Modified FOLFIRI as Second-Line Chemotherapy after Failure of Modified FOLFOX-4 in Advanced Gastric Cancer
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose The purpose of this study was to evaluate efficacy and toxicity of irinotecan, leucovorin and 5-fluorouracil (FOLFIRI) as second-line treatment after failure of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX) for advanced gastric cancer. Materials and Methods Patients who received modified FOLFOX-4 as first-line treatment and then received sequential modified FOLFIRI for disease progression were included in this study. The modified FOLFIRI regimen consisted of irinotecan 150 mg/m2 in a 90-minute intravenous infusion on day 1, leucovorin (LV) 20 mg/m2 and 5-fluorouracil (5-FU) 400 mg/m2 as a bolus followed by 600 mg/m2 as a 22-hour infusion on days 1 and 2 with the same dose of 5-FU/LV of modified FOLFOX-4 every 2 weeks. Results A total of 32 patients received 126 courses of FOLFIRI chemotherapy. No complete response was achieved. Three patients (9.4%; 95% confidence interval [CI], 0 to 20.1%) achieved partial response, whereas 11 (34.4%; 95% CI, 17.0 to 51.8%) patients showed stable disease. Disease control rate (complete response, partial responses and stable diseases) was 43.8%(95% CI, 25.6 to 61.9%) and median follow up duration was 11.3 months (range, 2.23 to 37.9months). Median time to progression was 2 months (95% CI, 1.49 to 2.51 months), and median overall survival from the start of FOLFIRI was 5.84 months (95% CI, 4.34 to 7.34 months). Toxicities were tolerable. Conclusion Modified FOLFIRI as second-line chemotherapy after failure of the modified FOLFOX-4 in advanced gastric cancer was tolerable but showed a lower response rate. Further study about retrying 5-FU/LV with irinotecan after failure of the 5-FU/LV combined regimen is necessary in advanced gastric cancer.
Abstract
Purpose The purpose of this study was to evaluate efficacy and toxicity of irinotecan, leucovorin and 5-fluorouracil (FOLFIRI) as second-line treatment after failure of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX) for advanced gastric cancer. Materials and Methods Patients who received modified FOLFOX-4 as first-line treatment and then received sequential modified FOLFIRI for disease progression were included in this study. The modified FOLFIRI regimen consisted of irinotecan 150 mg/m2 in a 90-minute intravenous infusion on day 1, leucovorin (LV) 20 mg/m2 and 5-fluorouracil (5-FU) 400 mg/m2 as a bolus followed by 600 mg/m2 as a 22-hour infusion on days 1 and 2 with the same dose of 5-FU/LV of modified FOLFOX-4 every 2 weeks. Results A total of 32 patients received 126 courses of FOLFIRI chemotherapy. No complete response was achieved. Three patients (9.4%; 95% confidence interval [CI], 0 to 20.1%) achieved partial response, whereas 11 (34.4%; 95% CI, 17.0 to 51.8%) patients showed stable disease. Disease control rate (complete response, partial responses and stable diseases) was 43.8%(95% CI, 25.6 to 61.9%) and median follow up duration was 11.3 months (range, 2.23 to 37.9months). Median time to progression was 2 months (95% CI, 1.49 to 2.51 months), and median overall survival from the start of FOLFIRI was 5.84 months (95% CI, 4.34 to 7.34 months). Toxicities were tolerable. Conclusion Modified FOLFIRI as second-line chemotherapy after failure of the modified FOLFOX-4 in advanced gastric cancer was tolerable but showed a lower response rate. Further study about retrying 5-FU/LV with irinotecan after failure of the 5-FU/LV combined regimen is necessary in advanced gastric cancer.
