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Title:
Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer | Gastric Cancer
Description:
Background Patients with advanced gastric cancer (AGC) are often treated with irinotecan monotherapy as salvage-line therapy. However, the survival benefit of this therapy remains to be elucidated. Methods Medical records of AGC patients who were treated with irinotecan monotherapy as salvage-line treatment in six institutions from 2007 to 2014 were reviewed. Results A total of 146 patients had prior fluoropyrimidine and taxane therapies, and 75.3% had prior platinum therapy. The median age was 66 (range 27–81) years, and 102 males (69.9%) were included. Performance status (PS) was 0/1/2/3 in 53/70/19/4 patients. Eighty-nine patients (61.0%) had two or more metastatic sites. Irinotecan monotherapy as 3rd-/4th-line therapy was performed in 135/11 (92.5%/7.5%). The median number of administrations was 4 (range 1–62). Forty-six patients (31.5%) required initial dose reduction at the physician’s discretion. The overall response rate was 6.8%, and the disease control rate was 43.1%. The median PFS was 3.19 months [95% confidence interval (CI) 2.30–4.08 months], and the median OS was 6.61 months (95% CI 5.94–7.28 months). Grade 3/4 adverse events were hematological toxicity (46 patients, 31.5%) and non-hematological toxicity (50 patients, 34.2%). Hospitalization due to adverse events was required in 31 patients (21.2%). Patients with relative dose intensity (RDI) less than 80% showed similar survival to those with RDI 80% or higher. Conclusions Irinotecan monotherapy was relatively safely performed as salvage-line treatment for AGC in Japanese clinical practice. Careful patient selection and intensive modification of the dose of irinotecan might possibly be associated with favorable survival.
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Keywords {🔍}
patients, irinotecan, dose, treatment, monotherapy, months, study, cancer, group, chemotherapy, gastric, median, agc, survival, treated, article, pfs, initial, advanced, therapy, phase, table, rdi, secondline, efficacy, present, google, scholar, clinical, patient, versus, pubmed, iii, mgm, cas, studies, thirdline, performed, adverse, events, nivolumab, trial, medical, safety, paclitaxel, grade, japan, laterline, salvageline, platinum,
Topics {✒️}
capecitabine/cisplatin versus 5-fluorouracil/cisplatin gastro-oesophageal junction cancer gastro-esophageal junction cancer her2-positive advanced gastric tcog gi-0801/birip trial gastro-oesophageal junction adenocarcinoma advanced gastric cancer 3rd-/4th-line therapy pretreated gastric cancer high-initial dose group low-initial dose group bi-weekly administration regimen hirofumi ohmura advanced esophagogastric cancer phase iii trial metastatic gastric cancer jcho kyushu hospital rdi-high group estimated privacy choices/manage cookies related subjects fluorouracil versus combination phase iii study manageable toxicity profile cancer chemother pharmacol present cohort included estimated cancer incidence therapy-related toxicities anti-her2 therapy clinical research institute treatment-related deaths her2-positive agc patients anti-vegfr therapy salvage-line treatment suggested bi-weekly administration randomised controlled trial gastric cancer gastric cancer gastric cancer 21 prior combination chemotherapy article makiyama diffuse-type adenocarcinoma intestinal-type adenocarcinoma refractory oesophagogastric adenocarcinoma common terminology criteria author information authors japanese clinical practice advanced gastric cisplatin versus s-1 prospective clinical studies present study showed
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headline:Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer
description:Patients with advanced gastric cancer (AGC) are often treated with irinotecan monotherapy as salvage-line therapy. However, the survival benefit of this therapy remains to be elucidated. Medical records of AGC patients who were treated with irinotecan monotherapy as salvage-line treatment in six institutions from 2007 to 2014 were reviewed. A total of 146 patients had prior fluoropyrimidine and taxane therapies, and 75.3% had prior platinum therapy. The median age was 66 (range 27–81) years, and 102 males (69.9%) were included. Performance status (PS) was 0/1/2/3 in 53/70/19/4 patients. Eighty-nine patients (61.0%) had two or more metastatic sites. Irinotecan monotherapy as 3rd-/4th-line therapy was performed in 135/11 (92.5%/7.5%). The median number of administrations was 4 (range 1–62). Forty-six patients (31.5%) required initial dose reduction at the physician’s discretion. The overall response rate was 6.8%, and the disease control rate was 43.1%. The median PFS was 3.19 months [95% confidence interval (CI) 2.30–4.08 months], and the median OS was 6.61 months (95% CI 5.94–7.28 months). Grade 3/4 adverse events were hematological toxicity (46 patients, 31.5%) and non-hematological toxicity (50 patients, 34.2%). Hospitalization due to adverse events was required in 31 patients (21.2%). Patients with relative dose intensity (RDI) less than 80% showed similar survival to those with RDI 80% or higher. Irinotecan monotherapy was relatively safely performed as salvage-line treatment for AGC in Japanese clinical practice. Careful patient selection and intensive modification of the dose of irinotecan might possibly be associated with favorable survival.
