Skip to main content
Top
Published in: Cancer Chemotherapy and Pharmacology 3/2009

01-02-2009 | Original Article

Treatment outcomes of oxaliplatin, 5-FU, and leucovorin as salvage therapy for patients with advanced or metastatic gastric cancer: a retrospective analysis

Authors: Hee Yeon Seo, Dae Sik Kim, Yoon Seok Choi, Hwa Jung Sung, Kyong Hwa Park, In Keun Choi, Seok Jin Kim, Sang Cheul Oh, Jae Hong Seo, Chul Won Choi, Byung Soo Kim, Sang Won Shin, Yeul Hong Kim, Jun Suk Kim

Published in: Cancer Chemotherapy and Pharmacology | Issue 3/2009

Login to get access

Abstract

Purpose

We performed a single-institution retrospective study to evaluate the efficacy and toxicities of oxaliplatin, 5-fluorouracil (5-FU), leucovorin (LV) combination chemotherapy as salvage treatment in patients with metastatic or advanced gastric cancer.

Methods

Sixty-two patients with advanced gastric cancer previously treated were eligible for the study. Patients received oxaliplatin 100 mg/m2 and LV 100 mg/m2 (2-h intravenous infusion) followed by 5-FU 2,400 mg/m2 (46-h continuous infusion) every 2 weeks, and responses were assessed after every three cycles.

Results

Fifty-nine out of 62 patients were assessable for response. Among them, 46 patients had previously been treated with cisplatin based chemotherapy. Patients had a median age of 57 years (range 32–76 years), 72.6% had an Eastern Cooperative Oncology Group performance status of 0 or 1. Total 296 courses of chemotherapy were administered as second-line (67.7%) or third-line (27.4%), and the median courses per patient was three cycles. Out of 59 evaluable patients, 14 partial responses were observed (overall response rate, 22.6%). Stable disease was observed in 22 patients (35.5%), and progressive disease in 23 patients (37.1%). The median response duration, time to progression, and overall survival were 2.3, 3.0, and 8.0 months, respectively. The major toxicities were neutropenia, mucositis, and peripheral neuropathy. Grade 3 or 4 hematologic toxicities included neutropenia in nine patients (14.5%) and thrombocytopenia in one patient (1.6%). Other grade 3 or 4 toxicities included mucositis in one patient (1.6%) and vomiting in two patients (3.2%). Grade 1 or 2 peripheral neuropathy were observed in 18 patients (29.0%), however there were no cases of grade 3 or 4 peripheral neuropathy and no treatment-related deaths.

