Oxaliplatin, 5-FU, Folinic Acid as First-line Palliative Chemotherapy in Elderly Patients with Metastatic or Recurrent Gastric Cancer

Choi, In Sil; Oh, Do‐Youn; Kim, Byoung-Su; Lee, Keun-Wook; Kim, Jee Hyun; Lee, Jong-Seok

doi:10.4143/crt.2007.39.3.99

Cited by 23 publications

(11 citation statements)

References 21 publications

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“…For patients with MGC, palliative chemotherapy and best supportive care are considered the only standard treatment to achieve extension of survival and palliation of symptoms [19]. By these means, however, the outcome has been very poor, with a median overall survival (OS) of \1 year [20,21].…”

Section: Introductionmentioning

confidence: 99%

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

et al. 2011

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Background This study was performed to investigate the role of surgery in patients with gastric cancer and distant metastases who had received systemic chemotherapy. Methods Patients with newly diagnosed gastric cancer and synchronous distant metastases who had received chemotherapy (n = 274) were categorized into 3 groups according to the surgical treatment rendered: complete gross resection of both primary and metastatic sites (group A; n = 42); debulking gastrectomy (group B; n = 47); and chemotherapy without debulking (group C; n = 185). Results The median overall survival of all patients was 11.8 months. The median overall survival and 3-year survival rates were 28.0, 15.5, and 9.0 months and 42.8, 8.1, and 3.5% in groups A, B, and C, respectively. In group A, patients with peritoneal seeding, intra-abdominal distant lymph nodes, or ovarian or hepatic metastases underwent complete gross resection, and 12 (29%) were disease-free at the time of the last analysis (median follow-up duration, 29.1 months). On multivariate analysis, the adjusted hazard ratios for death were 0.27 (P \ 0.001) and 0.64 (P = 0.024) for groups A and B, respectively, as compared to group C.Conclusions Our study suggests survival benefits of debulking gastrectomy or gastrectomy plus metastasectomy in gastric cancer patients with distant metastases receiving systemic chemotherapy. Prolonged disease-free survival was observed after complete resection (gastrectomy plus metastasectomy) that may lead to cure in some patients. Well-designed prospective trials of the role of multidisciplinary approaches combining chemotherapy and surgery are needed to confirm the observations of our study.

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Section: Introductionmentioning

confidence: 99%

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

et al. 2011

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“…Many chemotherapy regimens have been studied in clinical trials, but the survival benefits have been limited. Regimens containing 5-fluorouracil (5-FU) and platinum are considered the standard first-line therapy [5][6][7][8], and recently other regimens, including taxane or irinotecan, are also being actively tested [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…The aim of this study was to evaluate the efficacy and toxicity of 3-weekly S-1/cisplatin chemotherapy (S-1 80 mg/m 2 /day [days [1][2][3][4][5][6][7][8][9][10][11][12][13][14] and cisplatin 60 mg/m 2 [day 1]) in MRGC patients as first-line treatment.…”

Section: Introductionmentioning

confidence: 99%

Three-weekly S-1 plus cisplatin chemotherapy as first-line treatment for advanced gastric cancer

et al. 2010

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Combination chemotherapy of S-1 and cisplatin has shown promising activity against advanced gastric cancer, but the schedules and dose intensities of S-1 and cisplatin have not been consistent in several clinical trials. We investigated the efficacy and toxicity of 3-weekly S-1/cisplatin chemotherapy as first-line treatment in metastatic or relapsed gastric cancer (MRGC). Forty-six patients with MRGC were prospectively enrolled. S-1 (80 mg/m(2)/day; days 1-14) and cisplatin (60 mg/m(2); day 1) were administrated every 3 weeks. Among 46 patients who received chemotherapy, one achieved a complete response and 21 achieved a partial response, resulting in an overall response rate (RR) of 48%. Thirteen patients (28%) had stable disease and eight patients (17%) had progressive disease. After a median follow-up duration of 48.3 weeks, the median progression-free survival (PFS) and overall survival (OS) were 21.1 weeks and 68.3 weeks, respectively. Patients with good Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-1 had prolonged PFS and OS compared with patients with ECOG PS of 2. Common hematologic toxicities were anemia (93%), leucopenia (61%), and neutropenia (61%). However, grade 3/4 anemia, leucopenia, and neutropenia developed in only 11, 9, and 24% of patients, respectively. Grade 3/4 non-hematologic toxicities included anorexia (22%), fatigue (13%), nausea (7%), and diarrhea (7%). No treatment-related mortality occurred. Three-weekly S-1/cisplatin chemotherapy was active and well-tolerated in MRGC patients.

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“…The eligibility criteria included the following: (1) histologically confirmed, metastatic or recurrent adenocarcinoma of the stomach, (2) age between 18 and 75, (3) at least one measurable lesion, (4) no prior chemotherapy, except postoperative adjuvant chemotherapy that was received[6 months before entry into the study, (5) Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2, (6) adequate bone marrow, renal or hepatic functions. Detailed inclusion and exclusion criteria were described in our previous report [22].…”

Section: Patient Eligibilitymentioning

confidence: 99%

“…Systemic chemotherapy is widely accepted as palliative treatment in patients with metastatic or relapsed gastric cancer (MRGC), and regimens containing 5-fluorouracil (5-FU) and platinum have been indicated as effective first-line treatments [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Biomarker analysis in patients with advanced gastric cancer treated with S-1 plus cisplatin chemotherapy: orotate phosphoribosyltransferase expression is associated with treatment outcomes

et al. 2010

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This study was performed to analyze the impact of protein expression related to fluoropyrimidine and cisplatin metabolism (thymidylate synthase, dihydropyrimidine dehydrogenase, thymidine phosphorylase, orotate phosphoribosyltransferase [OPRT], excision repair cross-complementation 1, Fanconi anemia complementation group D2, glutathione S-transferase P1, and X-ray repair cross-complementing group 1) on treatment outcomes in patients with metastatic or relapsed gastric cancer (MRGC) receiving S-1/cisplatin chemotherapy. Protein expression was measured by immunohistochemistry (IHC). Of the 43 patients who had received S-1 (80 mg/m2/day; days 1-14) and cisplatin (60 mg/m2; day 1) every 3 weeks and had available tissue blocks, IHC was successfully performed in 41 patients. Patients with high OPRT levels in tumor tissues (IHC score≥6) had superior progression-free survival (PFS) (23.3 vs. 14.1 weeks [median]) and overall survival (OS) (72.4 vs. 55.4 weeks [median]) to those with low OPRT levels (IHC score≤5; P-values<.05). Expression levels of other proteins were not predictive of treatment outcomes. In multivariate analysis, both a good performance status and a high OPRT level were independently associated with prolonged PFS and OS. The OPRT expression level may be a good predictive marker in S-1/cisplatin-treated patients with MRGC.

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Oxaliplatin, 5-FU, Folinic Acid as First-line Palliative Chemotherapy in Elderly Patients with Metastatic or Recurrent Gastric Cancer

Cited by 23 publications

References 21 publications

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

Three-weekly S-1 plus cisplatin chemotherapy as first-line treatment for advanced gastric cancer

Biomarker analysis in patients with advanced gastric cancer treated with S-1 plus cisplatin chemotherapy: orotate phosphoribosyltransferase expression is associated with treatment outcomes

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