Literature DB >> 23192279

A randomized phase II study of biweekly irinotecan monotherapy or a combination of irinotecan plus 5-fluorouracil/leucovorin (mFOLFIRI) in patients with metastatic gastric adenocarcinoma refractory to or progressive after first-line chemotherapy.

Sun Jin Sym1, Junshik Hong, Jinny Park, Eun Kyung Cho, Jae Hoon Lee, Yeon Ho Park, Woon Ki Lee, Min Chung, Hyung-Sik Kim, Se Hoon Park, Dong Bok Shin.   

Abstract

BACKGROUND: The aim of this study was to evaluate the efficacy of irinotecan (CPT-11) monotherapy and CPT-11 plus 5-fluorouracil (5-FU)/leucovorin (LV) combination (mFOLFIRI) as second-line treatment in patients with advanced gastric cancer (AGC).
METHODS: A total of 59 patients were randomly assigned to either CPT-11 (150 mg/m(2) iv on day 1) or mFOLFIRI (CPT-11 150 mg/m(2) plus LV 20 mg/m(2) on day 1 followed by 5-FU 2,000 mg/m(2) over 48 h), every 2 weeks. The primary end point was objective response rate (ORR).
RESULTS: Following random assignment, 29 patients received CPT-11 and 30 patients mFOLFIRI. The ORR was 17.2 % [95 % confidence interval (CI) 3.4-30.9] and 20.0 % (95 % CI 5.6-34.3) for the CPT-11 and mFOLFIRI arms, respectively (P = 0.525). There was no significant difference in median progression-free survival: 2.2 months (95 % CI 0.2-4.3) for CPT-11 versus 3.0 months (95 % CI 2.0-3.7) for mFOLFIRI (P = 0.481) or in median overall survival: 5.8 months (95 % CI 3.0-8.7), compared with 6.7 months (95 % CI 5.3-8.2) (P = 0.514). Grade 3/4 toxicity was observed in 21 and 28 events in the CPT-11 and mFOLFIRI arms, respectively.
CONCLUSIONS: Although this study had a small sample size and limited statistical power, CPT-11 monotherapy and mFOLFIRI appear to be equally active and tolerable as second-line chemotherapy for AGC. The addition of 5-FU/LV to CPT-11 did not significantly improve efficacy.

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Year:  2012        PMID: 23192279     DOI: 10.1007/s00280-012-2027-3

Source DB:  PubMed          Journal:  Cancer Chemother Pharmacol        ISSN: 0344-5704            Impact factor:   3.333


  28 in total

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Authors:  Zhe-Ling Chen; Andi Zhao; Pan Li; Mi Zhang; Jiao Yang; Lingxiao Zhang; Xiaoai Zhao; Jin Yang; Le Wang
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Review 2.  Metastatic gastric cancer treatment: Second line and beyond.

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Journal:  World J Gastroenterol       Date:  2016-03-21       Impact factor: 5.742

3.  Eastern Canadian Colorectal Cancer Consensus Conference 2017.

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Journal:  Curr Oncol       Date:  2018-08-14       Impact factor: 3.677

4.  Meta-analysis of two randomized phase III trials (TCOG GI-0801 and ECRIN TRICS) of biweekly irinotecan plus cisplatin versus irinotecan alone as second-line treatment for advanced gastric cancer.

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Journal:  Gastric Cancer       Date:  2019-07-15       Impact factor: 7.370

5.  Tumor Response and Symptom Palliation from RAINBOW, a Phase III Trial of Ramucirumab Plus Paclitaxel in Previously Treated Advanced Gastric Cancer.

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Journal:  Oncologist       Date:  2020-12-23

6.  A phase 1b multicenter study of TAS-102 in combination with irinotecan in patients with advanced recurrent or unresectable gastric and gastroesophageal adenocarcinoma after at least one line of treatment with a fluoropyrimidine and platinum-containing regimen.

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7.  Efficacy and safety of second-line therapy with apatinib combined with chemotherapy as second-line therapy in advanced gastric cancer: a single-arm, open-label, prospective, multicenter study.

Authors:  Yan Zhang; Junying Xu; Qiong Wang; Guohong Ling; Yong Mao; Maohuai Cai; Yang Yang; Jingfeng Mei; Zhengxiang Han; Jifeng Feng; Yuan Wu; Lin Shi; Shaodi Wen; Bo Shen
Journal:  Ann Transl Med       Date:  2022-06

Review 8.  Chemotherapy for advanced gastric cancer.

Authors:  Anna Dorothea Wagner; Nicholas Lx Syn; Markus Moehler; Wilfried Grothe; Wei Peng Yong; Bee-Choo Tai; Jingshan Ho; Susanne Unverzagt
Journal:  Cochrane Database Syst Rev       Date:  2017-08-29

Review 9.  Second-line treatment of metastatic gastric cancer: Current options and future directions.

Authors:  Dheepak Kanagavel; Mikhail Fedyanin; Alexey Tryakin; Sergei Tjulandin
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Review 10.  Trastuzumab deruxtecan for the treatment of HER2-positive advanced gastric cancer: a clinical perspective.

Authors:  Masahiko Aoki; Satoru Iwasa; Narikazu Boku
Journal:  Gastric Cancer       Date:  2021-03-01       Impact factor: 7.370

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