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A fluorocuracil-based first-line chemotherapy regimen demonstrated acceptable response and survival outcomes and was less toxic and better tolerated than an epirubicin-based regimen for patients with advanced gastric cancers, Dr. Rosine Guimbaud and her colleagues reported in the October issue of the Journal of Clinical Oncology.
In a trial, conducted at 71 centers in France, 416 patients with advanced or metastatic gastric adenocarcinomas were randomized to receive fluorouracil, leucovorin, and irinotecan (FOLFIRI) or epirubicin, cisplatin, and capecitabine (ECX). After a median follow-up of 31 months, the median time to treatment failure was significantly longer with FOLFIRI than with ECX (5.1 vs. 4.2 months; P = .008), though there was no significant difference between the two groups in median progression-free or overall survival.
The rate of grade 3-4 toxicity was signficantly lower with FOLFIRI (69% vs. 84%; P less than .001), Toxicity leading to discontinuation occurred in 4% of the FOLFIRI group and 14.5% of the ECX group. Toxicity-related deaths occurred in two patients taking FOLFIRI and seven taking ECX.
The findings of the trial support retiring the use of the epirubicin-based regimen for patients with advanced gastric cancers, wrote Dr. Guimbaud of the Centre Hospitalier Universitaire de Toulouse (France) and her coauthors (J. Clin. Oncol. 2014 [doi:10.1200/JCO.2013.54.1011]).
“The utility of epirubicin is called into question; many continue to debate whether anthracyclines should be used for therapy, given their toxicity. Our results support abandoning their use,” they said.
Dr. Guimbaud disclosed financial ties with Roche; many of the coauthors also disclosed relationships with Roche and other pharmaceutical companies.
On Twitter @alz_gal
A fluorocuracil-based first-line chemotherapy regimen demonstrated acceptable response and survival outcomes and was less toxic and better tolerated than an epirubicin-based regimen for patients with advanced gastric cancers, Dr. Rosine Guimbaud and her colleagues reported in the October issue of the Journal of Clinical Oncology.
In a trial, conducted at 71 centers in France, 416 patients with advanced or metastatic gastric adenocarcinomas were randomized to receive fluorouracil, leucovorin, and irinotecan (FOLFIRI) or epirubicin, cisplatin, and capecitabine (ECX). After a median follow-up of 31 months, the median time to treatment failure was significantly longer with FOLFIRI than with ECX (5.1 vs. 4.2 months; P = .008), though there was no significant difference between the two groups in median progression-free or overall survival.
The rate of grade 3-4 toxicity was signficantly lower with FOLFIRI (69% vs. 84%; P less than .001), Toxicity leading to discontinuation occurred in 4% of the FOLFIRI group and 14.5% of the ECX group. Toxicity-related deaths occurred in two patients taking FOLFIRI and seven taking ECX.
The findings of the trial support retiring the use of the epirubicin-based regimen for patients with advanced gastric cancers, wrote Dr. Guimbaud of the Centre Hospitalier Universitaire de Toulouse (France) and her coauthors (J. Clin. Oncol. 2014 [doi:10.1200/JCO.2013.54.1011]).
“The utility of epirubicin is called into question; many continue to debate whether anthracyclines should be used for therapy, given their toxicity. Our results support abandoning their use,” they said.
Dr. