authors.forename: F
authors.initials: F
authors.lastname: Desseigne
authors.forename: J
authors.initials: J
authors.lastname: Edeline
authors.forename: E
authors.initials: E
authors.lastname: Mitry
authors.forename: O
authors.initials: O
authors.lastname: Bouché
authors.forename: A
authors.initials: A
authors.lastname: Adenis
authors.forename: T
authors.initials: T
authors.lastname: Aparicio
authors.forename: E
authors.initials: E
authors.lastname: Dorval
authors.forename: A
authors.initials: A
authors.lastname: Kramar
authors.forename: M
authors.initials: M
authors.lastname: Ychou
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D004943:Esophagogastric Junction; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000556:secondary*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin