A phase II study of irinotecan with 5-fluorouracil and leucovorin in patients with previously untreated gastric adenocarcinoma

C. D. Blanke*, D. G. Haller, A. B. Benson, M. L. Rothenberg, J. Berlin, M. Mori, Y. Ch Hsieh, L. L. Miller

*Corresponding author for this work

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

Background: A phase II study testing the safety and efficacy of irinotecan (CPT-11), 5-fluorouracil (5-FU), and leucovorin (LCV) was conducted in patients with advanced gastric adenocarcinomas. Patients and methods: Patients with metastatic or recurrent adenocarcinoma of the gastroesophageal junction (GEJ) or stomach were entered onto this study. Previous chemotherapy for metastatic disease was not allowed. Treatment consisted of repeated 6-week cycles comprising CPT-11 125 mg/m2 intravenously (i.v.) followed immediately by LCV 20 mg/m2 i.v. and 5-FU 500 mg/m2 i.v., all given weekly for four weeks followed by a two-week rest. Results: Thirty-eight patients were enrolled and 36 eligible patients received protocol therapy. Grade 3-5 toxicities consisted primarily of neutropenia (36%) and diarrhea (28%). Neutropenic infection was observed in 14% of patients, with 3 (8%) dying of neutropenic sepsis. The overall response rate was 22% (95% confidence interval [CI] 8.5% to 35.5%). Median survival was 7.6 months, and median time to progression was 4.4 months. Conclusion: This weekly regimen of CPT-11 with bolus 5-FU/LCV is active in patients with advanced adenocarcinomas of the stomach or gastroesophageal junction. While rates of grade 3-4 neutropenia and diarrhea were similar to those observed historically in patients receiving this regimen for colorectal cancer, neutropenic fever/sepsis appeared to be more frequent, and dose modifications were substantial. Future trials of this combination in patients with gastric cancer should decrease the absolute starting drug doses and/or employ altered scheduling that better accommodates the pattern of toxicity.

Original languageEnglish (US)
Pages (from-to)1575-1580
Number of pages6
JournalAnnals of Oncology
Volume12
Issue number11
DOIs
StatePublished - Dec 1 2001

Keywords

  • 5-fluoruracil
  • Gastric cancer
  • Irinotecan
  • Leucovorin

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Blanke, C. D., Haller, D. G., Benson, A. B., Rothenberg, M. L., Berlin, J., Mori, M., Hsieh, Y. C., & Miller, L. L. (2001). A phase II study of irinotecan with 5-fluorouracil and leucovorin in patients with previously untreated gastric adenocarcinoma. Annals of Oncology, 12(11), 1575-1580. https://doi.org/10.1023/A:1013129315036