Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer

Akitaka Makiyama, Kohei Arimizu, Gen Hirano, Chinatsu Makiyama, Yuzo Matsushita, Tsuyoshi Shirakawa, Hirofumi Ohmura, Masato Komoda, Keita Uchino, Kyoko Inadomi, Shuji Arita, Hiroshi Ariyama, Hitoshi Kusaba, Yudai Shinohara, Miyuki Kuwayama, Tatsuhiro Kajitani, Hisanobu Oda, Taito Esaki, Koichi Akashi, Eishi Baba

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

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 languageEnglish
Pages (from-to)464-472
Number of pages9
JournalGastric Cancer
Volume21
Issue number3
DOIs
Publication statusPublished - May 1 2018

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

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