title: Efficacy and safety of irinotecan monotherapy as third-line treatment for advanced gastric cancer.
abstract: Although irinotecan monotherapy is often used in third-line treatment after the failure of taxanes in Japanese clinical practice, its survival benefit is still unclear. The aim of this study is to investigate the efficacy and safety of irinotecan monotherapy as third-line treatment.
  
  
  
  Clinical data from consecutive patients in whom irinotecan had been initiated as third-line treatment between December 2003 and July 2015 in Shizuoka Cancer Center were retrospectively analyzed. Patients who were refractory or intolerant to fluoropyrimidine with or without platinum in first-line treatment and subsequent therapy with taxanes were included in this study. Irinotecan was administered at 150 mg/m(2) every 2 weeks.
  
  
  
  The data of 50 patients who met the inclusion criteria were analyzed. The overall response rate was 18.4 % (7/38) among the patients with measurable disease. The median progression-free survival time was 66 days, and the median survival time was 180 days from the initiation of irinotecan therapy. The major grade 3 or 4 adverse events including neutropenia, fatigue, and anorexia were observed in 12 (24 %), 8 (16 %), and 7 (14 %), respectively. No treatment-related deaths occurred. Thirteen patients (26 %) required a dose reduction to 120 mg/m(2) or less from the initiation of irinotecan.
  
  
  
  This study suggests that irinotecan as third-line treatment has an anti-tumor effect and is feasible with optimal dose modification for advanced gastric cancer.
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Takeshi
authors: T
authors: Kawakami
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan. no.machida@scchr.jp.
authors: Nozomu
authors: N
authors: Machida
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Hirofumi
authors: H
authors: Yasui
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Masahiro
authors: M
authors: Kawahira
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Sadayuki
authors: S
authors: Kawai
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Yosuke
authors: Y
authors: Kito
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Yukio
authors: Y
authors: Yoshida
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Satoshi
authors: S
authors: Hamauchi
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Takahiro
authors: T
authors: Tsushima
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Akiko
authors: A
authors: Todaka
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Tomoya
authors: T
authors: Yokota
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Kentaro
authors: K
authors: Yamazaki
authors: Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan.
authors: Akira
authors: A
authors: Fukutomi
authors: Department of Clinical Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
authors: Yusuke
authors: Y
authors: Onozawa
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin
keywords: Advanced gastric cancer; Irinotecan; Salvage line; Third-line treatment