Fadi Sami Farhat1. 1. Division of Hematology-Oncology, Hammoud Hospital University Medical Center, Ghassan Hammoud Street, Sidon, 652, Lebanon. drfadi@terra.net.lb
Abstract
BACKGROUND: The prognosis of gastric tumor is generally poor because most tumors are diagnosed at an advanced stage. Chemotherapy has a proven palliative role in advanced gastric cancer and several combination regimens were explored in the last 10 yr. Nevertheless, none of them showed a convincing improvement resulting in an enhancement of response rate and overall survival without discrimination of the quality of life. Irinotecan (CPT11) has been evaluated in multiple trials alone or in combined therapy with promising results and good tolerance. Thus, a review of the importance and impact of CPT11 in this indication is detailed. METHODS: This article reviews the evidence for the use of CPT11 in the treatment of gastric cancer based on a computerized MEDLINE search of literature published until August 2006 leading to a total of 91 publications. RESULTS: CPT11 was frequently used and showed a good response rate varying from 14% to 23% as single agent and 45% to 70% in combination with a median time to progression of 3 mo in single agent and 4-6 mo in combination, and median overall survival of approx 7 mo in single agent and up to 10.58 mo in combination. CONCLUSION: The overall response of irinotecan-based chemotherapy in advanced gastric cancer was shown to be as effective as other combined chemotherapy. The hematological and digestive toxicity were tolerable and mild, especially in weekly regimen. Thus, irinotecan-based chemotherapy should be considered as one of the preferred choices in front line chemotherapy in advanced gastric cancer.
BACKGROUND: The prognosis of gastric tumor is generally poor because most tumors are diagnosed at an advanced stage. Chemotherapy has a proven palliative role in advanced gastric cancer and several combination regimens were explored in the last 10 yr. Nevertheless, none of them showed a convincing improvement resulting in an enhancement of response rate and overall survival without discrimination of the quality of life. Irinotecan (CPT11) has been evaluated in multiple trials alone or in combined therapy with promising results and good tolerance. Thus, a review of the importance and impact of CPT11 in this indication is detailed. METHODS: This article reviews the evidence for the use of CPT11 in the treatment of gastric cancer based on a computerized MEDLINE search of literature published until August 2006 leading to a total of 91 publications. RESULTS: CPT11 was frequently used and showed a good response rate varying from 14% to 23% as single agent and 45% to 70% in combination with a median time to progression of 3 mo in single agent and 4-6 mo in combination, and median overall survival of approx 7 mo in single agent and up to 10.58 mo in combination. CONCLUSION: The overall response of irinotecan-based chemotherapy in advanced gastric cancer was shown to be as effective as other combined chemotherapy. The hematological and digestive toxicity were tolerable and mild, especially in weekly regimen. Thus, irinotecan-based chemotherapy should be considered as one of the preferred choices in front line chemotherapy in advanced gastric cancer.
Authors: Jaffer A Ajani; Miguel B Fodor; Sergei A Tjulandin; Vladimir M Moiseyenko; Yee Chao; Sebastiao Cabral Filho; Alejandro Majlis; Sylvie Assadourian; Eric Van Cutsem Journal: J Clin Oncol Date: 2005-08-20 Impact factor: 44.544
Authors: E Wasserman; C Cuvier; F Lokiec; F Goldwasser; S Kalla; D Méry-Mignard; M Ouldkaci; A Besmaine; G Dupont-André; M Mahjoubi; M Marty; J L Misset; E Cvitkovic Journal: J Clin Oncol Date: 1999-06 Impact factor: 44.544
Authors: Jaffer A Ajani; Garrett Walsh; Ritsuko Komaki; Jeff Morris; Stephen G Swisher; Joe B Putnam; Patrick M Lynch; Tsung-Teh Wu; Roy Smythe; Ara Vaporciyan; Josephine Faust; Deborah S Cohen; Rebecca Nivers; Jack A Roth Journal: Cancer Date: 2004-06-01 Impact factor: 6.860
Authors: Stuart G Marcus; Daniel Cohen; Ke Lin; Kwok Wong; Scott Thompson; Adina Rothberger; Milan Potmesil; Spiros Hiotis; Elliot Newman Journal: J Gastrointest Surg Date: 2003-12 Impact factor: 3.267
Authors: Michael Gubanski; Anders Johnsson; Eva Fernebro; Lianna Kadar; Ingegerd Karlberg; Petra Flygare; Ake Berglund; Bengt Glimelius; Pehr A Lind Journal: Gastric Cancer Date: 2010-09-05 Impact factor: 7.370
Authors: Allyson J Ocean; Paul Christos; Joseph A Sparano; Manish A Shah; Rhonda K Yantiss; Jonathan Cheng; Juan Lin; Michael Papetti; Dan Matulich; Felice Schnoll-Sussman; Christen Besanceney-Webler; Jenny Xiang; Maureen Ward; Kaili Temple Dilts; Roger Keresztes; Shannon Holloway; Eric X Chen; John J Wright; Maureen E Lane Journal: Invest New Drugs Date: 2014-02-15 Impact factor: 3.850
Authors: Fadi S Farhat; Joseph Kattan; Georges Y Chahine; Fariha C Younes; Fadi L Nasr; Raghda M Mroue; Marwan G Ghosn Journal: Med Oncol Date: 2009-07-31 Impact factor: 3.064
Authors: Kathrin Koucky; Axel Wein; Peter C Konturek; Heinz Albrecht; Udo Reulbach; Gudrun Männlein; Kerstin Wolff; Nicola Ostermeier; Dagmar Busse; Henriette Golcher; Claus Schildberg; Rolf Janka; Werner Hohenberger; Eckhart G Hahn; Jürgen Siebler; Markus F Neurath; Frank Boxberger Journal: Med Sci Monit Date: 2011-05