简化的FOLFIRI方案用于转移性胃癌预处理患者。

Simplified FOLFIRI in pre-treated patients with metastatic gastric cancer.

作者信息

Lorizzo Katia, Fazio Nicola, Radice Davide, Boselli Sabrina, Ariu Leonardo, Zampino Maria Giulia, Nolè Franco, Magni Elena, Ardito Raffaele, Minchella Ida, Rocca Andrea, Di Meglio Giovanni, Squadroni Michela, de Braud Filippo

机构信息

Department of Medical Oncology, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.

出版信息

Cancer Chemother Pharmacol. 2009 Jul;64(2):301-6. doi: 10.1007/s00280-008-0871-y. Epub 2008 Nov 26.

DOI:10.1007/s00280-008-0871-y

PMID:19034450

Abstract

PURPOSE

Second-line chemotherapy in patients with metastatic gastric cancer (MGC) pre-treated with cisplatin is not a standard option. We studied a combination of irinotecan, fluorouracil and folates.

METHODS

Patients progressive to cisplatin-based chemotherapy were enrolled. Irinotecan 180 mg/m(2), folinic acid 200 mg/m(2), and fluorouracil 400 mg/m(2) were given on day 1, immediately followed by fluorouracil 2,400 mg/m(2) 46 h continuous infusion (simplified FOLFIRI), every 2 weeks.

RESULTS

Between June 2002 and May 2003, 28 patients were treated. Median age was 57 years (range 38-68). Most patients had a distal primary (90%), and metastatic disease (71%). Partial response was obtained in six patients (21%, 95% CI 8-41) and stable disease in eight (21%, 95% CI 13-41). Among the six responsive patients three were refractory to docetaxel. At a median follow-up of 2.9 years median time to progression was 4 months (95% CI: 2-5), and median overall survival was 5 months (95% CI 4-9). Toxicity was mild, without treatment-related deaths or life-treating adverse events.

CONCLUSIONS

Simplified FOLFIRI was moderately active and well tolerated in unselected patients with MGC pre-treated with cisplatin-based chemotherapy. Its role in patients refractory to taxanes is promising and warrants further investigation.

摘要

目的

对于接受过顺铂预处理的转移性胃癌（MGC）患者，二线化疗并非标准选择。我们研究了伊立替康、氟尿嘧啶和叶酸的联合用药方案。

方法

纳入对基于顺铂的化疗方案产生进展的患者。在第1天给予伊立替康180mg/m²、亚叶酸钙200mg/m²和氟尿嘧啶400mg/m²，随后立即给予氟尿嘧啶2400mg/m²持续46小时静脉滴注（简化FOLFIRI方案），每2周重复一次。

结果

2002年6月至2003年5月期间，共治疗了28例患者。中位年龄为57岁（范围38 - 68岁）。大多数患者为远端原发性肿瘤（90%），且伴有转移性疾病（71%）。6例患者获得部分缓解（21%，95%CI 8 - 41），8例病情稳定（21%，95%CI 13 - 41）。在6例有反应的患者中，3例对多西他赛耐药。中位随访2.9年，中位疾病进展时间为4个月（95%CI：2 - 5），中位总生存期为5个月（95%CI 4 - 9）。毒性反应较轻，未出现与治疗相关的死亡或危及生命的不良事件。