P-0025 Modified Folfiri (mFolfiri) as Second Line Chemotherapy in Advanced Gastric Cancer (AGC)

ABSTRACT Introduction This retrospective review evaluates the efficacy and safety of m FOLFIRI in patients with AGC who failed chemotherapy including both fluoropyrimidine and platinum. Methods Patients (pts) with locally advanced or metastatic disease, histologically documented AGC who failed one prior chemotherapy, ECOG PS≤2, at least 1 measurable lesion, were treated with mFOLFIRI every 2 weeks. Treatment protocol included: Irinotecan: 180 mg/m2 over 90 mn, LV: 40 mg/m2 then bolus 5FU: 400 mg/m2 Day1, followed by 2400 mg/m2 CI over 46 hours. Prior chemotherapy: EOX: 9 FOLFOX: 9; ECX: 6; LV5FU2 CDDP: 12; other: 7. Primary objectives were toxicity, PFS and OS rate. Results A total of 43 pts were treated. Median age: 59 (28-74), male: 26 (60%); ECOG 0+1: 60%; 2: 40%. Site of disease: liver in 16 (37%), peritoneal in 24 (56%); lung/pleural in 11 (26%); lymph-nodes in 11 (26 %). Isolated metastatic site in 32%, multiple sites in 68%.The main toxicities were grade 2 diarrhea (12%); grade 3 neutropenia (7%); anemia: 7%; asthenia: 7%; stroke: 1. A total of 410 cycles were administered with a median of 8 cycles (range, 2-34). One patient (2 %) achieved confirmed partial response and 34 patients (79%) showed stable disease, resulting in a disease control rate of 81%. Median PFS time was 3.6 months (95% CI: 2.1- 4.9 months); median OS time was 7.8months (95% CI: 4.2 -9.9 months). Conclusion The current mFOLFIRI showed a high PFS and OS with an acceptable toxicity profile in patients with AGC and could be a valid second line option in selected cases.