Irinotecan monotherapy as third-line or later treatment in advanced gastric cancer |
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Authors: | 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 |
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Affiliation: | 1.Department of Hematology and Oncology,Japan Community Healthcare Organization Kyushu Hospital,Fukuoka,Japan;2.Department of Medical Oncology,Hamanomachi Hospital,Fukuoka,Japan;3.Department of Oncology,Miyazaki Prefectural Miyazaki Hospital,Miyazaki,Japan;4.Department of Medical Oncology, Clinical Research Institute,National Hospital Organization Kyushu Medical Center,Fukuoka,Japan;5.Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences,Kyushu University,Fukuoka,Japan;6.Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences,Kyushu University,Fukuoka,Japan;7.Department of Gastrointestinal and Medical Oncology,National Hospital Organization Kyushu Cancer Center,Fukuoka,Japan;8.Department of Medical Oncology,Saiseikai Fukuoka General Hospital,Fukuoka,Japan |
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Abstract: | BackgroundPatients 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.MethodsMedical records of AGC patients who were treated with irinotecan monotherapy as salvage-line treatment in six institutions from 2007 to 2014 were reviewed.ResultsA 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.ConclusionsIrinotecan 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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