Conclusion

The combination of oxaliplatin, 5-FU and LV was effective and safe salvage chemotherapy in advanced gastric cancer patients.
Literature
1.
go back to reference Shin HR, Won YJ, Jung KW et al (2005) Nationwide cancer incidence in Korea, 1999–2001; first result using the national cancer incidence database. Cancer Res Treat 37:325–331CrossRef Shin HR, Won YJ, Jung KW et al (2005) Nationwide cancer incidence in Korea, 1999–2001; first result using the national cancer incidence database. Cancer Res Treat 37:325–331CrossRef
2.
go back to reference Epelbaum R, Haim N, Stein M, Cohen Y, Robinson E (1987) Treatment of advanced gastric cancer with DDP (cisplatin), adriamycin, and 5-fluorouracil (DAF). Oncology 44:201–206PubMedCrossRef Epelbaum R, Haim N, Stein M, Cohen Y, Robinson E (1987) Treatment of advanced gastric cancer with DDP (cisplatin), adriamycin, and 5-fluorouracil (DAF). Oncology 44:201–206PubMedCrossRef
3.
go back to reference Lopez M, Di Lauro L, Papaldo P, Conti EM (1986) Treatment of advanced measurable gastric carcinoma with 5-fluorouracil, adriamycin, and BCNU. Oncology 43:288–291PubMed Lopez M, Di Lauro L, Papaldo P, Conti EM (1986) Treatment of advanced measurable gastric carcinoma with 5-fluorouracil, adriamycin, and BCNU. Oncology 43:288–291PubMed
4.
go back to reference Becouarn Y, Agostini C, Trufflandier N, Boulanger V (2001) Oxaliplatin: available data in non-colorectal gastrointestinal malignancies. Crit Rev Oncol Hematol 40:265–272PubMedCrossRef Becouarn Y, Agostini C, Trufflandier N, Boulanger V (2001) Oxaliplatin: available data in non-colorectal gastrointestinal malignancies. Crit Rev Oncol Hematol 40:265–272PubMedCrossRef
5.
go back to reference Raymond E, Faivre S, Woynarowski JM, Chaney SG (1998) Oxaliplatin: mechanism of action and antineoplastic activity. Semin Oncol 25:4–12PubMed Raymond E, Faivre S, Woynarowski JM, Chaney SG (1998) Oxaliplatin: mechanism of action and antineoplastic activity. Semin Oncol 25:4–12PubMed
6.
go back to reference Kollmannsberger C, Rick O, Derigs HG et al (2002) Activity of oxaliplatin in patients with relapsed or cisplatin-refractory germ cell cancer: a study of the German Testicular Cancer Study Group. J Clin Oncol 20:2031–2037PubMedCrossRef Kollmannsberger C, Rick O, Derigs HG et al (2002) Activity of oxaliplatin in patients with relapsed or cisplatin-refractory germ cell cancer: a study of the German Testicular Cancer Study Group. J Clin Oncol 20:2031–2037PubMedCrossRef
7.
go back to reference Extra JM, Espie M, Calvo F, Ferme C, Mignot L, Marty M (1990) Phase I study of oxaliplatin in patients with advanced cancer. Cancer Chemother Pharmacol 25:299–303PubMedCrossRef Extra JM, Espie M, Calvo F, Ferme C, Mignot L, Marty M (1990) Phase I study of oxaliplatin in patients with advanced cancer. Cancer Chemother Pharmacol 25:299–303PubMedCrossRef
8.
go back to reference Degardin M, Cappelaere P, Krakowski I, Fargeot P, Cupissol D, Brienza S (1996) Phase II trial of oxaliplatin (L-OHP) in advanced, recurrent and/or metastatic squamous cell carcinoma of the head and neck. Eur J Cancer B Oral Oncol 32B:278–279PubMedCrossRef Degardin M, Cappelaere P, Krakowski I, Fargeot P, Cupissol D, Brienza S (1996) Phase II trial of oxaliplatin (L-OHP) in advanced, recurrent and/or metastatic squamous cell carcinoma of the head and neck. Eur J Cancer B Oral Oncol 32B:278–279PubMedCrossRef
9.
go back to reference Louvet C, Andre T, Lledo G et al (2002) Gemcitabine combined with oxaliplatin in advanced pancreatic adenocarcinoma: final results of a GERCOR multicenter phase II study. J Clin Oncol 20:1512–1518PubMedCrossRef Louvet C, Andre T, Lledo G et al (2002) Gemcitabine combined with oxaliplatin in advanced pancreatic adenocarcinoma: final results of a GERCOR multicenter phase II study. J Clin Oncol 20:1512–1518PubMedCrossRef
10.
go back to reference Monnet I, Brienza S, Hugret F et al (1998) Phase II study of oxaliplatin in poor-prognosis non-small cell lung cancer (NSCLC). ATTIT. Association pour le Traitement des Tumeurs Intra Thoraciques. Eur J Cancer 34:1124–1127PubMedCrossRef Monnet I, Brienza S, Hugret F et al (1998) Phase II study of oxaliplatin in poor-prognosis non-small cell lung cancer (NSCLC). ATTIT. Association pour le Traitement des Tumeurs Intra Thoraciques. Eur J Cancer 34:1124–1127PubMedCrossRef
11.
