Gastric Cancer

, Volume 20, Issue 4, pp 655–662 | Cite as

Irinotecan monotherapy as third-line treatment for advanced gastric cancer refractory to fluoropyrimidines, platinum, and taxanes

  • Takashi Nishimura
  • Satoru Iwasa
  • Kengo Nagashima
  • Natsuko Okita
  • Atsuo Takashima
  • Yoshitaka Honma
  • Ken Kato
  • Tetsuya Hamaguchi
  • Yasuhide Yamada
  • Yasuhiro Shimada
  • Narikazu Boku
Original Article



Because standard chemotherapy for advanced gastric cancer consists of oral fluoropyrimidines plus platinum as first-line therapy, with paclitaxel plus ramucirumab as the second line, irinotecan is usually positioned as third-line chemotherapy in clinical practice in Japan.


A retrospective evaluation was conducted to determine the efficacy and safety of irinotecan as third-line chemotherapy for advanced gastric cancer in patients refractory or intolerant to fluoropyrimidines, platinum, and taxanes.


Between February 2008 and December 2013, 52 patients received third-line irinotecan monotherapy. Among the 32 patients with measurable lesions, 1 patient achieved a confirmed partial response and 6 patients had stable disease. The overall response rate was 3% and the disease control rate was 22%. Median progression-free survival was 2.3 months [95% confidence interval (CI), 1.8–2.8] and median overall survival was 4.0 months (95% CI, 2.6–5.3). The most common adverse events of grade 3 severity or higher were neutropenia (27%), febrile neutropenia (12%), anorexia (12%), and diarrhea (6%). Although no treatment-related deaths occurred, 2 patients (4%) died of disease progression within 30 days after the last administration of irinotecan.


Irinotecan monotherapy appears to be tolerated but was shown to have modest activity as third-line chemotherapy for advanced gastric cancer.


Irinotecan Third-line chemotherapy Gastric cancer 


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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2016

Authors and Affiliations

  • Takashi Nishimura
    • 1
    • 2
  • Satoru Iwasa
    • 1
  • Kengo Nagashima
    • 3
  • Natsuko Okita
    • 1
  • Atsuo Takashima
    • 1
  • Yoshitaka Honma
    • 1
  • Ken Kato
    • 1
  • Tetsuya Hamaguchi
    • 1
  • Yasuhide Yamada
    • 1
  • Yasuhiro Shimada
    • 1
  • Narikazu Boku
    • 1
  1. 1.Gastrointestinal Medical Oncology DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Department of Gastroenterology and HepatologyThe Jikei University School of MedicineTokyoJapan
  3. 3.Department of Global Clinical Research, Graduate School of MedicineChiba UniversityChibaJapan

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