Prognostic factors of second and third line chemotherapy using 5-FU with platinum, irinotecan, and taxane for advanced gastric cancer

Ji Soo Park, Jae Yun Lim, Seung Kyo Park, Min Kyung Kim, Hee Sung Ko, SunOch Yoon, Jong Won Kim, Seung Ho Choi, Jae Yong Cho

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: The aims of this study are to find out whether the sequence of chemotherapeutic regimens including second- and third-line taxane and irinotecan influences the survival of patients with unresectable gastric carcinoma and to identify clinical characteristics of patients with improved response. Materials and Methods: Fifty gastric carcinoma patients who were treated by third-line sequential chemotherapy between November 2004 and July 2010 were enrolled in this study. Their overall survival (OS) and time to progression (TTP) were set up as primary and secondary end points. For the sequence of chemotherapy regimen, two arms were used. Arm A was defined as 5-fluorouracil (5-FU)+cisplatin (FP) or folinic acid, 5-FU and oxaliplati (FOLFOX), followed by folinic acid, 5-FU and irinotecan (FOLFIRI), and paclitaxel or docetaxel plus 5-FU, with or without epirubicin. Arm B was defined as FP or FOLFOX, followed by paclitaxel or docetaxel plus 5-FU, and FOLFIRI. Results: The median OS of all patients was 16.0 months (95% confidence interval, 13.6 to 18.3 months), which is longer than historical control of patients who did not receive third-line chemotherapy. The sequence of second and third-line regimen, including irinotecan and taxane, did not present significant difference in OS or TTP after failure of 5-FU with platinum chemotherapy. In survival analysis of patients' clinicopathologic characteristics, poor prognosis was shown in patients with poorly differentiated histologic features, elevated serum carcinoembryonic level, and shorter TTP of first line chemotherapy. Conclusion: It is possible for patients to respond differently to chemotherapy due to differences in clinical features and underlying gene expression profiles. Development of individualized chemotherapy regimens based on gene expression profiles is warranted.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalCancer Research and Treatment
Volume43
Issue number4
DOIs
Publication statusPublished - 2011 Dec 1

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irinotecan
Platinum
Fluorouracil
Stomach Neoplasms
Drug Therapy
Leucovorin
docetaxel
Survival
Paclitaxel
Transcriptome
Stomach
Carcinoma
Epirubicin
taxane
Survival Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Park, Ji Soo ; Lim, Jae Yun ; Park, Seung Kyo ; Kim, Min Kyung ; Ko, Hee Sung ; Yoon, SunOch ; Kim, Jong Won ; Choi, Seung Ho ; Cho, Jae Yong. / Prognostic factors of second and third line chemotherapy using 5-FU with platinum, irinotecan, and taxane for advanced gastric cancer. In: Cancer Research and Treatment. 2011 ; Vol. 43, No. 4. pp. 236-243.
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title = "Prognostic factors of second and third line chemotherapy using 5-FU with platinum, irinotecan, and taxane for advanced gastric cancer",
abstract = "Purpose: The aims of this study are to find out whether the sequence of chemotherapeutic regimens including second- and third-line taxane and irinotecan influences the survival of patients with unresectable gastric carcinoma and to identify clinical characteristics of patients with improved response. Materials and Methods: Fifty gastric carcinoma patients who were treated by third-line sequential chemotherapy between November 2004 and July 2010 were enrolled in this study. Their overall survival (OS) and time to progression (TTP) were set up as primary and secondary end points. For the sequence of chemotherapy regimen, two arms were used. Arm A was defined as 5-fluorouracil (5-FU)+cisplatin (FP) or folinic acid, 5-FU and oxaliplati (FOLFOX), followed by folinic acid, 5-FU and irinotecan (FOLFIRI), and paclitaxel or docetaxel plus 5-FU, with or without epirubicin. Arm B was defined as FP or FOLFOX, followed by paclitaxel or docetaxel plus 5-FU, and FOLFIRI. Results: The median OS of all patients was 16.0 months (95{\%} confidence interval, 13.6 to 18.3 months), which is longer than historical control of patients who did not receive third-line chemotherapy. The sequence of second and third-line regimen, including irinotecan and taxane, did not present significant difference in OS or TTP after failure of 5-FU with platinum chemotherapy. In survival analysis of patients' clinicopathologic characteristics, poor prognosis was shown in patients with poorly differentiated histologic features, elevated serum carcinoembryonic level, and shorter TTP of first line chemotherapy. Conclusion: It is possible for patients to respond differently to chemotherapy due to differences in clinical features and underlying gene expression profiles. Development of individualized chemotherapy regimens based on gene expression profiles is warranted.",
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Prognostic factors of second and third line chemotherapy using 5-FU with platinum, irinotecan, and taxane for advanced gastric cancer. / Park, Ji Soo; Lim, Jae Yun; Park, Seung Kyo; Kim, Min Kyung; Ko, Hee Sung; Yoon, SunOch; Kim, Jong Won; Choi, Seung Ho; Cho, Jae Yong.

