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Oxaliplatin, 5-fluorouracil, and leuvocorin and (FOLFOX-4) combination chemotherapy as salvage treatment in pretreated patients with advanced gastric cancer (AGC)

Oxaliplatin, 5-fluorouracil, and leuvocorin and (FOLFOX-4) combination chemotherapy as salvage treatment in pretreated patients with advanced gastric cancer (AGC)

Journal of Clinical Oncology 26(15_suppl): 4577-4577

NlmCategory="UNASSIGNED">4577 Background: FOLFOX-4 combination chemotherapy has demonstrated activity against AGC. This study was designed to determine the effectiveness and tolerance of the FOLFOX-4 when used as a salvage treatment in patients with AGC who failed after prior fluoropyrimidine and platinum-containing regimens. AGC patients with an ECOG performance status of 0-1, progressive after prior treatments with both fluoropyrimidine and platinum, were registered onto this trial. Oxaliplatin was administered on day 1 at the dose of 85 mg/m2 as a 2-hour infusion, concurrently with leucovorin 200 mg/m2/day, followed by bolus 5-fluorouracil (FU) 400 mg/m2 and a 22-hour infusion of FU 600 mg/m2 for 2 consecutive days. The treatment was repeated every 2 weeks until disease progression or unacceptable toxicity occurred, or until a patient chose to discontinue treatment. In a total of 42 patients registered, all were previously treated either with a FU and cisplatin combination, or with a cisplatin-based regimen followed by second-line chemotherapy containing fluoropyrimidines. A total of 217 chemotherapy cycles were delivered (median 4, range 1-18). The patients' median age was 57 years (range 32-75) and 32 (76%) had tumor-related symptoms (performance status of 1). Eight patients (19%) achieved an objective response (1 CR, 7 PRs) which maintained for a median of 3 months. Thirteen additional patients achieved stable disease. The median progression-free survival was 3.9 months (95% CI 2.2-5.6) and the overall survival was 5.8 months (95% CI 5.0-6.6). Major toxic effects included nausea, diarrhea and peripheral neuropathy. Although there was one possible treatment-related death, toxicity profiles were generally predictable and manageable. Salvage chemotherapy with FOLFOX-4 is an active and well tolerated regimen for heavily pretreated patients with AGC. No significant financial relationships to disclose.

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Accession: 058488020

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PMID: 27948662

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