go back to reference Andre T, Bensmaine MA, Louvet C et al (1999) Multicenter phase II study of bimonthly high-dose leucovorin, fluorouracil infusion, and oxaliplatin for metastatic colorectal cancer resistant to the same leucovorin and fluorouracil regimen. J Clin Oncol 17:3560–3568PubMed Andre T, Bensmaine MA, Louvet C et al (1999) Multicenter phase II study of bimonthly high-dose leucovorin, fluorouracil infusion, and oxaliplatin for metastatic colorectal cancer resistant to the same leucovorin and fluorouracil regimen. J Clin Oncol 17:3560–3568PubMed
12.
go back to reference Raymond E, Buquet-Fagot C, Djelloul S et al (1997) Antitumor activity of oxaliplatin in combination with 5-fluorouracil and the thymidylate synthase inhibitor AG337 in human colon, breast and ovarian cancers. Anticancer Drugs 8:876–885PubMedCrossRef Raymond E, Buquet-Fagot C, Djelloul S et al (1997) Antitumor activity of oxaliplatin in combination with 5-fluorouracil and the thymidylate synthase inhibitor AG337 in human colon, breast and ovarian cancers. Anticancer Drugs 8:876–885PubMedCrossRef
13.
go back to reference Al-Batran SE, Atmaca A, Hegewisch-Becker S et al (2004) Phase II trial of biweekly infusional fluorouracil, folinic acid, and oxaliplatin in patients with advanced gastric cancer. J Clin Oncol 22:658–663PubMedCrossRef Al-Batran SE, Atmaca A, Hegewisch-Becker S et al (2004) Phase II trial of biweekly infusional fluorouracil, folinic acid, and oxaliplatin in patients with advanced gastric cancer. J Clin Oncol 22:658–663PubMedCrossRef
14.
go back to reference Cavanna L, Artioli F, Codignola C et al (2006) Oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic gastric cancer (MGC). Am J Clin Oncol 29:371–375PubMedCrossRef Cavanna L, Artioli F, Codignola C et al (2006) Oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic gastric cancer (MGC). Am J Clin Oncol 29:371–375PubMedCrossRef
15.
go back to reference De Vita F, Orditura M, Matano E et al (2005) A phase II study of biweekly oxaliplatin plus infusional 5-fluorouracil and folinic acid (FOLFOX-4) as first-line treatment of advanced gastric cancer patients. Br J Cancer 92:1644–1649PubMedCrossRef De Vita F, Orditura M, Matano E et al (2005) A phase II study of biweekly oxaliplatin plus infusional 5-fluorouracil and folinic acid (FOLFOX-4) as first-line treatment of advanced gastric cancer patients. Br J Cancer 92:1644–1649PubMedCrossRef
16.
go back to reference Lordick F, Lorenzen S, Stollfuss J et al (2005) Phase II study of weekly oxaliplatin plus infusional fluorouracil and folinic acid (FUFOX regimen) as first-line treatment in metastatic gastric cancer. Br J Cancer 93:190–194PubMedCrossRef Lordick F, Lorenzen S, Stollfuss J et al (2005) Phase II study of weekly oxaliplatin plus infusional fluorouracil and folinic acid (FUFOX regimen) as first-line treatment in metastatic gastric cancer. Br J Cancer 93:190–194PubMedCrossRef
17.
go back to reference Louvet C, Andre T, Tigaud JM et al (2002) Phase II study of oxaliplatin, fluorouracil, and folinic acid in locally advanced or metastatic gastric cancer patients. J Clin Oncol 20:4543–4548PubMedCrossRef Louvet C, Andre T, Tigaud JM et al (2002) Phase II study of oxaliplatin, fluorouracil, and folinic acid in locally advanced or metastatic gastric cancer patients. J Clin Oncol 20:4543–4548PubMedCrossRef
18.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef
19.
go back to reference Levi F, Misset JL, Brienza S et al (1992) A chronopharmacologic phase II clinical trial with 5-fluorouracil, folinic acid, and oxaliplatin using an ambulatory multichannel programmable pump. High antitumor effectiveness against metastatic colorectal cancer. Cancer 69:893–900PubMedCrossRef Levi F, Misset JL, Brienza S et al (1992) A chronopharmacologic phase II clinical trial with 5-fluorouracil, folinic acid, and oxaliplatin using an ambulatory multichannel programmable pump. High antitumor effectiveness against metastatic colorectal cancer. Cancer 69:893–900PubMedCrossRef
20.
go back to reference Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMed Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMed
21.
go back to reference Glimelius B, Ekstrom K, Hoffman K et al (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168PubMedCrossRef Glimelius B, Ekstrom K, Hoffman K et al (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168PubMedCrossRef
22.
