Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer – A randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO)

Thuss‐Patience, Peter; Kretzschmar, Albrecht; Bichev, Dmitry; Deist, Tillman; Hinke, Axel; Breithaupt, Kirstin; Doğan, Yasemin; Gebauer, Bernhard; Schumacher, Guido; Reichardt, Peter

doi:10.1016/j.ejca.2011.06.002

Cited by 537 publications

(419 citation statements)

References 24 publications

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“…Thereby, it was demonstrated that second-line therapy provided an advantage of survival over BSC. In the study presented by Thuss-Patience et al this result was supported with a randomized phase III study that compared BSC and second-line irinotecan (Thuss-Patience et al, 2011). In this study, median OS was reported to be 2.4 months (95% CI 1.7-4.9) vs 4.0 months (95% CI 3.6-7.5) for BSC vs. irinotecan, respectively.…”

Section: Discussionsupporting

confidence: 66%

Second-Line Irinotecan after Cisplatin, Fluoropyrimidin and Docetaxel for Chemotherapy of Metastatic Gastric Cancer

Küçükzeybek¹,

Dirican²,

Erten³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Aim: Tumors of upper gastrointestinal tract are among the cancers that have a quite lethal course. Cytotoxic chemotherapy is the most efficient therapeutic modality for metastatic gastric cancer. In patients who do not respond to first-line treatment, the response rate to second-line therapies is generally low and the toxicity rates high. This study concerned the efficacy and the side effect profile of second-line therapy with irinotecan in the patients who were being followed-up with the diagnosis of metastatic gastric cancer in İzmir, Turkey.

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Section: Discussionsupporting

confidence: 66%

Second-Line Irinotecan after Cisplatin, Fluoropyrimidin and Docetaxel for Chemotherapy of Metastatic Gastric Cancer

Küçükzeybek¹,

Dirican²,

Erten³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…However, the reported median progression-free survival (PFS) has been only 4-7 months, and nearly all patients receiving first-line chemotherapy eventually progress. The median OS after the progression of first-line chemotherapy is only 2-4 months with BSC alone [4,5]. Recently, two phase III trials comparing second-line chemotherapy with BSC alone showed OS benefit [4,5], and many previous phase II or retrospective studies have shown similar OS results [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 59%

“…Recently, two phase III trials comparing second-line chemotherapy with BSC alone showed OS benefit [4,5], and many previous phase II or retrospective studies have shown similar OS results [6][7][8][9][10]. Therefore, second-line chemotherapy is currently considered a standard of care in MRGC patients with a good performance status (PS) after the failure of first-line therapy, and taxane-or irinotecan-based regimens are commonly used in clinical practice [4,5,10]. However, the response rate (RR) of second-line chemotherapy is low, and all patients suffer from disease progression.…”

Section: Introductionmentioning

confidence: 99%

Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival

Kang

et al. 2012

Gastric Cancer

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Background The aim of this study was to evaluate the activity and safety of the combination chemotherapy of 5-fluorouracil (5-FU), leucovorin, and irinotecan (FOLFIRI regimen) after failure of fluoropyrimidine, platinum, and taxane in gastric cancer (GC) and to evaluate the prognostic factors for survival. Methods Patients received biweekly FOLFIRI chemotherapy as third-line treatment. The FOLFIRI-1 consisted of irinotecan (180 mg/m 2 in a 2-h infusion) on day 1, and then leucovorin (200 mg/m 2 in a 2-h infusion) and 5-FU (a 400 mg/m 2 bolus, followed by 600 mg/m 2 in a 22-h continuous infusion) on days 1 and 2. FOLFIRI-2 consisted of irinotecan (180 mg/m 2 in a 2-h infusion) on day 1, and then leucovorin (400 mg/m 2 in a 2-h infusion) and 5-FU (a 400 mg/m 2 bolus, followed by 2400 mg/m 2 in a 46-h continuous infusion) on day 1. Results A total of 158 patients were included. The overall response rate was 9.6 % in patients with measurable lesions. The median progression-free survival (PFS) and overall survival (OS) were 2.1 months [95 % confidence interval (CI), 1.7-2.5] and 5.6 months (95 % CI, 4.7-6.5), respectively. The major grade 3/4 toxicity was myelosuppression (36.7 %). Good performance status (PS), fewer metastatic sites, and longer duration from the first-line to third-line chemotherapy were independent prognostic factors affecting both PFS and OS. Conclusions The FOLFIRI regimen showed antitumor activity and tolerable toxicity profiles against advanced GC in the third-line setting. Patients with good PS, fewer metastatic sites and longer previous treatment duration might have the maximal benefit from third-line chemotherapy.

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“…It has been shown that chemotherapy can prolong survival in this setting [12]. This is true for first-line treatment as well as for second-and further-line chemotherapy (Table 1) [13][14][15][16][17]. Symptom control and quality of life have also been looked at in some studies, and have been demonstrated to be improved by chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

“…Three randomized controlled trials showed superior survival of patients on either irinotecan or docetaxel monotherapy compared with those receiving best supportive care [16,17,66]. In the smallest study, which was performed in Germany, it was reported that post-progression chemotherapy not only prolonged survival but also led to better symptom control.…”

Section: Post-progression Treatmentmentioning

confidence: 99%

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

et al. 2013

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Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer – A randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO)

Cited by 537 publications

References 24 publications

Second-Line Irinotecan after Cisplatin, Fluoropyrimidin and Docetaxel for Chemotherapy of Metastatic Gastric Cancer

Second-Line Irinotecan after Cisplatin, Fluoropyrimidin and Docetaxel for Chemotherapy of Metastatic Gastric Cancer

Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

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