datePublished:2017-08-10T00:00:00Z
dateModified:2017-08-10T00:00:00Z
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keywords:
Gastric cancer
Advanced
Chemotherapy
Irinotecan
Surgical Oncology
Oncology
Abdominal Surgery
Gastroenterology
Cancer Research
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headline:Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer
description:Patients with advanced gastric cancer (AGC) are often treated with irinotecan monotherapy as salvage-line therapy. However, the survival benefit of this therapy remains to be elucidated. Medical records of AGC patients who were treated with irinotecan monotherapy as salvage-line treatment in six institutions from 2007 to 2014 were reviewed. A total of 146 patients had prior fluoropyrimidine and taxane therapies, and 75.3% had prior platinum therapy. The median age was 66 (range 27–81) years, and 102 males (69.9%) were included. Performance status (PS) was 0/1/2/3 in 53/70/19/4 patients. Eighty-nine patients (61.0%) had two or more metastatic sites. Irinotecan monotherapy as 3rd-/4th-line therapy was performed in 135/11 (92.5%/7.5%). The median number of administrations was 4 (range 1–62). Forty-six patients (31.5%) required initial dose reduction at the physician’s discretion. The overall response rate was 6.8%, and the disease control rate was 43.1%. The median PFS was 3.19 months [95% confidence interval (CI) 2.30–4.08 months], and the median OS was 6.61 months (95% CI 5.94–7.28 months). Grade 3/4 adverse events were hematological toxicity (46 patients, 31.5%) and non-hematological toxicity (50 patients, 34.2%). Hospitalization due to adverse events was required in 31 patients (21.2%). Patients with relative dose intensity (RDI) less than 80% showed similar survival to those with RDI 80% or higher. Irinotecan monotherapy was relatively safely performed as salvage-line treatment for AGC in Japanese clinical practice. Careful patient selection and intensive modification of the dose of irinotecan might possibly be associated with favorable survival.
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Gastric cancer
Advanced
Chemotherapy
Irinotecan
Surgical Oncology
Oncology
Abdominal Surgery
Gastroenterology
Cancer Research
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https://media.springernature.com/lw1200/springer-static/image/art%3A10.1007%2Fs10120-017-0759-9/MediaObjects/10120_2017_759_Fig1_HTML.gif
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address:
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
type:PostalAddress
type:Organization
name:Saiseikai Fukuoka General Hospital
address:
name:Department of Medical Oncology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
type:PostalAddress
type:Organization
name:Taito Esaki
affiliation:
name:National Hospital Organization Kyushu Cancer Center
address:
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
type:PostalAddress
type:Organization
name:Koichi Akashi
affiliation:
name:Kyushu University
address:
name:Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
type:PostalAddress
type:Organization
name:Eishi Baba
url:http://orcid.org/0000-0001-9428-6772
affiliation:
name:Kyushu University
address:
name:Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
type:PostalAddress
type:Organization
email:[email protected]
PostalAddress:
name:Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
name:Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
name:Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
name:Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
name:Department of Medical Oncology, Hamanomachi Hospital, Fukuoka, Japan
name:Department of Oncology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
name:Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
name:Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
name:Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
name:Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
name:Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
name:Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
name:Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
name:Department of Medical Oncology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
name:Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
name:Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
name:Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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