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A general review of the role of irinotecan (CPT11) in the treatment of gastric cancer

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Abstract

Background

The prognosis of gastric tumor is generally poor because most tumors are diagnosed at an advanced stage. Chemotherapy has a proven palliative role in advanced gastric cancer and several combination regimens were explored in the last 10 yr. Nevertheless, none of them showed a convincing improvement resulting in an enhancement of response rate and overall survival without discrimination of the quality of life. Irinotecan (CPT11) has been evaluated in multiple trials alone or in combined therapy with promising results and good tolerance. Thus, a review of the importance and impact of CPT11 in this indication is detailed.

Methods

This article reviews the evidence for the use of CPT11 in the treatment of gastric cancer based on a computerized MEDLINE search of literature published until August 2006 leading to a total of 91 publications.

Results

CPT11 was frequently used and showed a good response rate varying from 14% to 23% as single agent and 45% to 70% in combination with a median time to progression of 3 mo in single agent and 4–6 mo in combination, and median overall survival of approx 7 mo in single agent and up to 10.58 mo in combination.

Conclusion

The overall response of irinotecan-based chemotherapy in advanced gastric cancer was shown to be as effective as other combined chemotherapy. The hematological and digestive toxicity were tolerable and mild, especially in weekly regimen. Thus, irinotecan-based chemotherapy should be considered as one of the preferred choices in front line chemotherapy in advanced gastric cancer.

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References

  1. Tsai JY, Safran H. Status of treatment for advanced gastric carcinoma.Curr Oncol Rep 2003;5(3):210–218.

    Article  PubMed  Google Scholar 

  2. Schipper DL, Wagener DJ. Chemotherapy of gastric cancer.Anticancer Drugs 1996;7(2):137–149.

    Article  PubMed  CAS  Google Scholar 

  3. Vanhoefer U, et al. 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 2000;18(14): 2648–2657.

    PubMed  CAS  Google Scholar 

  4. Bugat R. Irinotecan in the treatment of gastric cancer.Ann Oncol 2003;14(Suppl 2):ii37–40.

    Article  PubMed  Google Scholar 

  5. Ajani JA, et al. Phase II multi-institutional randomized trial of docetaxel plus cisplatin with or without fluorouracil in patients with untreated, advanced gastric, or gastroesophageal adenocarcinoma.J Clin Oncol 2005;23(24): 5660–5667.

    Article  PubMed  CAS  Google Scholar 

  6. Futatsuki K, et al. Phase II study of CPT-11, a new camptothecin derivative, in metastatic colorectal cancer. CPT-11 Gastrointestinal Cancer Study Group.J Clin Oncol 1993;11(5):909–913.

    PubMed  Google Scholar 

  7. Enzinger PC, Ilson DH, Saltz LB, O’Reilly EM, Kelsen DP. Irinotecan and cisplatin in upper gastrointestinal malignancies.Oncology 1998;12(8 Suppl 6):110–113.

    PubMed  CAS  Google Scholar 

  8. Takahashi Y, Mai M. [Chemotherapy by combination of low-dose CPT-11 and PSK in an elderly man with liver metastasis from gastric cancer] [Article in Japanese].Gan To Kagaku Ryoho 2001;28(4):531–534.

    PubMed  CAS  Google Scholar 

  9. Kanat O, et al. Single-agent irinotecan as second-line treatment for advanced gastric cancer.Tumori 2003;89(4):405–407.

    PubMed  CAS  Google Scholar 

  10. Kohne CH, et al. Irinotecan is active in chemonaive patients with metastatic gastric cancer: a phase II multicentric trial.Br J Cancer 2003;89(6):997–1001.

    Article  PubMed  CAS  Google Scholar 

  11. Lim WT, Lim ST, Wong NS, Koo WH. CPT-11 and cisplatin in the treatment of advanced gastric cancer in Asians.J Chemother 2003;15(4):400–405.

    PubMed  CAS  Google Scholar 

  12. Wilke HJ, Van Cutsem E. Current treatments and future perspectives in colorectal and gastric cancer.Ann Oncol 2003;14(Suppl 2):ii49–55.

    Article  PubMed  Google Scholar 

  13. Chun JH, et al. Weekly irinotecan in patients with metastatic gastric cancer failing cisplatin-based chemotherapy.Jpn J Clin Oncol 2004;34(1):8–13.

