Abstract
Background. S-1 plus cisplatin has been established to be standard first-line chemotherapy for advanced gastric cancer in Japan. The optimal second-line treatment refractory to S-1 plus cisplatin remains unclear. Methods. We retrospectively studied the efficacy, toxicity, and survival of irinotecan plus mitomycin C in patients with advanced gastric cancer refractory to a fluoropyrimidine plus cisplatin. Results. Twenty-four patients were studied. Prior chemotherapy was S-1 plus cisplatin in 15 patients, S-1 plus cisplatin and docetaxel in 8, and 5-fluorouracil plus cisplatin with radiotherapy in 1. The overall response rate was 17.4%. The median overall survival was 8.6 months, and the median progression-free survival was 3.6 months. Grade 3 or 4 toxicities included leukopenia (33%), neutropenia (50%), anemia (33%), thrombocytopenia (4%), anorexia (13%), diarrhea (4%), and febrile neutropenia (13%). Conclusion. A combination of irinotecan and mitomycin C is potentially effective in patients with advanced gastric cancer refractory to a fluoropyrimidine plus cisplatin.
Highlights
Gastric cancer remains one of the most important malignancies in Japan, with a mortality rate of about 50,000 deaths per 100,000 inhabitants, making it the second leading cause of cancer-related death [1]
We retrospectively investigated efficacy, toxicity, and survival in patients who received irinotecan plus mitomycin C after they were found to be refractory to combined chemotherapy with a fluoropyrimidine plus cisplatin, especially S-1 plus cisplatin, which is the standard first-line treatment for advanced gastric cancer in Japan
From November 2006 through March 2008, we studied 24 patients (22 men and 2 women) with advanced gastric cancer who received irinotecan plus mitomycin C as second-line treatment after failure to respond to firstline chemotherapy with a fluoropyrimidine plus cisplatin at Toyama University Hospital, Takaoka City Hospital, or Kouseiren Takaoka Hospital
Summary
Gastric cancer remains one of the most important malignancies in Japan, with a mortality rate of about 50,000 deaths per 100,000 inhabitants, making it the second leading cause of cancer-related death [1]. Chemotherapy for advanced gastric cancer has not been standardized for a long time in Japan. The Japan Clinical Oncology Group (JCOG) 9205 trial was a three-arm phase III study that compared UFT (a combination of uracil and tegafur) plus mitomycin C with 5-fluorouracil (5-FU) plus cisplatin and with 5-FU alone as first-line chemotherapy. Two important phase III studies of first-line chemotherapy for advanced gastric cancer have been reported. S-1 plus cisplatin has been established to be standard first-line chemotherapy for advanced gastric cancer in Japan. We retrospectively studied the efficacy, toxicity, and survival of irinotecan plus mitomycin C in patients with advanced gastric cancer refractory to a fluoropyrimidine plus cisplatin. A combination of irinotecan and mitomycin C is potentially effective in patients with advanced gastric cancer refractory to a fluoropyrimidine plus cisplatin
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