title: Irinotecan, leucovorin and 5-fluorouracil (modified FOLFIRI) as salvage chemotherapy for frail or elderly patients with advanced gastric cancer.
abstract: We retrospectively evaluated the efficacy and safety of the modified FOLFIRI regimen in frail or elderly patients with advanced gastric cancer (AGC). We reviewed 24 frail [Eastern Cooperative Oncology Group performance status (ECOG PS) of 2] or elderly (65 years or over) patients with AGC who received the modified FOLFIRI regimen as salvage chemotherapy. Patients received irinotecan 150 mg/m(2) and leucovorin (LV) 100 mg/m(2) as a 2 h intravenous infusion, followed by 5-fluorouracil (5-FU) 2,000 mg/m(2) as a 46 h continuous infusion. Among the 24 patients, 18 (75%) had an ECOG PS of 2, and 11 (45.8%) were aged 65 years or over. A total of 113 cycles were conducted, with a median number of 4 cycles per patient. A total of 3 patients achieved partial response (PR) and 8 demonstrated stable disease (SD). On an intent-to-treat basis, the overall response rate (RR) was 12.5% and the disease control rate (PR and SD) was 45.8%. The median time to progression (TTP) was 2 months [95% confidence interval (CI), 1.9-2.1 months] and the median overall survival (OS) was 5.4 months (95% CI, 4.1-6.7 months). Grade 3-4 hematological toxicities, including neutropenia, anemia and thrombocytopenia, were observed in 6 (25%), 4 (16.7%) and 1 (4.2%) patients, respectively. Additionally, 3 (12.5%) patients developed febrile neutropenia, of which 1 succumbed to pneumonia. Grade 3-4 gastrointestinal toxicities, including nausea, vomiting, diarrhea and mucositis, were observed in 3 (12.5%), 2 (8.3%), 1 (4.2%) and 1 (4.2%) patients, respectively. In conclusion, the modified FOLFIRI regimen as salvage chemotherapy for AGC patients over 65 years of age or with a poor PS was effective and acceptable. These results suggest that this regimen may be an effective option for frail or elderly patients with AGC.
authors.affiliation: Departments of Internal Medicine and.
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyeong Su
authors.initials: HS
authors.lastname: Kim
authors.forename: A Rum
authors.initials: AR
authors.lastname: Han
authors.forename: In Ho
authors.initials: IH
authors.lastname: Moh
authors.forename: Doo Cheol
authors.initials: DC
authors.lastname: Chung
authors.forename: Dae Ro
authors.initials: DR
authors.lastname: Choi
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Jang
authors.forename: Jin Bae
authors.initials: JB
authors.lastname: Kim
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Yang
authors.forename: Soon Il
authors.initials: SI
authors.lastname: Lee
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Zang