    Article  PubMed  Google Scholar 

  14. Takahashi Y, et al. Pilot study of low-dose, divided maximum tolerated dose of CPT-11 in 21 consecutive patients with metastatic colorectal or gastric cancer.Surg Today 2004;34(3):246–250.

    Article  PubMed  CAS  Google Scholar 

  15. Lim DH, et al. Mitomycin-C and capecitabine as third-line chemotherapy in patients with advanced colorectal cancer: a phase II study.Cancer Chemother Pharmacol 2005;56(1): 10–14.

    Article  PubMed  CAS  Google Scholar 

  16. Matsuoka H, et al. Cytotoxicity of CPT-11 and SN-38 for gastrointestinal and recurrent carcinomas cultured on contactsensitive plates.Anticancer Res 1994;14(2A):405–409.

    PubMed  CAS  Google Scholar 

  17. Goldberg RM, et al. A phase I study of sequential irinotecan and 5-fluorouracil/leucovorin.Ann Oncol 2002;13(10): 1674–1680.

    Article  PubMed  CAS  Google Scholar 

  18. Wasserman E, et al. Combination of oxaliplatin plus irinotecan in patients with gastrointestinal tumors: results of two independent phase I studies with pharmacokinetics.J Clin Oncol 1999;17(6):1751–1759.

    PubMed  CAS  Google Scholar 

  19. Ychou M, et al. An open phase I study assessing the feasibility of the triple combination: oxaliplatin plus irinotecan plus leucovorin/ 5-fluorouracil every 2 weeks in patients with advanced solid tumors.Ann Oncol 2003;14(3):481–489.

    Article  PubMed  CAS  Google Scholar 

  20. Shirao K. Phase I-II study of irinotecan hydrochloride combined with cisplatin in patients with advanced gastric cancer.J Clin Oncol 1997;15(3):921–927.

    PubMed  CAS  Google Scholar 

  21. Yamao T, et al. Phase I-II study of irinotecan combined with mitomycin-C in patients with advanced gastric cancer.Ann Oncol 2001;12(12):1729–1735.

    Article  PubMed  CAS  Google Scholar 

  22. Hecht JR, Blanke CD, Benson AB 3rd, Lenz HJ. Irinotecan and paclitaxel in metastatic adenocarcinoma of the esophagus and gastric cardia.Oncology 2003;17(9 Suppl 8):13–15.

    PubMed  Google Scholar 

  23. Komaki R, et al. Phase I study of irinotecan and concurrent radiation therapy for upper GI tumors.Oncology2000;14(12 Suppl 14):34–37.

    PubMed  CAS  Google Scholar 

  24. Kume S, et al. [A case of advanced gastric cancer successfully treated by neoadjuvant chemotherapy with CPT-11, CDDP and 5-FU] [Article in Japanese].Gan To Kagaku Ryoho 1999;26(4):539–542.

    PubMed  CAS  Google Scholar 

  25. Newman E, et al. Neoadjuvant chemotherapy with CPT-11 and cisplatin downstages locally advanced gastric cancer.J Gastrointest Surg 2002;6(2):212–223.

    Article  PubMed  Google Scholar 

  26. Shimada S, et al. Irinotecan plus low-dose cisplatin for alpha-fetoprotein-producing gastric carcinoma with multiple liver metastases: report of two cases.Surg Today 2002;32(12):1075–1080.

    Article  PubMed  Google Scholar 

  27. Sato A, et al. Preliminary study of fortnightly irinotecan hydrochloride plus cisplatin therapy in patients with advanced gastric and colorectal cancer.Cancer Chemother Pharmacol 2001;47(5):380–384.

    Article  PubMed  CAS  Google Scholar 

  28. Kobayashi A, Hirose T, Yamada T. [Three patients with advanced nonresectable and recurrent gastric cancer responding to chronomodulation chemotherapy with tegafur + cisplatin + isovorin followed by CPT-11 administration] [Article in Japanese].Gan To Kagaku Ryoho 2002;29(8): 1439–1445.

    PubMed  Google Scholar 

  29. Fujitani K, Tsujinaka T, Hirao M. Pharmacokinetic study of two infusion schedules of irinotecan combined with cisplatin in patients with advanced gastric cancer.Oncology 2003;64(2):111–115.

