Outcomes of Third-Line Docetaxel-Based Chemotherapy in Advanced Gastric Cancer Who Failed Previous Oxaliplatin-Based and Irinotecan-Based Chemotherapies
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Purpose Little is known about outcomes in the use of third-line chemotherapy in cases of advanced gastric cancer (AGC). The primary aim of this retrospective study was to evaluate outcomes of docetaxel-based chemotherapy in patients with AGC that progressed after both oxaliplatin-based and irinotecan-based regimens. Materials and Methods Eligible patients were those with AGC who had previous chemotherapy including fluoropyrimidine and oxaliplatin as well as fluoropyrimidine and irinotecan and who received subsequent docetaxel-based chemotherapy. Thirty-five patients were retrospectively recruited from 5 medical centers in Korea. Patients received either weekly or 3 weekly with docetaxel +/- cisplatin. Results Thirty-one out of 35 patients were evaluated for treatment response. A total of 94 cycles of chemotherapy (median, 2; range, 1 to 7) were administered. The overall response rate was 14.3%, and the disease control rate was 45.7%. The median progression-free survival (PFS)was 1.9 months (95% confidence interval [CI], 1.1 to 2.7 months). The median overall survival (OS) was 3.6 months (95% CI, 2.8 to 4.4 months). PFS and OS were significantly prolonged in patients of the Eastern Cooperative Oncology Group, with performance status of 0 or 1 in multivariate analysis (PFS: hazard ratio[HR], 0.411; 95% CI, 0.195 to 0.868; p=0.020 and OS:HR, 0.390; 95% CI, 0.184 to 0.826; p=0.014, respectively). Four of the 35 patients enrolled in the study died due to infection associated with neutropenia. Conclusion Our findings suggest that salvage docetaxel-based chemotherapy is a feasible treatment option for AGC patients with good performance status (PS), whereas chemotherapy for patients with poor PS (PS≤2) should be undertaken with caution for those who previously failed oxaliplatin- and irinotecan-based regimens.
Abstract
Purpose Little is known about outcomes in the use of third-line chemotherapy in cases of advanced gastric cancer (AGC). The primary aim of this retrospective study was to evaluate outcomes of docetaxel-based chemotherapy in patients with AGC that progressed after both oxaliplatin-based and irinotecan-based regimens. Materials and Methods Eligible patients were those with AGC who had previous chemotherapy including fluoropyrimidine and oxaliplatin as well as fluoropyrimidine and irinotecan and who received subsequent docetaxel-based chemotherapy. Thirty-five patients were retrospectively recruited from 5 medical centers in Korea. Patients received either weekly or 3 weekly with docetaxel +/- cisplatin. Results Thirty-one out of 35 patients were evaluated for treatment response. A total of 94 cycles of chemotherapy (median, 2; range, 1 to 7) were administered. The overall response rate was 14.3%, and the disease control rate was 45.7%. The median progression-free survival (PFS)was 1.9 months (95% confidence interval [CI], 1.1 to 2.7 months). The median overall survival (OS) was 3.6 months (95% CI, 2.8 to 4.4 months). PFS and OS were significantly prolonged in patients of the Eastern Cooperative Oncology Group, with performance status of 0 or 1 in multivariate analysis (PFS: hazard ratio[HR], 0.411; 95% CI, 0.195 to 0.868; p=0.020 and OS:HR, 0.390; 95% CI, 0.184 to 0.826; p=0.014, respectively). Four of the 35 patients enrolled in the study died due to infection associated with neutropenia. Conclusion Our findings suggest that salvage docetaxel-based chemotherapy is a feasible treatment option for AGC patients with good performance status (PS), whereas chemotherapy for patients with poor PS (PS≤2) should be undertaken with caution for those who previously failed oxaliplatin- and irinotecan-based regimens.
참고문헌 (22)
- Jemal A, "Global cancer statistics", CA Cancer J Clin, 61, pp.69~90 (2011)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality and Survival in 2005", Journal of Korean Medical Science, 24(6), pp.995~1003 (2009), 대한의학회
- Kong SH, "Clinicopathologic features of asymptomatic gastric adenocarcinoma patients in Korea", Jpn J Clin Oncol, 34, pp.1~7 (2004)
- Glimelius B, "Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer", Ann Oncol, 8, pp.163~168 (1997)
- Pyrhonen S, "Randomised comparison of fluorouracil, epidoxorubicin and methotrexate(FEMTX)plus supportive care with supportive care alone in patients with non-resectable gastric cancer", Br J Cancer, 71, pp.587~591 (1995)
- Wagner AD, "Chemotherapy for advanced gastric cancer", Cochrane Database Syst Rev, (3), pp.CD004064~ (2010)
- Wohrer SS, "Palliative chemotherapy for advanced gastric cancer", Ann Oncol, 15, pp.1585~1595 (2004)
- Kang JH, "Salvage chemotherapy for pretreated gastric cancer : a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone", J Clin Oncol, 30, pp.1513~1518 (2012)
- Kang H, "Chemotherapy in the treatment of metastatic gastric cancer: is there a global standard?", Curr Treat Options Oncol, 12, pp.96~106 (2011)
- Wagner AD, "Chemotherapy in advanced gastric cancer : a systematic review and meta-analysis based on aggregate data", J Clin Oncol, 24, pp.2903~2909 (2006)
- 전은경, "Modified FOLFIRI as Second-Line Chemotherapy after Failure of Modified FOLFOX-4 in Advanced Gastric Cancer", Cancer Research and Treatment, 43(3), pp.148~153 (2011), 대한암학회
- 이한홍, "Outcomes of Modified FOLFOX-6 as First Line Treatment in Patients with Advanced Gastric Cancer in a Single Institution; Retrospective Analysis", Cancer Research and Treatment, 42(1), pp.18~23 (2010), 대한암학회
- Kim SH, "A phase II study of irinotecan, continuous 5-fluorouracil, and leucovorin (FOLFIRI) combination chemotherapy for patients with recurrent or metastatic gastric cancer previously treated with a fluoropyrimidine- based regimen", Am J Clin Oncol, 33, pp.572~576 (2010)
- Kim BG, "A phase II study of irinotecan with biweekly, low dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFIRI) as first line therapy for patients with recurrent or metastatic gastric cancer", Am J Clin Oncol, 33, pp.246~250 (2010)
- Khokhar NZ, "Refining docetaxel-containing therapy for gastric cancer", Gastrointest Cancer Res, 4, pp.96~105 (2011)
- Eisenhauer EA, "New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)", Eur J Cancer, 45, pp.228~247 (2009)
- Moon YW, "Outcomes of multiple salvage chemotherapy for advanced gastric cancer: implications for clinical practice and trial design", CANCER CHEMOTHERAPY AND PHARMACOLOGY, 66(4), pp.797~805 (2010), SPRINGER
- Shin SJ, "Capecitabine and doxorubicin combination chemotherapy as salvage therapy in pretreated advanced gastric cancer", Cancer Chemotherapy And Pharmacology, 61, pp.157~165 (2008)
- Shim HJ, "Prognostic factor analysis of third-line chemotherapy in patients with advanced gastric cancer", GASTRIC CANCER, 14(3), pp.249~256, SPRINGER
- Grothey A, "Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment", J Clin Oncol, 22, pp.1209~1214 (2004)
- Hasegawa H, "Optimal indications for second-line chemotherapy in advanced gastric cancer", Anticancer Drugs, 23, pp.465~470 (2012)
- Rivera E, "Phase 3 study comparing the use of docetaxel on an every-3-week versus weekly schedule in the treatment of metastatic breast cancer", Cancer, 112, pp.1455~1461 (2008)