Evaluation of Irinotecan and Trifluridine/Tipiracil as Fourth-line Treatments After Third-line Nivolumab for Advanced Gastric Cancer

• Published in: Anticancer research Vol. 43; no. 6; pp. 2831 - 2840
• Main Authors: Hayashi, Kei, Furuta, Mitsuhiro, Furusawa, Kyoko, Hamaguchi, Tomomi, Watanabe, Mamoru, Inokuchi, Yasuhiro, Onuma, Shizune, Hashimoto, Itaru, Suematsu, Hideaki, Nagasawa, Shinsuke, Kanematsu, Kyohei, Yamada, Takanobu, Notsu, Akifumi, Ogata, Takashi, Oshima, Takashi, Machida, Nozomu, Furuse, Junji, Maeda, Shin
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.06.2023
• Subjects: Cancer; Diarrhea; Effectiveness; Frontotemporal dementia; Gastric cancer; Irinotecan; Neutropenia; Safety; irinotecan; nivolumab; Gastric cancer; trifluridine/tipiracil
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.16452

Irinotecan and trifluridine/tipiracil (FTD/TPI) are fourth-line treatment options after third-line nivolumab for advanced gastric cancer (AGC). However, the efficacy and safety of irinotecan and FTD/TPI in the fourth-line setting after third-line nivolumab remains unclear. This study aimed to evaluate the efficacy and safety of irinotecan and FTD/TPI in the fourth-line setting after third-line nivolumab. We identified 137 AGC patients treated with nivolumab as third-line treatment in our institute between October 2017 and July 2021. Of these, we recruited 19 AGC patients who initiated irinotecan and 23 AGC patients who initiated FTD/TPI in the fourth-line setting until September 2021. The median overall survival was 5.83 months for irinotecan and 6.31 months for FTD/TPI. Median time-to-treatment failure was 2.07 months for irinotecan and 1.64 months for FTD/TPI. While the frequency of all-grade diarrhea was higher in irinotecan (36% vs. 17%), grade ≥3 neutropenia tended to be higher in FTD/TPI (21% vs. 35%). Irinotecan and FTD/TPI may be clinically useful as fourth-line treatments after nivolumab.