P-088 - Evaluation of prognostic and predictive factors in second-line treatment with irinotecan based chemotherapy in gastric cancer

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter R. Biernacka
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors R. Biernacka, T. Lewandowski
  • Maria Skłodowska-Curie Cancer Centre Institute, Warsaw/PL

Abstract

Introduction

Results of treatment of gastric cancer remains poor, hence the significant role of palliative treatment. Irinotecan is one of the drugs used after treatment failure with platinum and fluoropyrimidine. General condition, level of hemoglobin, alkaline phosphatase (ALP), sites of metastases have an impact on the prognosis of patients treated with first-line chemotherapy. Similar factors may be important in the second-line treatment.

Evaluation of the effectiveness of second-line chemotherapy with irinotecan and establishing prognostic and predictive factors: histological type, surgical treatment, previous chemotherapy, location of metastases, BMI, hemoglobin, lymphocytes, and ALP in patients with gastric cancer and gastroesophageal junction cancer.

Methods

Analysis included 51 patients after failure of first-line palliative treatment (between 2008-2014) with platinum and fluoropyrimidine. In the second-line treatment FOLFIRI schedule and its modifications were used. Connection of the efficacy of second-line treatment with clinical and pathological data was evaluated.

Results

Response rate was available for 43 patients. CR was observed in 2.3%, PR-18.6%, SD- 20.9%, and PD -58.1%. Disease control was achieved in 41.9% of patients. Median TTP was 92 days. Median OS -199 days. Male gender (p = 0.009), age under 51 years old (p = 0.019), previous treatment with cisplatin, not oxaliplatin (p = 0.003) and 5-FU, not capecitabine (p = 0.004) were associated with a higher probability of disease control. There was no correlation with the grade of malignancy, Lauren type, gastrectomy, BMI, hemoglobin, lymphocytes, and ALP. There was a trend toward better disease control rate (DCR) in patients treated in the first line with doublet regimen, not triplet (p = 0.067). First line chemotherapy with 5-FU (p = 0.037) and docetaxel (p = 0.024) coexisted with longer OS. The presence of peritoneal metastases was associated with a tendency to shorter OS (p = 0.085).

Conclusion

Male gender, up to 51 years of age, first-line treatment with DDP and 5-FU, by doublet regimen rather than triplet and absence of peritoneal metastases were associated with greater benefit from the use of second-line chemotherapy. The study of molecular prognostic and predictive factors in the future may indicate a more precise group of patients that may benefit from such treatment.