Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: Treatment outcomes and a prognostic model to predict survival

Eun Joo Kang, Seock Ah Im, Do Youn Oh, Sae Won Han, Jin Soo Kim, In Sil Choi, Jin Won Kim, Yu Jung Kim, Jee Hyun Kim, Tae You Kim, Jong Seok Lee, Yung Jue Bang, Keun Wook Lee

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27 Citations (Scopus)

Abstract

Background: The aim of this study was to evaluate the activity and safety of the combination chemotherapy of 5-fluorouracil (5-FU), leucovorin, and irinotecan (FOLFIRI regimen) after failure of fluoropyrimidine, platinum, and taxane in gastric cancer (GC) and to evaluate the prognostic factors for survival. Methods: Patients received biweekly FOLFIRI chemotherapy as third-line treatment. The FOLFIRI-1 consisted of irinotecan (180 mg/m2 in a 2-h infusion) on day 1, and then leucovorin (200 mg/m2 in a 2-h infusion) and 5-FU (a 400 mg/m2 bolus, followed by 600 mg/m 2 in a 22-h continuous infusion) on days 1 and 2. FOLFIRI-2 consisted of irinotecan (180 mg/m2 in a 2-h infusion) on day 1, and then leucovorin (400 mg/m2 in a 2-h infusion) and 5-FU (a 400 mg/m 2 bolus, followed by 2400 mg/m2 in a 46-h continuous infusion) on day 1. Results: A total of 158 patients were included. The overall response rate was 9.6 % in patients with measurable lesions. The median progression-free survival (PFS) and overall survival (OS) were 2.1 months [95 % confidence interval (CI), 1.7-2.5] and 5.6 months (95 % CI, 4.7-6.5), respectively. The major grade 3/4 toxicity was myelosuppression (36.7 %). Good performance status (PS), fewer metastatic sites, and longer duration from the first-line to third-line chemotherapy were independent prognostic factors affecting both PFS and OS. Conclusions: The FOLFIRI regimen showed antitumor activity and tolerable toxicity profiles against advanced GC in the third-line setting. Patients with good PS, fewer metastatic sites and longer previous treatment duration might have the maximal benefit from third-line chemotherapy.

Original languageEnglish
Pages (from-to)581-589
Number of pages9
JournalGastric Cancer
Volume16
Issue number4
DOIs
Publication statusPublished - 2013 Oct 1

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Keywords

  • FOLFIRI
  • Gastric cancer
  • Irinotecan
  • Prognostic factor
  • Third-line chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

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