Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 464-472 |
| Number of pages | 9 |
| Journal | Gastric Cancer |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - May 1 2018 |
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All Science Journal Classification (ASJC) codes
- Oncology
- Gastroenterology
- Cancer Research
Cite this
Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer. / Makiyama, Akitaka; Arimizu, Kohei; Hirano, Gen; Makiyama, Chinatsu; Matsushita, Yuzo; Shirakawa, Tsuyoshi; Ohmura, Hirofumi; Komoda, Masato; Uchino, Keita; Inadomi, Kyoko; Arita, Shuji; ariyama, hiroshi; Kusaba, Hitoshi; Shinohara, Yudai; Kuwayama, Miyuki; Kajitani, Tatsuhiro; Oda, Hisanobu; Esaki, Taito; Akashi, Koichi; Baba, Eishi.
In: Gastric Cancer, Vol. 21, No. 3, 01.05.2018, p. 464-472.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer
AU - Makiyama, Akitaka
AU - Arimizu, Kohei
AU - Hirano, Gen
AU - Makiyama, Chinatsu
AU - Matsushita, Yuzo
AU - Shirakawa, Tsuyoshi
AU - Ohmura, Hirofumi
AU - Komoda, Masato
AU - Uchino, Keita
AU - Inadomi, Kyoko
AU - Arita, Shuji
AU - ariyama, hiroshi
AU - Kusaba, Hitoshi
AU - Shinohara, Yudai
AU - Kuwayama, Miyuki
AU - Kajitani, Tatsuhiro
AU - Oda, Hisanobu
AU - Esaki, Taito
AU - Akashi, Koichi
AU - Baba, Eishi
PY - 2018/5/1
Y1 - 2018/5/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85027114002&partnerID=8YFLogxK
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U2 - 10.1007/s10120-017-0759-9
DO - 10.1007/s10120-017-0759-9
M3 - Article
C2 - 28799048
AN - SCOPUS:85027114002
VL - 21
SP - 464
EP - 472
JO - Gastric Cancer
JF - Gastric Cancer
SN - 1436-3291
IS - 3
ER -