    Article  PubMed  CAS  Google Scholar 

  30. Shimoyama S, et al. Activity and safety of a low dose, fractional administration of irinotecan hydrochloride (CPT-11) in combination with cisplatin for relapsed gastric cancer patients: a preliminary report.Int J Clin Oncol 2003;8(1): 49–52.

    Article  PubMed  CAS  Google Scholar 

  31. Suzuki S, et al. [A case of gastric cancer with multiple liver metastasis responding to combination therapy of CPT-11 and CDDP][Article in Japanese]Gan To Kagaku Ryoho 2003;30(6):859–861.

    PubMed  Google Scholar 

  32. Boku N, et al. Phase II study of a combination of irinotecan and cisplatin against metastatic gastric cancer.J Clin Oncol 1999;17(1):319–323.

    PubMed  CAS  Google Scholar 

  33. Sairenji T, Fujii Y, Eriguchi M. [A case of advanced gastric cancer with lung and liver metastasis responding remarkably to combination chemotherapy with CDDP and CPT-11], [Article in Japanese].Gan To Kagaku Ryoho 2000;27(1):103–106.

    PubMed  CAS  Google Scholar 

  34. Yoshikawa T, et al. Neoadjuvant chemotherapy with a combination of irinotecan and cisplatin in advanced gastric cancer —a case report.Hepatogastroenterology 2000;47(36): 1575–1578.

    PubMed  CAS  Google Scholar 

  35. Yoshida M, et al. Combination chemotherapy of irinotecan plus cisplatin for advanced gastric cancer: efficacy and feasibility in clinical practice.Gastric Cancer 2001;4(3):144–149.

    Article  PubMed  CAS  Google Scholar 

  36. Asami T, et al. [A case of AFP-producing gastric cancer with multiple liver metastases responding to CPT-11 and cisplatin combination chemotherapy].Gan To Kagaku Ryoho 2002;29(11):1985–1988.

    PubMed  Google Scholar 

  37. Tadatomo H, et al. [A case of advanced gastric cancer treated with neoadjuvant chemotherapy of low-dose CPT-11 + CDDP] [Article in Japanese]Gan To Kagaku Ryoho 2001;28(6):821–824.

    PubMed  CAS  Google Scholar 

  38. Yamao T, et al. A preliminary study of preoperative chemotherapy combining irinotecan and cisplatin in patients with gastric cancer with unresectable para-aortic lymph node metastases.Jpn J Clin Oncol 2004;34(5):255–261.

    Article  PubMed  Google Scholar 

  39. Ajani JA, Fairweather J, Pisters PW, Charnsangavej C. Irinotecan and cisplatin in advanced gastric or gastroesophageal junction carcinoma.Oncology 2000;14(12 Suppl 14):19–21.

    PubMed  CAS  Google Scholar 

  40. Ajani JA, et al. Irinotecan plus cisplatin in advanced gastric or gastroesophageal junction carcinoma.Oncology 2001;15(3 Suppl 5):52–54.

    PubMed  CAS  Google Scholar 

  41. Nemoto H, et al. [A case of AFP-producing gastric cancer responding to low-dose CPT-11 and low-dose cisplatin combination chemotherapy] [Article in Japanese].Gan To Kagaku Ryoho 2001;28(3):387–390.

    PubMed  CAS  Google Scholar 

  42. Ajani JA, et al. Irinotecan/cisplatin in advanced, treated gastric or gastroesophageal junction carcinoma.Oncology 2002;16(5 Suppl 5):16–18.

    PubMed  Google Scholar 

  43. Ajani JA, et al. CPT-11 plus cisplatin in patients with advanced, untreated gastric or gastroesophageal junction carcinoma: results of a phase II study.Cancer 2002;94(3): 641–664.

    Article  PubMed  CAS  Google Scholar 

  44. Gotoh M, Kawabe S, Takiuchi H, Ohta S, Katsu K. [Effectiveness of chemotherapy for outpatients with gastric or colorectal cancer] [Article in Japanese]Gan To Kagaku Ryoho 2002;29(Suppl 3):470–474.

    PubMed  Google Scholar 

  45. Slater S, Shamash J, Wilson P, Gallagher CJ, Slevin ML. Irinotecan, cisplatin and mitomycin in inoperable gastrooesophageal and pancreatic cancers—a new active regimen.Br J Cancer2002;87(8):850–853.

