Cancer Research and Treatment

Meta-Analysis

Irinotecan Monotherapy Versus Irinotecan-Based Combination as Second-Line Chemotherapy in Advanced Gastric Cancer: A Meta-Analysis: Yo-Han Cho, So Young Yoon, Soo-Nyung Kim; Cancer Res Treat. 2017;49(1):255-262. Published online May 18, 2016; DOI: https://doi.org/10.4143/crt.2015.452

Purpose
A meta-analysis was conducted to examine the question of whether combination regimens are more effective than monotherapy as a second-line chemotherapy in advanced gastric cancer.
Materials and Methods
The MEDLINE and the EMBASE databases and the Cochrane Central Register for Controlled Trials were searched using appropriate keywords. Only randomized controlled trials were eligible.
Results
Taxane-based study is rare; thus, four irinotecan-based studies were finally included in the meta-analysis. Out of 661 patients, 331 patients were assigned to combination therapy and 330 to monotherapy. Cisplatin or fluoropyrimidine (S-1 or 5-fluorouracil) was used as a combination partner to irinotecan. The pooled hazard ratio (HR) for overall survival (OS) and for progression-free survival (PFS) was 0.938 (95% confidence interval [CI], 0.796 to 1.104; p=0.442) and 0.815 (95% CI, 0.693 to 0.958; p=0.013). In subgroup analysis according to previous exposure to a partner agent, the PFS benefit of combination was observed only in the partially exposed group (HR, 0.784; 95% CI, 0.628 to 0.980; p=0.032).
Conclusion
Second-line irinotecan-based combination was not associated with increased OS, but with PFS benefit, which seemed particularly significant for patients receiving combination with a new agent.

Citations

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Case Report

Hepatic Metastases of Gastric Adenocarcinoma Showing Metabolic Remission on FDG-PET Despite an Increase in Size on CT: So Young Yoon, Sung-Yong Kim, Yo-Han Cho, Hyun Woo Chung, Young So, Hong M Lee; Cancer Res Treat. 2009;41(2):100-103. Published online June 30, 2009; DOI: https://doi.org/10.4143/crt.2009.41.2.100

Abstract PDF PubReader ePub

We report a gastric adenocarcinoma patient with liver metastases. The metastases showed progression on computed tomography (CT), but this was not true progression in terms of metabolic activity according to ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET). Discordance between size criteria and metabolic criteria has been reported in liver gastrointestinal stromal tumors, hepatomas, and renal cell carcinomas after dramatic responses with targeted therapies such as imatinib, sorafenib, and sunitinib (1-6). However, this discordance has been rarely reported in liver metastases of gastric adenocarcinoma when treated with conventional chemotherapy.

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