Comparison of the Efficacy of FOLFIRI and Paclitaxel Chemotherapy Regimens in the Second Line Treatment of Metastatic Gastric Cancer

Abstract

Introduction: Although the incidence of gastric cancer has shown a significant decrease over the years, it remains the fourth leading cause of cancer-related deaths, resulting in more than 700,000 annual deaths worldwide. The main goal of metastatic gastric cancer treatment is to alleviate symptoms and, if feasible, improve survival. The purpose of our study was to compare the effectiveness of two chemotherapy regimens, FOLFIRI and paclitaxel, which are commonly used in the second-line treatment of metastatic gastric cancer.
 Material and Method: Patients over the age of 18 with a diagnosis of metastatic gastric carcinoma who were treated with either FOLFIRI or paclitaxel as second-line therapy were enrolled in our study. These two treatment groups were compared in terms of overall and progression-free survival. 
 Results: A total of 99 patients were included. 56 (56.6%) patients had received FOLFIRI and 43 (43.3%) had received paclitaxel. The median overall survival for the entire cohort was 9 months: 10 months for FOLFIRI and 8 months for paclitaxel, with no statistically significant difference between them. In multivariate analysis, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index, and number of chemotherapy cycles were identified as independent prognostic factors.
 Conclusion: We compared two commonly used regimens in the second-line treatment of metastatic gastric cancer, FOLFIRI and paclitaxel, in terms of overall and progression-free survival. There was no statistically significant difference between the two regimens. Both regimens can be considered as reasonable second-line treatment options. According to the results of our study, the choice of chemotherapy for second-line treatment should be made on an individual basis, considering factors such as the treatment received in the first-line, side effects, medication cost, and accessibility.