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Efficacy and safety of irinotecan monotherapy as third-line treatment for advanced gastric cancer

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Abstract

Purpose

Although irinotecan monotherapy is often used in third-line treatment after the failure of taxanes in Japanese clinical practice, its survival benefit is still unclear. The aim of this study is to investigate the efficacy and safety of irinotecan monotherapy as third-line treatment.

Methods

Clinical data from consecutive patients in whom irinotecan had been initiated as third-line treatment between December 2003 and July 2015 in Shizuoka Cancer Center were retrospectively analyzed. Patients who were refractory or intolerant to fluoropyrimidine with or without platinum in first-line treatment and subsequent therapy with taxanes were included in this study. Irinotecan was administered at 150 mg/m2 every 2 weeks.

Results

The data of 50 patients who met the inclusion criteria were analyzed. The overall response rate was 18.4 % (7/38) among the patients with measurable disease. The median progression-free survival time was 66 days, and the median survival time was 180 days from the initiation of irinotecan therapy. The major grade 3 or 4 adverse events including neutropenia, fatigue, and anorexia were observed in 12 (24 %), 8 (16 %), and 7 (14 %), respectively. No treatment-related deaths occurred. Thirteen patients (26 %) required a dose reduction to 120 mg/m2 or less from the initiation of irinotecan.

Conclusions

This study suggests that irinotecan as third-line treatment has an anti-tumor effect and is feasible with optimal dose modification for advanced gastric cancer.

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Acknowledgments

The authors thank the patients and their families for their participation in this study.

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Authors and Affiliations

  1. Department of Gastrointestinal Oncology, Shizuoka Cancer Center, Shimonagakubo 1007, Sunto-Gun, Nagizumi-Cho, Shizuoka, 411-0934, Japan

    Takeshi Kawakami, Nozomu Machida, Hirofumi Yasui, Masahiro Kawahira, Sadayuki Kawai, Yosuke Kito, Yukio Yoshida, Satoshi Hamauchi, Takahiro Tsushima, Akiko Todaka, Tomoya Yokota, Kentaro Yamazaki & Akira Fukutomi

  2. Department of Clinical Oncology, Shizuoka Cancer Center, Shizuoka, Japan

    Yusuke Onozawa

Authors
  1. Takeshi Kawakami
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  2. Nozomu Machida
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  3. Hirofumi Yasui
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  4. Masahiro Kawahira
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  14. Yusuke Onozawa
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Corresponding author

Correspondence to Nozomu Machida.

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Kawakami, T., Machida, N., Yasui, H. et al. Efficacy and safety of irinotecan monotherapy as third-line treatment for advanced gastric cancer. Cancer Chemother Pharmacol 78, 809–814 (2016). https://doi.org/10.1007/s00280-016-3138-z

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  • DOI: https://doi.org/10.1007/s00280-016-3138-z

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