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

Authors
 Ji Soo Park  ;  Jae Yun Lim  ;  Seung Kyo Park  ;  Min Kyung Kim  ;  Hee Sung Ko  ;  Sun Och Yoon  ;  Jong Won Kim  ;  Seung Ho Choi  ;  Jae Yong Cho 
Citation
 CANCER RESEARCH AND TREATMENT, Vol.43(4) : 236-243, 2011 
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
 1598-2998 
Issue Date
2011
Keywords
Irinotecan ; Oxaliplatin ; Prognosis ; Salvage therapy ; Stomach neoplasms ; Taxane
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.
Files in This Item:
T201104743.pdf Download
DOI
10.4143/crt.2011.43.4.236
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Won(김종원)
Park, Ji Soo(박지수) ORCID logo https://orcid.org/0000-0002-0023-7740
Yoon, Sun Och(윤선옥) ORCID logo https://orcid.org/0000-0002-5115-1402
Lim, Jae Yun(임재윤)
Cho, Jae Yong(조재용) ORCID logo https://orcid.org/0000-0002-0926-1819
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94817
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