Non-randomized comparison between irinotecan plus mitomycin C and irinotecan alone in patients with advanced gastric cancer refractory to fluoropyrimidine and platinum.
BACKGROUND
Irinotecan alone and plus mitomycin C have been proven to be effective as second-line chemotherapy for advanced gastric cancer. The objective of the present study was to compare the efficacy and safety of irinotecan alone (CA) and with mitomycin C (CM) in clinical practice.


METHODS
Between November 2006 and December 2011, 46 patients with advanced gastric cancer refractory to fluoropyrimidine and platinum were treated with CM (n=22) or CA (n=24).


RESULTS
Baseline characteristics of the patients were similar in the two treatment groups, with the exception of the sex ratio. The median progression-free survival was 3.9 months in the CM arm and 3.7 months in the CA arm (p=0.25), and the median overall survival was 9.6 and 8.7 months (p=0.36), respectively. The overall response rate was 18% in the CA arm and 9% in the CM arm (p=0.38). Grade 3/4 neutropenia (45% vs. 25%), anemia (36% vs. 4%), febrile neutropenia (14% vs. 8%), anorexia (14% vs. 8%) tended to be higher in the CM arm than in the CA arm.


CONCLUSIONS
Although the efficacy of CM and CA for advanced gastric cancer refractory to fluoropyrimidine and platinum was not significantly different, CM tended to lead to greater incidence of adverse events in clinical practice.
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan. ayhosoka@med.u-toyama.ac.jp.
Akira
A
Ueda
Ayumu
A
Hosokawa
Kohei
K
Ogawa
Hiroki
H
Yoshita
Hiroshi
H
Mihara
Takayuki
T
Ando
Shinya
S
Kajiura
Haruka
H
Fujinami
Jun
J
Nishikawa
Masami
M
Minemura
Mitsuhiro
M
Terada
Takashi
T
Kobayashi
Naoki
N
Horikawa
Kazuhisa
K
Yabushita
Masayuki
M
Note
Toshiro
T
Sugiyama
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010984:Platinum / Q000008:administration & dosage; D011379:Prognosis; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
D010984:Platinum; D016685:Mitomycin; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin
Gastric cancer; chemotherapy; irinotecan; mitomycin C