Irinotecan Combined with Infusional 5-Fluorouracil and High-Dose Leucovorin for the Treatment of Advanced Gastric Carcinoma as the First-Line Chemotherapy

Yılmaz, Uğur; Öztop, İlhan; Alacacıoğlu, Ahmet; Yaren, Arzu; Tarhan, Oktay; Somali, İşıl

doi:10.1159/000094769

Cited by 15 publications

(17 citation statements)

References 39 publications

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“…Results of this clinical trial represented the first published evidence of the activity of pemetrexed monotherapy in gastric cancer and were promising [34][35][36] . The response rate achieved was comparable with single-agent activity observed with the most active conventional drugs, but also with newer agents, including taxanes and irinotecan [37,38] .…”

Section: Gastric Cancermentioning

confidence: 55%

The Potential Role of Pemetrexed in Gastrointestinal Cancer

et al. 2007

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In 2004, the new-generation multitargeted antifolate pemetrexed was approved by the US Food and Drug Administration for the treatment of malignant pleural mesothelioma and as second-line monochemotherapy for advanced non-small cell lung cancer. However, pemetrexed as a single agent showed activity in preclinical and clinical studies, as well as in many other neoplasms such as gastrointestinal tumors, breast, head and neck, bladder and cervix cancer. Its tolerability profile is very favorable since the introduction of oral folic acid and vitamin B₁₂ supplementation in December 1999, and therefore, the maximum tolerated dose as single agent is probably higher than the dose actually utilized in clinical practice. Gastrointestinal tumors are the most common malignancies in the world, accounting for more than 25% of all cancers. In phase II studies exploring this multitargeted antifolate in advanced gastrointestinal tumors, pemetrexed showed an interesting degree of clinical activity, encouraging further trials evaluating the synergism with other drugs such as oxaliplatin, irinotecan and gemcitabine.

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Section: Gastric Cancermentioning

confidence: 55%

The Potential Role of Pemetrexed in Gastrointestinal Cancer

et al. 2007

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“…Most currently used treatment regimens for gastric cancer include 5-FU [5,17] , and the effect of adding 5-FU to the combination of DC has been the subject of recent investigations. In an ongoing phase II/III trial (study V325), docetaxel-cisplatin-5-FU (DCF; incorporating docetaxel at a dose of 75 mg/m 2 ) was selected over DC on the basis of the tumour response rate observed during the phase II stage (43 vs. 26%, respectively) [18] .…”

Section: Discussionmentioning

confidence: 99%

A Multicentre Phase II Study of Docetaxel plus Cisplatin for the Treatment of Advanced Gastric Cancer

Fahlke

Ridwelski²,

Schmidt

et al. 2007

Chemotherapy

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Background: The optimum regimen for advanced gastric cancer requires definition. This multicentre phase II study evaluated docetaxel-cisplatin combination in advanced gastric cancer. Methods: Chemotherapy-naïve patients with locally advanced or metastatic disease received docetaxel plus cisplatin (75/75 mg/m²) every 21 days for up to 9 cycles. Endpoints included tumour response, time to progression, overall survival and toxicity. Results: Of 113 patients recruited, 88 were completely evaluable. The median age was 58 years, and most patients had metastatic disease. The overall response rate was 29.6%. Five patients (5.7%) achieved a complete response and 21 patients (23.9%) had a partial response. Tumour control, including stable disease, was achieved in 57 patients (64.8%). The median time to progression and median overall survival time was 4.8 and 8.7 months, respectively. The major toxicity was haematological: 37.5% of patients experienced grade 3–4 neutropenia, whereas febrile neutropenia was observed in only 2% of patients. Conclusion: Docetaxel-cisplatin was active with a predictable and manageable toxicity profile.

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“…The de Gramont regimen has also been investigated for the treatment of AGC either alone [28], in combination with cisplatin [29,30], in combination with irinotecan [30,31], in combination with cisplatin plus mitomycin-C [32], in combination with cisplatin plus epirubicin [33], or in combination with docetaxel plus cisplatin [34,35]. The results of these trials were encouraging in terms of both the safety profile and the activity.…”

Section: Introductionmentioning

confidence: 99%

Bimonthly regimen of high-dose leucovorin, infusional 5-fluorouracil, docetaxel, and cisplatin (modified DCF) in advanced gastric adenocarcinoma

et al. 2012

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Background The combination of docetaxel, cisplatin, and 5-fluorouracil (DCF) is an effective but highly toxic regimen for the treatment of advanced gastric cancer. To improve tolerability while maintaining the efficacy of the DCF regimen, we developed a modified DCF regimen including an infusional 5-fluorouracil administration according to the de Gramont regimen. Methods In this study, 70 patients with advanced gastric cancer were treated. Each 2-week cycle consisted of docetaxel (60 mg/m 2 ), cisplatin (50 mg/m 2 ), a 5-fluorouracil (400 mg/m 2 ) IV bolus, and 5-fluorouracil (2,400 mg/m 2 ) IV over 46 h plus leucovorin (400 mg/m 2 ) IV over 2 h. Results The median progression-free survival and overall survival were 9.0 months (95 % CI, 7.1-10.9) and 10.8 months (95 % CI, 7.4-14.2), respectively; the 1-year and 2-year overall survival rates were 46.3 and 18.4 %, respectively. Twenty-nine (41.4 %) partial responses, 19 (27.1 %) stable disease, and 22 (31.4 %) progression of disease were observed. Grade 3-4 toxicities included neutropenia (37.1 %), febrile neutropenia (15.7 %), thrombocytopenia (10.0 %), anemia (8.6 %), nausea and vomiting (10.0 %), stomatitis (5.7 %), infection (8.6 %), and diarrhea (2.9 %). ConclusionsOur results show that a de Gramont-based DCF regimen may have tolerable toxicities and be an effective and convenient palliative treatment for advanced gastric cancer.

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Irinotecan Combined with Infusional 5-Fluorouracil and High-Dose Leucovorin for the Treatment of Advanced Gastric Carcinoma as the First-Line Chemotherapy

Cited by 15 publications

References 39 publications

The Potential Role of Pemetrexed in Gastrointestinal Cancer

The Potential Role of Pemetrexed in Gastrointestinal Cancer

A Multicentre Phase II Study of Docetaxel plus Cisplatin for the Treatment of Advanced Gastric Cancer

Bimonthly regimen of high-dose leucovorin, infusional 5-fluorouracil, docetaxel, and cisplatin (modified DCF) in advanced gastric adenocarcinoma

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