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Japanese Journal of Clinical Oncology 34:8-13 (2004)
© 2004 Foundation for Promotion of Cancer Research

Weekly Irinotecan in Patients with Metastatic Gastric Cancer Failing Cisplatin-based Chemotherapy

Jong Ho Chun, Hark Kyun Kim, Jong Seok Lee, Jin Yi Choi, Hong Gi Lee, Sung Min Yoon, Il Ju Choi, Keun Won Ryu, Young-Woo Kim and Jae-Moon Bae+

Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Korea

Background: The goal of this study is to determine the efficacy and toxicity of weekly irinotecan as second-line chemotherapy in advanced gastric cancer after failure of cisplatin-based regimen.

Methods: Gastric cancer patients failing cisplatin-based chemotherapy received 125 mg/m2 of irinotecan weekly for 4 weeks followed by 2-week rest, until disease progression.

Results: Thirty-seven patients were enrolled into this study. The objective response was documented in seven of 35 patients with measurable lesion (response rate 20%, 95% CI: 6.1–33.9). Eight patients (22.9%) had stable disease and overall tumor control rate was 42.9%. The disease remained stable in both of two patients without measurable disease. At a median follow-up duration of 15.8 months, median time to progression and overall survival were 2.6 months (95% CI: 2.4–2.8) and 5.2 months (95% CI: 3.6–6.7), respectively. Neutropenia and diarrhea were the main toxicities. Among 37 patients treated, grade 3/4 (G3/4) neutropenia occurred in 43.2/24.3% of patients, respectively, and was accompanied with fever in three patients. Non-hematologic toxicities consisted mainly of delayed diarrhea (G3/4, 18.9/0%) and nausea/vomiting (G3/4, 18.9/0%). These toxicities were manageable and there was no treatment-related death.

Conclusions: This weekly schedule of irinotecan was modestly active against cisplatin-refractory gastric cancer and relatively well-tolerated with appropriate dose modification.

+ For reprints and all correspondence: Hark Kyun Kim, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, 411-769, Korea. E-mail: hkim{at}ncc.re.kr


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