Modified FOLFIRI as Second-Line Chemotherapy after Failure of Modified FOLFOX-4 in Advanced Gastric Cancer.
- Author:
Eun Kyoung JEON
1
;
Sook Hee HONG
;
Tae Hee KIM
;
Seung Eun JUNG
;
Ji Chan PARK
;
Hye Sung WON
;
Yoon Ho KO
;
Sang Young RHO
;
Young Seon HONG
Author Information
1. Division of Oncology, Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea. y331@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Chemotherapy;
FOLFIRI
- MeSH:
Camptothecin;
Disease Progression;
Fluorouracil;
Follow-Up Studies;
Humans;
Infusions, Intravenous;
Leucovorin;
Organoplatinum Compounds;
Stomach Neoplasms
- From:Cancer Research and Treatment
2011;43(3):148-153
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to evaluate efficacy and toxicity of irinotecan, leucovorin and 5-fluorouracil (FOLFIRI) as second-line treatment after failure of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX) for advanced gastric cancer. MATERIALS AND METHODS: Patients who received modified FOLFOX-4 as first-line treatment and then received sequential modified FOLFIRI for disease progression were included in this study. The modified FOLFIRI regimen consisted of irinotecan 150 mg/m2 in a 90-minute intravenous infusion on day 1, leucovorin (LV) 20 mg/m2 and 5-fluorouracil (5-FU) 400 mg/m2 as a bolus followed by 600 mg/m2 as a 22-hour infusion on days 1 and 2 with the same dose of 5-FU/LV of modified FOLFOX-4 every 2 weeks. RESULTS: A total of 32 patients received 126 courses of FOLFIRI chemotherapy. No complete response was achieved. Three patients (9.4%; 95% confidence interval [CI], 0 to 20.1%) achieved partial response, whereas 11 (34.4%; 95% CI, 17.0 to 51.8%) patients showed stable disease. Disease control rate (complete response, partial responses and stable diseases) was 43.8% (95% CI, 25.6 to 61.9%) and median follow up duration was 11.3 months (range, 2.23 to 37.9 months). Median time to progression was 2 months (95% CI, 1.49 to 2.51 months), and median overall survival from the start of FOLFIRI was 5.84 months (95% CI, 4.34 to 7.34 months). Toxicities were tolerable. CONCLUSION: Modified FOLFIRI as second-line chemotherapy after failure of the modified FOLFOX-4 in advanced gastric cancer was tolerable but showed a lower response rate. Further study about retrying 5-FU/LV with irinotecan after failure of the 5-FU/LV combined regimen is necessary in advanced gastric cancer.
