Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma

被引：8

作者：

Loupakis, Fotios ^{[1
,2
]}

Masi, Gianluca ^{[1
,2
]}

Fornaro, Lorenzo ^{[1
,2
]}

Vasile, Enrico ^{[1
,2
]}

Allegrini, Giacomo ^{[3
]}

Fontana, Eloise ^{[4
]}

Granetto, Cristina ^{[5
]}

Salvatore, Lisa ^{[1
,2
]}

Mentuccia, Lucia ^{[6
]}

Andreuccetti, Michele ^{[1
,2
]}

Cortesi, Enrico ^{[6
]}

Merlano, Marco ^{[5
]}

Cascinu, Stefano ^{[7
]}

Falcone, Alfredo ^{[1
,2
]}

机构：

[1] Azienda Ospedaliero Univ Pisana, Unit Med Oncol 2, Ist Toscano Tumori, I-56126 Pisa, Italy

[2] Univ Pisa, Dept Oncol Transplants & New Technol Med, I-56126 Pisa, Italy

[3] Azienda USL 5, Ist Toscano Tumori, Med Oncol Unit, Pontedera, Italy

[4] Azienda USL 6, Ist Toscano Tumori, Med Oncol Unit, Cecina, Italy

[5] Azienda Ospedaliera S Croce & Carle, Unit Oncol, Cuneo, Italy

[6] Univ Roma La Sapienza, Med Oncol Unit, Dept Expt Med & Pathol, Rome, Italy

[7] Univ Politecn Marche, Azienda Osped Osped Riuniti, Med Oncol Unit, Ancona, Italy

来源：

CANCER CHEMOTHERAPY AND PHARMACOLOGY | 2010年 / 66卷 / 03期

关键词：

Gastric cancer; Cisplatin; 5-Fluorouracil; Irinotecan; Docetaxel; Sequential chemotherapy; 1ST-LINE THERAPY; CANCER; FLUOROURACIL; CHEMOTHERAPY; TRIAL; METAANALYSIS; LEUCOVORIN; MANAGEMENT; REGIMEN;

D O I：

10.1007/s00280-009-1196-1

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

5-Fluorouracil (5-FU) plus cisplatin (C) can be considered a standard option for advanced gastric cancer (AGC). Irinotecan (Ir) and docetaxel (D) are active agents with no complete cross-resistance with C and 5-FU. Concomitant combination of Ir or D with C and 5-FU is feasible, but with substantial toxicities. A different way to include all active agents in first-line treatment of AGC may be to use them sequentially. We aimed to evaluate the activity and the safety profile of sequential chemotherapy with 5-FU-based doublets with C, Ir and D in the first-line treatment of AGC. We conducted a phase II study of first-line sequential chemotherapy in metastatic GC. Treatment consisted of 3 cycles of C + infused 5-FU and leucovorin (CFL) followed by 3 cycles of Ir + 5-FU/LV (IrFL) followed by 3 cycles of D + 5-FU/LV (DFL). Primary end-point was response rate. Forty-six patients were enrolled, median age 60 years, sites of disease (single/multiple) = 9/37, PS 0/1 = 27/19, gastric/gastro-oesophageal junction = 39/7. Median number of cycles was 9. Main grade 3-4 toxicities were neutropenia (37%), febrile neutropenia (2%), diarrhoea (4%), stomatitis (9%). Response rate after the planned 9 cycles was 45% (15 partial and 5 complete responses among 43 evaluable patients). Median PFS and OS: 6.8 and 11.1 months, respectively. This sequential treatment is feasible with a favourable safety profile and produced encouraging results in terms of activity and efficacy.

引用

页码：559 / 566

页数：8

共 21 条

[1] Standard of care for gastric cancer based on meta-analysis? Treading on thin ice or it is very nice! [J].