Delivery rate of patients with advanced gastric cancer to third-line chemotherapy and those patients’ characteristics: an analysis in real-world setting

133 Background: We performed multicenter retrospective study to evaluate the activity and the safety of a docetaxel as the third-line chemotherapy in advanced gastric cancer (AGC) patients who had undergone oxaliplatin (FOLFOX) and irinotecan (FOLFIRI)-based chemotherapy regimens. Methods: Thirty-eight patients with AGC previously treated were eligible for this study. Patients received docetaxel 30 mg/m2 +/- cisplatin 30 mg/m2 IV on day 1, 8 or docetaxel 60 mg/m2 +/- cisplatin 60 mg/m2 IV on day 1 every 3 weeks until disease progression, and responses were assessed after every two cycles according to RECIST criteria and toxicity was evaluated by NCI-CTC. Results: Thirty-two out of 38 patients were evaluable for response. A total of 95.1 cycles of chemotherapy (median 2, range 0.5–7) were administered. Relative dose intensities of docetaxel and cisplatin were 93.4% and 87.8%, respectively. The overall response rate was 15.6% and the disease control rate was 50%. With a median follow-up duration of 3.1 months (range 0.3-14.3 months), 36 patients had disease progression, and 34 patients had died at the time of analysis. The median progression-free survival was 1.8 months (95% CI, 1.3–2.3 months). The median overall survival was 3.1 months (95% CI, 2.3–3.9 months). Grade 3 or 4 hematologic toxicities included neutropenia in thirteen patients (38.3%), febrile neutropenia in four patients (11.7%). and thrombocytopenia in one patient (2.9%). Other grade 3 or 4 toxicities included neuropathy in three patients (8.8%) and mucositis in two patients (5.9%). There were three treatment-related deaths (8.8%) caused by infection associated with neutropenia. Conclusions: Salvage docetaxel chemotherapy in AGC patients failed in oxaliplatin and irinotecan-based treatment is not recommend routinely. However, selected patients with good performance status and sufficient albumin levels may have derived some survival benefits from salvage chemotherapy. No significant financial relationships to disclose.

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Clinical Impact of Oral Intake in Second-line or Third-line Chemotherapy for 589 Patients With Advanced Gastric Cancer

American Journal of Clinical Oncology ◽

10.1097/coc.0000000000000835 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Takatsugu Ogata ◽

Yukiya Narita ◽

Ryosuke Kumanishi ◽

Taiko Nakazawa ◽

Yuki Matsubara ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Oral Intake ◽

Clinical Impact ◽

Second Line ◽

Third Line ◽

Line Chemotherapy

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P-072 Overall survival (OS) of patients with advanced gastric cancer (AGC) according to the availability of 5-FU, platinum, taxanes and irinotecan as first, second and third-line chemotherapy

Annals of Oncology ◽

10.1093/annonc/mdv233.72 ◽

2015 ◽

Vol 26 ◽

pp. iv20

Author(s):

M.J. Kim ◽

K.H. Yoo ◽

S.J. Lee ◽

S. Kim ◽

J. Lee ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Advanced Gastric Cancer ◽

Third Line ◽

Line Chemotherapy

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Efficacy and safety of irinotecan monotherapy as third line treatment for advanced gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.113 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 113-113

Author(s):

Takeshi Kawakami ◽

Nozomu Machida ◽

Masahiro Kawahira ◽

Sadayuki Kawai ◽

Yosuke Kito ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Peritoneal Dissemination ◽

Dose Intensity ◽

Progression Free Survival ◽

Efficacy And Safety ◽

Third Line ◽

Gastric Cancer Patients ◽

Metastatic Sites ◽

Line Chemotherapy

113 Background: Several randomized trials demonstrated the survival benefit in advanced gastric cancer patients (AGC pts) receiving irinotecan or taxanes as second-line chemotherapy (SLC). Taxanes are used for SLC in daily clinical practice in Japan because of its less toxicity, especially in AGC pts with peritoneal dissemination, compared with irinotecan. Although irinotecan is often administered after refractory or intolerant to taxanes as SLC, the efficacy and safety of irinotecan as third-line chemotherapy (TLC) is still unclear. Methods: We retrospectively investigated the data of AGC pts administered irinotecan 150mg/m2 as TLC every two weeks until disease progression, unacceptable toxicity, or pts’ refusal between December 2002 and June 2015. Inclusion criteria were (1) age 75 years or less (2) refractory or intolerant to fluoropyrimidine with or without platinum as first-line chemotherapy (3) refractory or intolerant to taxanes as SLC. Results: A total of 52 pts were analyzed. Pts’ characteristics were as follows: median age, 66 (range, 33-75) years; male/female, 35/17 pts; ECOG PS 0-1/2, 42/10 pts; peritoneal dissemination +/-, 32/20 pts; ascites +/-, 22/30 pts, number of metastatic sites 1-2/3-4, 44/8 pts. Median follow-up period was 548 (141-1931) days. Median progression-free survival was 70 days (95%CI 49-137) and median overall survival was 144 days (95%CI 120-231) from the initiation of irinotecan administration. Response rate and disease control rate was 10.8% and 50.4%, respectively. Relative dose intensity was 74.7% (56 mg/m2/week); 14 pts needed dose reduction in the first course, and 22 pts after the second course. Grade 3 or 4 neutropenia, anemia, diarrhea, nausea, and febrile neutropenia were observed in 13 (25%), 21 (40.4%), 5 (9.6%), 3 (5.8%) and 3 (5.8%) pts, respectively. No treatment-related death was observed. Conclusions: This study suggests that irinotecan monotherapy as TLC has acceptable anti-tumor effect and has manageable toxicity in appropriately selected AGC pts.

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Prognostic factor for third-line chemotherapy in patients with advanced gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15702 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15702-e15702 ◽

Cited By ~ 1

Author(s):

Jonggwon Choi

Keyword(s):

Gastric Cancer ◽

Risk Factor ◽

Prognostic Factor ◽

Advanced Gastric Cancer ◽

Multivariate Analyses ◽

Risk Group ◽

Poor Overall Survival ◽

Poor Prognostic Factor ◽

Third Line ◽

Line Chemotherapy

e15702 Background: To evaluate prognostic factors for patients with advanced gastric cancer treated by Third-line chemotherapy, and to identify the characteristics of long-term survivors. Methods: Eighty seven advanced gastric adenocarcinoma patients, who received third-line chemotherapy, were enrolled in this retrospective study from January 2010 until December 2014. Univariate and multivariate analyses were created using log-rank tests and Cox’s proportional hazard model, respectively. Results: In univariate and multivariate analyses, poor prognostic factor were investigated and four independent factors were found to be associated with poor overall survival: time-to progression under first-line chemotherapy≤6 months (HR, 1.64; 95% CI, 1.18–2.25; P ≤ 0.01), CA 19-9 level > 50 ng/ml (HR, 1.78; 95% CI, 1.32–2.67; P ≤0.007), the presence of ascites (HR, 1.67; 95% CI 1.295– 2.37, P ≤0.001), the presence of greater than or equal to three metastatic sites of disease (HR, 1.45; 95% CI 1.19– 2.19, P ≤0.004). 87 patients were classified as low-risk group( no risk factor), intermediate-risk group (one to two risk factors), high- risk group (three to four risk factor), and median survival times for each groups were 14.3 months, 12.1 months, and 7.4 months, respectively (P ≤0.01). Conclusions: This model will help in selecting the patients with advanced gastric cancer who could benefit from proceeding with third-line chemotherapy.

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