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- Title
Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer.
- Authors
Makiyama, Akitaka; Arimizu, Kohei; Hirano, Gen; Makiyama, Chinatsu; Matsushita, Yuzo; Shirakawa, Tsuyoshi; Ohmura, Hirofumi; Komoda, Masato; Uchino, Keita; Inadomi, Kyoko; Arita, Shuji; Ariyama, Hiroshi; Kusaba, Hitoshi; Shinohara, Yudai; Kuwayama, Miyuki; Kajitani, Tatsuhiro; Oda, Hisanobu; Esaki, Taito; Akashi, Koichi; Baba, Eishi
- Abstract
Background: Patients with advanced gastric cancer (AGC) are often treated with irinotecan monotherapy as salvage-line therapy. However, the survival benefit of this therapy remains to be elucidated.Methods: Medical records of AGC patients who were treated with irinotecan monotherapy as salvage-line treatment in six institutions from 2007 to 2014 were reviewed.Results: A total of 146 patients had prior fluoropyrimidine and taxane therapies, and 75.3% had prior platinum therapy. The median age was 66 (range 27-81) years, and 102 males (69.9%) were included. Performance status (PS) was 0/1/2/3 in 53/70/19/4 patients. Eighty-nine patients (61.0%) had two or more metastatic sites. Irinotecan monotherapy as 3rd-/4th-line therapy was performed in 135/11 (92.5%/7.5%). The median number of administrations was 4 (range 1-62). Forty-six patients (31.5%) required initial dose reduction at the physician’s discretion. The overall response rate was 6.8%, and the disease control rate was 43.1%. The median PFS was 3.19 months [95% confidence interval (CI) 2.30-4.08 months], and the median OS was 6.61 months (95% CI 5.94-7.28 months). Grade 3/4 adverse events were hematological toxicity (46 patients, 31.5%) and non-hematological toxicity (50 patients, 34.2%). Hospitalization due to adverse events was required in 31 patients (21.2%). Patients with relative dose intensity (RDI) less than 80% showed similar survival to those with RDI 80% or higher.Conclusions: Irinotecan monotherapy was relatively safely performed as salvage-line treatment for AGC in Japanese clinical practice. Careful patient selection and intensive modification of the dose of irinotecan might possibly be associated with favorable survival.
- Subjects
STOMACH cancer treatment; CANCER treatment; GASTRIC diseases; ANTINEOPLASTIC agents; IRINOTECAN
- Publication
Gastric Cancer, 2018, Vol 21, Issue 3, p464
- ISSN
1436-3291
- Publication type
Article
- DOI
10.1007/s10120-017-0759-9