Irinotecan Plus Mitomycin C as Second-Line Chemotherapy for Advanced Gastric Cancer Resistant to Fluoropyrimidine and Cisplatin : A Retrospective Study

Abstract EN

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.