    Article  PubMed  CAS  Google Scholar 

  46. Ajani JA, et al. Preoperative induction of CPT-11 and cisplatin chemotherapy followed by chemoradiotherapy in patients with locoregional carcinoma of the esophagus or gastroesophageal junction.Cancer 2004;100(11):2347–2354.

    Article  PubMed  CAS  Google Scholar 

  47. Bouche O, et al. Federation Francophone de Cancerologie Digestive Group. Randomized multicenter phase II trial of a biweekly regimen of fluorouracil and leucovorin (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 2004;22(21):4319–4328.

    Article  PubMed  CAS  Google Scholar 

  48. Pozzo C, et al. Irinotecan in combination with 5-fluorouracil and folinic acid or with cisplatin in patients with advanced gastric or esophageal-gastric junction adenocarcinoma: results of a randomized phase II study.Ann Oncol 2004;15(12):1773–1781.

    Article  PubMed  CAS  Google Scholar 

  49. Shimoyama S, et al. [Successful downstaging by a lowdose, fractional administration of irinotecan hydrochloride (CPT-11) in combination with cisplatin in peritoneal lavage cytology positive, 5-fluorouracil refractory advanced gastric cancer patients] [Article in Japanese]Gan To Kagaku Ryoho 2004;31(6):929–932.

    PubMed  Google Scholar 

  50. Saitoh H, et al. Five-year survivor with liver metastasis from gastric cancer successfully treated with systemic chemotherapy.Gastric Cancer 2000;3(2):106–109.

    Article  PubMed  Google Scholar 

  51. Licitra EJ, et al. Phase I evaluation of sequential topoisomerase targeting with irinotecan/cisplatin followed by etoposide in patients with advanced malignancy.Clin Cancer Res 2003;9(5):1673–1679.

    PubMed  CAS  Google Scholar 

  52. Mezawa S, et al. [A case of gastric carcinoma with multiple skin, bone, and bilateral ovary metastasis; effective treatment by chemotherapy] [Article in Japanese].Gan To Kagaku Ryoho 2003;30(12):1973–1975.

    PubMed  Google Scholar 

  53. Shimada S, Yagi Y, Kuramoto M, Aoki N, Ogawa M. Second-line chemotherapy with combined irinotecan and low-dose cisplatin for patients with metastatic gastric carcinoma resistant to 5-fluorouracil.Oncol Rep 2003;10(3): 687–691.

    PubMed  CAS  Google Scholar 

  54. Fujiwara H, et al. [A case of liver metastatic recurrence of gastric cancer effectively treated by combined chemotherapy of CPT-11 and CDDP] [Article in Japanese].Gan To Kagaku Ryoho 2004;31(12):2035–2038.

    PubMed  Google Scholar 

  55. Assersohn L, et al. Phase II study of irinotecan and 5-fluorouracil/ leucovorin in patients with primary refractory or relapsed advanced oesophageal and gastric carcinoma.Ann Oncol 2004;15(1):64–69.

    Article  PubMed  CAS  Google Scholar 

  56. Blanke CD, et al. A phase II study of irinotecan with 5-fluorouracil and leucovorin in patients with previously untreated gastric adenocarcinoma.Ann Oncol 2001;12(11): 1575–1580.

    Article  PubMed  CAS  Google Scholar 

  57. Moehler M, et al. Safety and efficacy of CPT11/FA/5-FU (ILF) versus ELF in previously untreated advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction. ASCO, 2003.

  58. Yoshioka T, et al. Biweekly administration regimen of docetaxel combined with CPT-11 in patients with inoperable or recurrent gastric cancer.Gastric Cancer 2003;6(3):153–158.

    Article  PubMed  CAS  Google Scholar 

  59. Jatoi A, et al. A phase II trial of docetaxel and CPT-11 in patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction, and gastric cardia.Int J Gastrointest Cancer 2002;32(2-3):115–123.

    Article  PubMed  CAS  Google Scholar 

  60. Yamao T, et al. Tumor markers CEA, CA19-9 and CA125 in monitoring of response to systemic chemotherapy in patients with advanced gastric cancer.Jpn J Clin Oncol 1999;29(11):550–555.

    Article  PubMed  CAS  Google Scholar 

  61. Bamias A, Papamichael D, Syrigos K, Pavlidis N. Phase II study of irinotecan and mitomycin C in 5-fluorouracil-pretreated patients with advanced colorectal and gastric cancer.J Chemother 2003;15(3):275–281.

