Cancer Res Treat.  2011 Sep;43(3):148-153.

Modified FOLFIRI as Second-Line Chemotherapy after Failure of Modified FOLFOX-4 in Advanced Gastric Cancer

• Jeon EK
• Hong SH
• Kim TH
• Jung SE
• Park JC
• Won HS
• Ko YH
• Rho SY
• Hong YS

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.

Keyword

Stomach neoplasms; Chemotherapy; FOLFIRI

MeSH Terms

Camptothecin
Disease Progression
Fluorouracil
Follow-Up Studies
Humans
Infusions, Intravenous
Leucovorin
Organoplatinum Compounds
Stomach Neoplasms
Camptothecin
Fluorouracil
Leucovorin
Organoplatinum Compounds

Figure

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  Fig. 1 Time to progression (TTP) curve.

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  Fig. 2 Overall survival (OS) curve.

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