762 - Third-line FOLFIRI in metastatic gastric cancer patients

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter Chiara Caparello
Authors C. Caparello1, E. Vasile2, M. Lencioni1, M.G. Fabrini3, M. Lucchesi4, L. Ginocchi1, S. Caponi4, S. Santi5, S. Ricci1, A. Falcone6
  • 1Oncologia, Trapianti E Nuove Tecnologie In Medicina, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 2Oncology, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 3Division Of Radiation Oncology, S. Chiara Pisa Hospital, Pisa, Italy, Pisa/IT
  • 4Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 5Department Of Gastroenterology, Esophageal Surgery Unit, Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal Disease, Pisa, Italy, Pisa/IT
  • 6Dept. Of Oncology-presidio Ospedaliero, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT

Abstract

Background

The use of systemic chemotherapy increased median survival of advanced gastric cancer patients. Besides fluoropyrimidines and platinum compounds, different active agents such as docetaxel and irinotecan became available giving physicians the opportunity to administer to patients further lines of treatment. Second-line chemotherapy with docetaxel or irinotecan showed improved overall survival over best supportive care. There are many patients progressed after two lines of therapy who maintain a good performance status that could be evaluated for further treatment.

Methods

The aim of this retrospective analysis was to evaluate the activity of the combination of 5-fluorouracil/folinic acid and irinotecan (FOLFIRI) as third-line treatment for metastatic gastric adenocarcinoma patients.

Results

A total of twenty-one patients (M/F 16/5; ECOG Performance Status 0/1: 3/18) treated between 2009 and 2011 were included in the study; median age was 64 years (range 38-77). All the patients had received first-line fluoropyrimidine plus platinum compound chemotherapy; in 7 of them a triple-drug combination with epirubicin was used; one patient with HER-2 positive tumor was treated with trastuzumab in combination with chemotherapy. All patients had received taxanes in second-line (docetaxel in 18 and paclitaxel in 3 patients), in 5 cases in association with 5-fluorouracil. A total of 151 cycles of third-line FOLFIRI were administered (median number 7; range 2-18). Treatment was well tolerated; grade 3 or 4 toxicities included neutropenia in 3 patients, diarrhea in 3 patients, asthenia and vomiting in 1 patient each; delay of treatment was required in 9 patients and a reduction of doses only in 3 cases. Among the twenty evaluable patients, two (10%) partial responses and 8 (40%) stable disease were observed, thus obtaining a disease control in half of patients. Median duration of response was 7 months. Median progression-free survival was 3.8 months. Median overall survival from the start of third-line treatment was 9.1 months.

Conclusions

FOLFIRI was feasible and showed interesting activity also in third-line setting of largely pretreated selected metastatic gastric cancer patients.

Disclosure

All authors have declared no conflicts of interest.