    PubMed  CAS  Google Scholar 

  62. Hirao K, Hirasaki S, Tsuzuki T, Kajiwara T, Hyodo I. Unresectable alpha fetoprotein-producing gastric cancer successfully treated with irinotecan and mitomycin C after S-1 failure.Intern Med 2004;43(2):106–110.

    Article  PubMed  Google Scholar 

  63. Grau J, et al. Phase II study of irinotecan (CPT-11) and mitomycin C (MMC) combination in patients with advanced gastric cancer (ENG). Preliminary results.Proc Am Soc Clin Oncol 2001;20: abstr 2284.

    Google Scholar 

  64. Villalona M, et al. Phase II randomized study of mitomycin C (MMC) as a modulator of irinotecan in patients (pts) with esophageal and GE Junction adenocarcinomas.J Clin Oncol 2005;23 (16S, Part I): 4027.

    Google Scholar 

  65. Jordan K, Kellner O, Kegel T, Schmoll HJ, Grothey A. Phase II trial of capecitabine/irinotecan and capecitabine/ oxaliplatin in advanced gastrointestinal cancers.Clin Colorectal Cancer 2004;4(1):46–50.

    Article  PubMed  CAS  Google Scholar 

  66. Farhat F, et al. Preliminary results of phase II study of irinotecan and capecitabine combination as first line chemotherapy for advanced and metastatic gastric cancer.J Clin Oncol 2006 (submitted).

  67. Maki H, et al. Augmented anti-metastatic efficacy of a selective matrix metalloproteinaseinhibitor, MMI-166, in combination with CPT-11.Clin Exp Metastasis 2002;19(6):519–526.

    Article  PubMed  CAS  Google Scholar 

  68. Nakajima N et al. [A case of gastric cancer associated with synchronous liver metastasis successfully treated with combination therapy of systemic and hepatic arterial infusion chemotherapy] [Article in Japanese]Gan To Kagaku Ryoho 2002;29(12):2442–2446.

    PubMed  Google Scholar 

  69. Takahashi Y, et al. A randomized phase II clinical trial of tailored CPT-11 + S-1 vs S-1 in patients with advanced or recurrent gastric carcinoma as the first line chemotherapy.Jpn J Clin Oncol 2004;34(6):342–345.

    Article  PubMed  Google Scholar 

  70. Yamada Y, et al. Phase I study of irinotecan and S-1 combination therapy in patients with metastatic gastric cancer.Int J Clin Oncol 2003;8(6):374–380.

    Article  PubMed  CAS  Google Scholar 

  71. Kawabata Y, Kusumoto C, Miyamoto K. [A case of TS-1 resistant recurrent gastric cancer responding to TS-1 +CPT-11 combination therapy] [Article in Japanese].Gan To Kagaku Ryoho 2004;31(7):1087–1089.

    PubMed  Google Scholar 

  72. Souglakos J, et al. Combination of irinotecan (CPT-11) plus oxaliplatin (L-OHP) as first-line treatment in locally advanced or metastatic gastric cancer: a multicentre phase II trial.Ann Oncol 2004;15(8):1204–1209.

    Article  PubMed  CAS  Google Scholar 

  73. Kliche KO, Kubsch K, Raida M, Masri-Zada R, Hoffken K. Chronomodulated chemotherapy in metastatic gastrointestinal cancer combining 5-FU and sodium folinate with oxaliplatin, irinotecan or gemcitabine: the Jena experience in 79 patients.J Cancer Res Clin Oncol 2002;128(9):516–524.

    Article  PubMed  CAS  Google Scholar 

  74. Heike M. Weekly treatment with irinotecan, folinic acid and infusional 5-fluorouracil (ILF) in patients with advanced gastric cancer.Anticancer Drugs 2003;14(8):645–650.

    Article  PubMed  Google Scholar 

  75. Moehler M, et al. Weekly treatment with irinotecan, folinic acid and infusional 5-fluorouracil (ILF) in patients with advanced gastric cancer.Anticancer Drugs 2003;14(8): 645–650.

    Article  PubMed  CAS  Google Scholar 

  76. Sato A, et al. Effectiveness of doxifluridine (5’-DFUR)/docetaxel against advanced/recurrent gastric cancer showing resistance to various anticancer drug regimens.Gastric Cancer 2002;5(4):233–236.