go back to reference Kim DY, Kim JH, Lee SH et al (2003) Phase II study of oxaliplatin, 5-fluorouracil and leucovorin in previously platinum-treated patients with advanced gastric cancer. Ann Oncol 14:383–387PubMedCrossRef Kim DY, Kim JH, Lee SH et al (2003) Phase II study of oxaliplatin, 5-fluorouracil and leucovorin in previously platinum-treated patients with advanced gastric cancer. Ann Oncol 14:383–387PubMedCrossRef
23.
go back to reference Chao Y, Yeh KH, Chang CJ et al (2004) Phase II study of weekly oxaliplatin and 24-h infusion of high-dose 5-fluorouracil and folinic acid in the treatment of advanced gastric cancer. Br J Cancer 91:453–458PubMedCrossRef Chao Y, Yeh KH, Chang CJ et al (2004) Phase II study of weekly oxaliplatin and 24-h infusion of high-dose 5-fluorouracil and folinic acid in the treatment of advanced gastric cancer. Br J Cancer 91:453–458PubMedCrossRef
24.
go back to reference Oh SY, Kwon HC, Seo BG, Kim SH, Kim JS, Kim HJ (2007) A phase II study of oxaliplatin with low dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFOX-4) as first line therapy for patients with advanced gastric cancer. Acta Oncol 46:336–341PubMedCrossRef Oh SY, Kwon HC, Seo BG, Kim SH, Kim JS, Kim HJ (2007) A phase II study of oxaliplatin with low dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFOX-4) as first line therapy for patients with advanced gastric cancer. Acta Oncol 46:336–341PubMedCrossRef
25.
go back to reference Kim SG, Oh SY, Kwon HC et al (2007) A phase II study of irinotecan with bi-weekly, low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFIRI) as salvage therapy for patients with advanced or metastatic gastric cancer. Jpn J Clin Oncol 37:744–749PubMedCrossRef Kim SG, Oh SY, Kwon HC et al (2007) A phase II study of irinotecan with bi-weekly, low-dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFIRI) as salvage therapy for patients with advanced or metastatic gastric cancer. Jpn J Clin Oncol 37:744–749PubMedCrossRef
26.
go back to reference Ueda S, Hironaka S, Boku N, Fukutomi A, Yoshino T, Onozawa Y (2006) Combination chemotherapy with irinotecan and cisplatin in pretreated patients with unresectable or recurrent gastric cancer. Gastric Cancer 9:203–207PubMedCrossRef Ueda S, Hironaka S, Boku N, Fukutomi A, Yoshino T, Onozawa Y (2006) Combination chemotherapy with irinotecan and cisplatin in pretreated patients with unresectable or recurrent gastric cancer. Gastric Cancer 9:203–207PubMedCrossRef
27.
go back to reference Park SH, Choi EY, Bang SM et al (2005) Salvage chemotherapy with irinotecan and cisplatin in patients with metastatic gastric cancer failing both 5-fluorouracil and taxanes. Anticancer Drugs 16:621–625PubMedCrossRef Park SH, Choi EY, Bang SM et al (2005) Salvage chemotherapy with irinotecan and cisplatin in patients with metastatic gastric cancer failing both 5-fluorouracil and taxanes. Anticancer Drugs 16:621–625PubMedCrossRef
28.
go back to reference Kim ST, Kang WK, Kang JH et al (2005) Salvage chemotherapy with irinotecan, 5-fluorouracil and leucovorin for taxane- and cisplatin-refractory, metastatic gastric cancer. Br J Cancer 92:1850–1854PubMedCrossRef Kim ST, Kang WK, Kang JH et al (2005) Salvage chemotherapy with irinotecan, 5-fluorouracil and leucovorin for taxane- and cisplatin-refractory, metastatic gastric cancer. Br J Cancer 92:1850–1854PubMedCrossRef
29.
go back to reference Lee JL, Ryu MH, Chang HM et al (2008) A phase II study of docetaxel as salvage chemotherapy in advanced gastric cancer after failure of fluoropyrimidine and platinum combination chemotherapy. Cancer Chemother Pharmacol 61:631–637PubMedCrossRef Lee JL, Ryu MH, Chang HM et al (2008) A phase II study of docetaxel as salvage chemotherapy in advanced gastric cancer after failure of fluoropyrimidine and platinum combination chemotherapy. Cancer Chemother Pharmacol 61:631–637PubMedCrossRef
Metadata
Title
Treatment outcomes of oxaliplatin, 5-FU, and leucovorin as salvage therapy for patients with advanced or metastatic gastric cancer: a retrospective analysis
Authors
Hee Yeon Seo
Dae Sik Kim
Yoon Seok Choi
Hwa Jung Sung
Kyong Hwa Park
In Keun Choi
Seok Jin Kim
Sang Cheul Oh
Jae Hong Seo
Chul Won Choi
Byung Soo Kim
Sang Won Shin
Yeul Hong Kim
Jun Suk Kim
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Cancer Chemotherapy and Pharmacology / Issue 3/2009
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-008-0753-3

Other articles of this Issue 3/2009

Cancer Chemotherapy and Pharmacology 3/2009 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine