FOLFIRI regimen as second-line treatment of metastatic gastric cancer: a retrospective analysis of efficacy, safety and prognostic factors

Abstract

Background: There is no standard second-line treatment for mGC. FOLFIRI has shown efficacy and safety in this setting. Methods: Retrospective study of patients with mGC treated with FOLFIRI as a second line. We evaluated the response rate (RR), clinical benefit rate (CBR), progression-free survival (PFS), OS and toxicity. Results: Sixty-six patients were included. Among evaluable patients there was an overall response rate of 20% and stable disease in 34%. Median PFS was 3 months and median OS 6 months. The number of metastatic sites was found to be a prognostic factor for PFS (HR 2.23; p=0.005) and OS (HR 2.71; p<0.001). PFS in the first line was a prognostic factor for OS (HR 1.71; p=0.045), but not for PFS (HR 1.37; p=0.226). PFS in the first line <7 months and ≥2 metastatic sites were identified as poor prognostic factors. We defined two prognostic groups, with patients in the poor prognostic group having worse PFS (HR 2.08; p=0.030) and OS (HR 2.97; p=0.003). The most common grade 3-4 toxicity was neutropenia 27%. Conclusions: FOLFIRI is effective and well-tolerated as a second-line treatment in mGC. The number of metastatic sites and PFS in the first line are prognostic factors in this group of patients.