评估纳武利尤单抗三线治疗后伊立替康和替氟尿苷/替匹嘧啶作为四线治疗晚期胃癌的疗效。

Evaluation of Irinotecan and Trifluridine/Tipiracil as Fourth-line Treatments After Third-line Nivolumab for Advanced Gastric Cancer.

机构信息

Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.

Department of Gastroenterology, Yokohama City University Graduate school of Medicine, Yokohama, Japan.

出版信息

Anticancer Res. 2023 Jun;43(6):2831-2840. doi: 10.21873/anticanres.16452.

DOI:10.21873/anticanres.16452

PMID:37247885

Abstract

BACKGROUND/AIM: Irinotecan and trifluridine/tipiracil (FTD/TPI) are fourth-line treatment options after third-line nivolumab for advanced gastric cancer (AGC). However, the efficacy and safety of irinotecan and FTD/TPI in the fourth-line setting after third-line nivolumab remains unclear. This study aimed to evaluate the efficacy and safety of irinotecan and FTD/TPI in the fourth-line setting after third-line nivolumab.

PATIENTS AND METHODS

We identified 137 AGC patients treated with nivolumab as third-line treatment in our institute between October 2017 and July 2021. Of these, we recruited 19 AGC patients who initiated irinotecan and 23 AGC patients who initiated FTD/TPI in the fourth-line setting until September 2021.

RESULTS

The median overall survival was 5.83 months for irinotecan and 6.31 months for FTD/TPI. Median time-to-treatment failure was 2.07 months for irinotecan and 1.64 months for FTD/TPI. While the frequency of all-grade diarrhea was higher in irinotecan (36% vs. 17%), grade ≥3 neutropenia tended to be higher in FTD/TPI (21% vs. 35%).

CONCLUSION

Irinotecan and FTD/TPI may be clinically useful as fourth-line treatments after nivolumab.

摘要

背景/目的：伊利替康和替氟尿苷/盐酸替匹嘧啶（FTD/TPI）是三线纳武利尤单抗治疗晚期胃癌（AGC）后的四线治疗选择。然而，三线纳武利尤单抗后四线应用伊利替康和 FTD/TPI 的疗效和安全性尚不清楚。本研究旨在评估三线纳武利尤单抗后四线应用伊利替康和 FTD/TPI 的疗效和安全性。

患者和方法

我们在 2017 年 10 月至 2021 年 7 月期间确定了在我院接受纳武利尤单抗作为三线治疗的 137 例 AGC 患者。其中，我们招募了 19 例在四线应用伊利替康和 23 例在四线应用 FTD/TPI 的 AGC 患者。

结果

伊利替康的中位总生存期为 5.83 个月，FTD/TPI 的中位总生存期为 6.31 个月。伊利替康的中位治疗失败时间为 2.07 个月，FTD/TPI 的中位治疗失败时间为 1.64 个月。虽然伊利替康的全级别腹泻发生率更高（36%比 17%），但 FTD/TPI 的≥3 级中性粒细胞减少症发生率较高（21%比 35%）。