Keywords
Irinotecan
Bolus 5-FU
First line treatment
Categories
How to Cite
Abstract
Background: This study aims to determine the efficacy and toxicity of a non-platinum-based chemotherapy combination using irinotecan associated with bolus 5-FU as first-line treatment in advanced gastric cancer.
Materiel and methods: Retrospective analysis of a population of patients treated for metastatic and locally advanced gastric cancer with irinotecan and 5-FU as upfront chemotherapy.
Results: Thirteen patients were enrolled. The median age was 56 years. Seven patients were males and six were females. Ten patients had metastatic disease and three patients had locally advanced disease. Patients received a total number of 43 cycles of chemotherapy. The overall response rate was 38,4%, the median time to progression (TTP) was 3 months, and the median overall survival was 4 months. Three patients (23,1%) presented grade 3 /4 neutropenia complicated with an infectious episode with fever in two cases, three patients (23,1%) required blood transfusion for a grade 4 anemia, and one patient (7,6%) was hospitalized for a severe episode of diarrhea.
Conclusion: Three weekly irinotecan and bolus 5-FU is an interesting combination as first-line treatment of advanced gastric cancer; designed clinical trials are needed to confirm the activity of this combination.
References
Kim TW, Innocenti F. Insights, challenges, and future directions in irinogenetics. Ther Drug Monit. 2007 Jun; 29(3):265-70. https://doi.org/10.1097/ftd.0b013e318068623b
Futatsuki K, Wakui A, Nakao I, Sakata Y, Kambe M, Shimada Y, et al. [Late phase II study of irinotecan hydrochloride (CPT-11) in advanced gastric cancer. (CPT-11) Gastrointestinal Cancer Study Group]. Gan To Kagaku Ryoho. 1994 Jun; 21(7):1033-8.
Blanke CD, Haller DG, Benson AB, Rothenberg ML, Berlin J, Mori M, et al. A phase II study of irinotecan with 5-fluorouracil and leucovorin in patients with previously untreated gastric adenocarcinoma. Ann Oncol. 2001 Nov; 12(11):1575-80. https://doi.org/10.1023/a:1013129315036
Wang DL, Gu DY, Huang HY, Xu Z, Chen JF. Irinotecan-involved regimens for advanced gastric cancer: a pooled-analysis of clinical trials. World J Gastroenterol. 2010 Dec 14; 16(46):5889-94. https://doi.org/10.3748/wjg.v16.i46.5889
Dank M, Zaluski J, Barone C, Valvere V, Yalcin S, Peschel C, Et al. Randomized phase III study comparing irinotecan combined with 5-fluorouracil and folinic acid to cisplatin combined with 5-fluorouracil in chemotherapy-naive patients with advanced adenocarcinoma of the stomach or esophagogastric junction. Ann Oncol. 2008 Aug; 19(8):1450-7. https://doi.org/10.1093/annonc/mdn166
Kim SG, Oh SY, Kwon HC, Lee S, Kim JH, Kim SH, et al. A phase II study of irinotecan with bi-weekly, low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFIRI) as salvage therapy for patients with advanced or metastatic gastric cancer. Jpn J Clin Oncol. 2007 Oct; 37(10):744-9. https://doi.org/10.1093/jjco/hym103
Park SH, Nam E, Park J, Cho EK, Shin DB, Lee JH, et al. Randomized phase II study of irinotecan, leucovorin and 5-fluorouracil (ILF) versus cisplatin plus ILF (PILF) combination chemotherapy for advanced gastric cancer. Ann Oncol. 2008 Apr; 19(4):729-33. https://doi.org/10.1093/annonc/mdm502
Rosati G, Cordio S, Caputo G, Condorelli S, Germano D, Mattina M, et al. Phase II trial of a biweekly regimen of fluorouracil and leucovorin plus irinotecan in patients with previously untreated advanced gastric cancer. J Chemother. 2007 Oct; 19(5):570-6. https://doi.org/10.1179/joc.2007.19.5.570
Moehler M, Eimermacher A, Siebler J, Höhler T, Wein A, Menges M, et al. Randomised phase II evaluation of irinotecan plus high-dose 5-fluorouracil and leucovorin (ILF) vs 5-fluorouracil, leucovorin, and etoposide (ELF) in untreated metastatic gastric cancer. Br J Cancer. 2005 Jun 20; 92(12):2122-8. https://doi.org/10.1038/sj.bjc.6602649
Pozzo C, Barone C, Szanto J, Padi E, Peschel C, Bükki J, et al. Irinotecan in combination with 5-fluorouracil and folinic acid or with cisplatin in patients with advanced gastric or esophageal-gastric junction adenocarcinoma: results of a randomized phase II study. Ann Oncol. 2004 Dec; 15(12):1773-81. https://doi.org/10.1093/annonc/mdh473
Bouché O, Raoul JL, Bonnetain F, Giovannini M, Etienne PL, Lledo G. Randomized multicenter phase II trial of a biweekly regimen of fluorouracil and leucovorin (LV5FU2), LV5FU2 plus cisplatin, or LV5FU2 plus irinotecan in patients with previously untreated metastatic gastric cancer: a Federation Francophone de Cancerologie Digestive Group Study--FFCD 9803. J Clin Oncol. 2004 Nov 1; 22(21):4319-28. https://doi.org/10.1200/jco.2004.01.140
Guimbaud R, Louvet C, Ries P, Ychou M, Maillard E, André T, et al. Prospective, randomized, multicenter, phase III study of fluorouracil, leucovorin, and irinotecan versus epirubicin, cisplatin, and capecitabine in advanced gastric adenocarcinoma: a French intergroup (Fédération Francophone de Cancérologie Digestive, Fédération Nationale des Centres de Lutte Contre le Cancer, and Groupe Coopérateur Multidisciplinaire en Oncologie) study. J Clin Oncol. 2014 Nov 1; 32(31):3520-6. https://doi.org/10.1200/jco.2013.54.1011
Qi WX, Shen Z, Lin F, Sun YJ, Min DL, Tang LN, et al. Overall survival benefits for irinotecan-containing regimens as first-line treatment for advanced gastric cancer: an updated meta-analysis of ten randomized controlled trials. Int J Cancer. 2013 Jan 15; 132(2): E66-73. https://doi.org/10.1002/ijc.27775
Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006 Jun 20; 24(18):2903-9. https://doi.org/10.1200/jco.2005.05.0245
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2016 Mohamed Mesmoudi et al.