In: Cancer Research and Treatment, Vol. 43, No. 4, 01.12.2011, p. 236-243.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic factors of second and third line chemotherapy using 5-FU with platinum, irinotecan, and taxane for advanced gastric cancer

AU - Park, Ji Soo

AU - Lim, Jae Yun

AU - Park, Seung Kyo

AU - Kim, Min Kyung

AU - Ko, Hee Sung

AU - Yoon, SunOch

AU - Kim, Jong Won

AU - Choi, Seung Ho

AU - Cho, Jae Yong

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Purpose: The aims of this study are to find out whether the sequence of chemotherapeutic regimens including second- and third-line taxane and irinotecan influences the survival of patients with unresectable gastric carcinoma and to identify clinical characteristics of patients with improved response. Materials and Methods: Fifty gastric carcinoma patients who were treated by third-line sequential chemotherapy between November 2004 and July 2010 were enrolled in this study. Their overall survival (OS) and time to progression (TTP) were set up as primary and secondary end points. For the sequence of chemotherapy regimen, two arms were used. Arm A was defined as 5-fluorouracil (5-FU)+cisplatin (FP) or folinic acid, 5-FU and oxaliplati (FOLFOX), followed by folinic acid, 5-FU and irinotecan (FOLFIRI), and paclitaxel or docetaxel plus 5-FU, with or without epirubicin. Arm B was defined as FP or FOLFOX, followed by paclitaxel or docetaxel plus 5-FU, and FOLFIRI. Results: The median OS of all patients was 16.0 months (95% confidence interval, 13.6 to 18.3 months), which is longer than historical control of patients who did not receive third-line chemotherapy. The sequence of second and third-line regimen, including irinotecan and taxane, did not present significant difference in OS or TTP after failure of 5-FU with platinum chemotherapy. In survival analysis of patients' clinicopathologic characteristics, poor prognosis was shown in patients with poorly differentiated histologic features, elevated serum carcinoembryonic level, and shorter TTP of first line chemotherapy. Conclusion: It is possible for patients to respond differently to chemotherapy due to differences in clinical features and underlying gene expression profiles. Development of individualized chemotherapy regimens based on gene expression profiles is warranted.

AB - Purpose: The aims of this study are to find out whether the sequence of chemotherapeutic regimens including second- and third-line taxane and irinotecan influences the survival of patients with unresectable gastric carcinoma and to identify clinical characteristics of patients with improved response. Materials and Methods: Fifty gastric carcinoma patients who were treated by third-line sequential chemotherapy between November 2004 and July 2010 were enrolled in this study. Their overall survival (OS) and time to progression (TTP) were set up as primary and secondary end points. For the sequence of chemotherapy regimen, two arms were used. Arm A was defined as 5-fluorouracil (5-FU)+cisplatin (FP) or folinic acid, 5-FU and oxaliplati (FOLFOX), followed by folinic acid, 5-FU and irinotecan (FOLFIRI), and paclitaxel or docetaxel plus 5-FU, with or without epirubicin. Arm B was defined as FP or FOLFOX, followed by paclitaxel or docetaxel plus 5-FU, and FOLFIRI. Results: The median OS of all patients was 16.0 months (95% confidence interval, 13.6 to 18.3 months), which is longer than historical control of patients who did not receive third-line chemotherapy. The sequence of second and third-line regimen, including irinotecan and taxane, did not present significant difference in OS or TTP after failure of 5-FU with platinum chemotherapy. In survival analysis of patients' clinicopathologic characteristics, poor prognosis was shown in patients with poorly differentiated histologic features, elevated serum carcinoembryonic level, and shorter TTP of first line chemotherapy. Conclusion: It is possible for patients to respond differently to chemotherapy due to differences in clinical features and underlying gene expression profiles. Development of individualized chemotherapy regimens based on gene expression profiles is warranted.

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