Weekly paclitaxel for heavily treated advanced or recurrent gastric cancer refractory to fluorouracil, irinotecan, and cisplatin

Shimoyama, Rai; Yasui, Hirofumi; Boku, Narikazu; Onozawa, Yusuke; Hironaka, Shuichi; Fukutomi, Akira; Yamazaki, Kentaro; Taku, Keisei; Kojima, Takashi; Machida, Nozomu; Todaka, Akiko; Tomita, Hideharu; Sakamoto, Takeshi; Tsushima, Takahiro

doi:10.1007/s10120-009-0524-9

Cited by 42 publications

(29 citation statements)

References 19 publications

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“…Because several prior studies on secondline (± later-line) FOLFIRI chemotherapy showed favorable efficacy and tolerable toxicities [6][7][8][9]22], we explored whether third-line FOLFIRI would be beneficial for MRGC patients. In our study, as expected, third-line FOLFIRI showed tolerable toxicity profiles as in the second-line setting [6][7][8] and similar efficacy to previously reported studies on third-line therapy in MRGC [15,16].…”

Section: Discussionsupporting

confidence: 91%

“…At the present time, although there have been some studies on salvage chemotherapy for MRGC in which chemotherapy regimens were used as second-or third-line treatments [9,[12][13][14], studies specifically focused on third-line chemotherapy have been scarce [15,16]. To our knowledge, this report is one of the largest studies about third-line palliative chemotherapy and the first study on third-line FOLFIRI therapy in MRGC patients.…”

Section: Discussionmentioning

confidence: 87%

“…The reported median PFS was 2.1-5.6 months and the median OS was 6.1-7.6 months in those studies. Regarding studies on third-line chemotherapy using a single regimen, there was only one retrospective study [16]. Shimoyama et al [16] reported the efficacy of third-line weekly paclitaxel in 85 patients with MRGC who were refractory to all three drugs (fluoropyrimidine, irinotecan, and cisplatin); median PFS and OS were 3.5 and 6.7 months, respectively, and the overall RR was 23.2 %.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding studies on third-line chemotherapy using a single regimen, there was only one retrospective study [16]. Shimoyama et al [16] reported the efficacy of third-line weekly paclitaxel in 85 patients with MRGC who were refractory to all three drugs (fluoropyrimidine, irinotecan, and cisplatin); median PFS and OS were 3.5 and 6.7 months, respectively, and the overall RR was 23.2 %. In another study using various regimens as the third-line therapy, median PFS and OS were 2.6 and 6.4 months, respectively, and the RR was 10.3 % [15].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…In previous phase II trials, weekly PAC administration was found to be active against GC with peritoneal metastasis (14,15). Moreover, it has been suggested that the regimen is feasible, safe and shows consistent activity against heavily treated GC in a second-line or further setting (12,20). neutropenia (14.9%), anemia (10%), leukopenia (4%), and anorexia (4%) were the most common grade 3/4 adverse events observed in this study, occurring less frequently than in previous reports.…”

Section: Discussionsupporting

confidence: 50%

Availability of irinotecan in a second-line setting confers survival benefit to patients with advanced gastric cancer refractory to fluoropyrimidine-based regimens

et al. 2011

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Abstract.Optimal second-line chemotherapy may contribute to favorable survival in patients who receive first-line treatment for advanced gastric cancer. The aim of this retrospective study was to compare a second-line setting using irinotecan with paclitaxel in terms of survival benefit and safety. A total of 179 patients with recurrent or unresectable gastric cancer who had received prior chemotherapy with a fluoropyrimidine-based regimen were treated with irinotecan alone at 150 mg/m 2 on days 1 and 15 every 4 weeks (Cohort I) or weekly paclitaxel at 80 mg/m 2 on days 1, 8 and 15 every 4 weeks (Cohort P) between April, 2004 and March, 2009. Patient characteristics, overall response rate, disease control rate, progression-free survival, overall survival and safety were investigated. Of the 179 patients, 92 received irinotecan and 87 patients who were contraindicated for irinotecan received weekly paclitaxel. The overall response and disease control rates in Cohort I were 6.5 and 43.5%, respectively, as compared with 9.8 and 54.9%, respectively, in Cohort P. No variation was noted in median progression-free survival (Cohort I vs. P, 2.6 vs. 2.8 months; P=0.812), whereas median overall survival (Cohort I vs. P, 9.8 vs. 4.9 months; P<0.0001) differed significantly between the two cohorts. The most common grade 3/4 adverse events were neutropenia, leukopenia, anemia and anorexia, which were tolerable in each treatment cohort. Availability of irinotecan in a second-line setting confers a survival benefit to advanced gastric cancer patients in whom fluoropyrimidine-based firstline chemotherapy was unsuccessful.

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Gastric Cancer

Bystrický¹,

Cunningham²

2012

Handbook of Gastrointestinal Cancer

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Weekly paclitaxel for heavily treated advanced or recurrent gastric cancer refractory to fluorouracil, irinotecan, and cisplatin

Abstract: Weekly paclitaxel administration shows activity against advanced gastric cancer also in the third-line setting.

Cited by 42 publications

References 19 publications

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

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

Availability of irinotecan in a second-line setting confers survival benefit to patients with advanced gastric cancer refractory to fluoropyrimidine-based regimens

Gastric Cancer

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