참고문헌 (25)
- Yaich L, "Analysis of the PvuII restriction fragmentlength polymorphism and exon structure of the estrogen receptor gene in breast cancer and peripheral blood", Cancer Res, 52, pp.77~83 (1992)
- Yoo CH, "Recurrence following curative resection for gastric carcinoma", Br J Surg, 87, pp.236~242 (2000)
- 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)
- Vanhoefer U, "Final results of a randomized phase III trial of sequential high-dose methotrexate, fluorouracil, and doxorubicin versus etoposide, leucovorin, and fluorouracil versus infusional fluorouracil and cisplatin in advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group", J Clin Oncol, 18, pp.2648~2657 (2000)
- Ross P, "Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer", J Clin Oncol, 20, pp.1996~2004 (2002)
- Schulz C, "UGT1A1 genotyping: a predictor of irinotecan-associated side effects and drug efficacy", Anticancer Drugs, 20, pp.867~879 (2009)
- Saltz LB, "Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group", N Engl J Med, 343, pp.905~914 (2000)
- Douillard JY, "Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial", Lancet, 355, pp.1041~1047 (2000)
- Kohne CH, "Final results of a phase II trial of CPT-11 in patients with advanced gastric cancer", Proc Am Soc Clin Oncol, 18 (1999)
- Bouché O, "Randomized multicenter phase II trial of a biweekly regimen of fluorouracil and eucovorin (LV5FU2), LV5FU2 plus cisplatin, or LV5FU2 plus irinotecan in patients with previously untreated metastatic gastric cancer: a Federation Francophone de Cancerologie Digestive Group Study--FFCD 9803", J Clin Oncol, 22, pp.4319~4328 (2004)
- Yilmaz U, "Irinotecan combined with infusional 5-fluorouracil and high-dose leucovorin for the treatment of advanced gastric carcinoma as the first-line chemotherapy", Chemotherapy, 52, pp.264~270 (2006)
- Rosati G, "Phase II trial of a biweekly regimen of fluorouracil and leucovorin plus irinotecan in patients with previously untreated advanced gastric cancer", J Chemother, 19, pp.570~576 (2007)
- Park SH, "Randomized phase II study of irinotecan, leucovorin and 5-fluorouracil (ILF) versus cisplatin plus ILF (PILF) combination chemotherapy for advanced gastric cancer", ANNALS OF ONCOLOGY, 19(4), pp.729~733 (2008), OXFORD UNIV PRESS
- Seo MD, "Irinotecan combined with 5- fluorouracil and leucovorin as second-line chemotherapy for metastatic or relapsed gastric cancer", Jpn J Clin Oncol, 38, pp.589~595 (2008)
- Assersohn L, "Phase II study of irinotecan and 5-fluorouracil", leucovorin in patients with primary refractory or relapsed advanced oesophageal and gastric carcinoma, 2004, pp.15, 64~69
- Lorizzo K, "Simplified FOLFIRI in pre-treated patients with metastatic gastric cancer", Cancer Chemother Pharmacol, 64, pp.301~306 (2009)
- Kim SG, "A phase II study of irinotecan with bi-weekly, low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFIRI) as salvage therapy for patients with advanced or metastatic gastric cancer", Jpn J Clin Oncol, 37, pp.744~749 (2007)
- 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", AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 33, pp.572~576 (2010), american journal of clinical oncology
- Liu JY, "Distribution of the UGT1A1*28 polymorphism in Caucasian and Asian populations in the US: a genomic analysis of 138 healthy individuals", Anticancer Drugs, 18, pp.693~696 (2007)
- Jäger E, "Weekly high-dose leucovorin versus low-dose leucovorin combined with fluorouracil in advanced colorectal cancer: results of a randomized multicenter trial. Study Group for Palliative Treatment of Metastatic Colorectal Cancer Study Protocol 1", J Clin Oncol, 14, pp.2274~2279 (1996)
- Rothenberg ML, "Superiority of oxaliplatin and fluorouracil-leucovorin compared with either therapy alone in patients with progressive colorectal cancer after irinotecan and fluorouracilleucovorin: interim results of a phase III trial", J Clin Oncol, 21, pp.2059~2069 (2003)
- de Gramont A, "Oxaliplatin with high-dose leucovorin and 5-fluorouracil 48-hour continuous infusion in pretreated metastatic colorectal cancer", Eur J Cancer, 33, pp.214~219 (1997)
- Mans DR, "Sequence-dependent growth inhibition and DNA damage formation by the irinotecan-5-fluorouracil combination in human colon carcinoma cell lines", Eur J Cancer, 35, pp.1851~1861 (1999)
- Tournigand C, "FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study", J Clin Oncol, 22, pp.229~237 (2004)
- Seymour MT, "Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial", Lancet, 370, pp.143~152 (2007)