Korean J Gastroenterol.  2015 Jul;66(1):10-16. 10.4166/kjg.2015.66.1.10.

Efficacy and Safety of FOLFIRI after Failure of FOLFOX-4 in Advanced Gastric Cancer

• Kwon HJ
• Park MI
• Park SJ
• Moon W
• Kim SE
• Lee HW
• Choi YJ
• Kim JH

• KMID: 2373306
• DOI: http://doi.org/10.4166/kjg.2015.66.1.10

Abstract

BACKGROUND/AIMS
The purpose of this study was to investigate the efficacy and safety of irinotecan based FOLFIRI chemotherapy as a second-line treatment after failure of FOLFOX-4 chemotherapy in patients with advanced gastric cancer.
METHODS
Fifty-two patients who were pathologically diagnosed with unresectable gastric cancer and received FOLFIRI chemotherapy after failure of FOLFOX-4 chemotherapy between September 2005 and February 2012 were enrolled in this study. Data were collected by retrospectively reviewing the medical records. The response to chemotherapy was assessed every 3 cycles by World Health Organization criteria and long term survival was analyzed. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institution (NCI) toxicity criteria version 3.0.
RESULTS
Median age of the patients was 57 years. Median overall survival (OS) and time to progression (TTP) were 7.8 and 5 months, respectively. The number of patients showing complete remission, partial remission, stable disease, and progressive disease were 0 (0.0%), 9 (17.3%), 30 (57.7%), and 13 (25.0%), respectively. The overall response rate was 17.3%. During a total of 345 cycles, anemia worse than NCI toxicity grade 3 occurred in 2.9%, leukopenia in 20.3%, neutropenia in 12.2%, and thrombocytopenia in 1.5%. Patients with less organ involvement by metastasis, less than 34 U/mL of CA 19-9 and good responsiveness to third cycle of second line chemotherapy were associated with longer OS and TTP.
CONCLUSIONS
FOLFIRI chemotherapy has a modest efficacy with acceptable toxicities in patients with advanced gastric cancer as a second-line treatment. Further well-controlled studies are needed to elucidate the efficacy of FOLFIRI chemotherapy as second-line treatment in patients with advanced stomach cancer.

Keyword

FOLFIRI protocol; Advanced gastric carcinoma; Second line chemotherapy; FOLFOX-4 protocol

MeSH Terms

Adult
Aged
Anemia/etiology
Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
Camptothecin/adverse effects/*analogs & derivatives/therapeutic use
Disease Progression
Female
Fluorouracil/adverse effects/therapeutic use
Humans
Kaplan-Meier Estimate
Leucovorin/adverse effects/therapeutic use
Male
Middle Aged
Neoplasm Staging
Organoplatinum Compounds/adverse effects/therapeutic use
Retrospective Studies
Stomach Neoplasms/*drug therapy/mortality/pathology
Treatment Outcome
Camptothecin
Fluorouracil
Leucovorin
Organoplatinum Compounds

Figure

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  Fig. 1. Overall survival and progression free survival of patients after FOLFIRI combination therapy. (A) The median overall survival was 7.8 months (95% CI, 6.6–9.0). (B) The median time to progression was 5 months (95% CI, 2.3–7.7).

Reference

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