    Article  PubMed  Google Scholar 

  77. Narahara H, Imamura H, Ikeda M, Kobayashi K, Fujitani M. Phase II study of CPT-11 plus CDDP in patients with metastatic gastric cancer.Jpn J Clin Oncol 2004;34(8): 481–488.

    Article  Google Scholar 

  78. Natsui S, et al. [Pharmacokinetic study of CPT-11, SN-38 and SN-38 glucuronide in the ascites, plasma and bile after intraperitoneal administration of CPT-11] [Article in Japanese].Gan To Kagaku Ryoho 2002;29(12):2188–2190.

    PubMed  Google Scholar 

  79. Maruyama M et al. [Pharmacokinetic study of the intraperitoneal administration of CPT-11 for patients with peritoneal seedings of gastric and colonic cancers] [Article in Japanese].Gan To Kagaku Ryoho 2001;28(11):1505–11507.

    PubMed  CAS  Google Scholar 

  80. Maruyama M, et al. [Experimental study on CPT-11 intraperitoneal chemotherapy—metabolism of CPT-11 in malignant ascites] [Article in Japanese].Gan To Kagaku Ryoho 2000;27(12):1858–1860.

    PubMed  CAS  Google Scholar 

  81. Sobajima J, et al. [A case of postoperative liver metastasis of alpha-fetoprotein producing gastric cancer successfully treated with intrahepatic chemotherapy (adriamycin, cisplatin, irinotecan hydrochloride)] [Article in Japanese].Gan To Kagaku Ryoho 2002;29(12):2132–2134.

    PubMed  Google Scholar 

  82. Nagai S, et al. Establishment and characterization of human gastric and colonic xenograft lines resistant to CPT-11 (a new derivative of camptothecin).J Surg Oncol 1995;59(2): 116–124.

    Article  PubMed  CAS  Google Scholar 

  83. Marcus SG, et al. Complications of gastrectomy following CPT-11-based neoadjuvant chemotherapy for gastric cancer.J Gastrointest Surg 2003;7(8):1015–1022.

    Article  PubMed  Google Scholar 

  84. Wills J, Roermond M. Perspectives in adjuvant gastric.Arch Oncol 2003;11(3):153–154.

    Article  Google Scholar 

  85. Dank M, et al. Randomized phase 3 trial of irinotecan (CPT-11) + 5FU/folinic acid (FA) vs CDDP + 5FU in 1st-line advanced gastric cancer patients.J Clin Oncol 2005;23 (16S, Part I of II): abstract 4003.

    Google Scholar 

  86. Takiuchi H, et al. [Second-line chemotherapy in gastric cancer].Gan To Kagaku Ryoho 2005;32(1):19–23.

    PubMed  Google Scholar 

  87. Koizumi W, et al. [Controversial issues in chemotherapy for inoperable gastric cancer] [Article in Japanese]Gan To Kagaku Ryoho 2003;30(9):1249–1255.

    PubMed  Google Scholar 

  88. Ohtsu A, et al. Disparities in gastric cancer chemotherapy between the east and west.J Clin Oncol 2006;24: 2188–2196.

    Article  PubMed  Google Scholar 

  89. Rougier P, et al. Is age a prognostic factor of toxicity and efficacy in patients (pts) with metastatic colorectal cancer (MCRC) receiving irinotecan in combination with 5FU/folinic acid (FA)?Proc Am Soc Clin Oncol 2003;22: abstr 1072.

    Google Scholar 

  90. Lenz HJ, et al. Thymidylate synthase mRNA level in adenocarcinoma of the stomach: a predictor for primary tumor response and overall survival.J Clin Oncol 1996;14(1): 176–182.

    PubMed  CAS  Google Scholar 

  91. Ichikawa W, et al. Thymidylate synthase predictive power is overcome by irinotecan combination therapy with S-1 for gastric cancer.Br J Cancer 2004;91(7):1245–1250.

    Article  PubMed  CAS  Google Scholar 

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  1. Head of Division Hematology-Oncology, Hammoud Hospital University Medical Center, Ghassan Hammoud Street, 652, Sidon, Lebanon

    Fadi Sami Farhat MD

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Farhat, F.S. A general review of the role of irinotecan (CPT11) in the treatment of gastric cancer. Med Oncol 24, 137–146 (2007). https://doi.org/10.1007/BF02698032

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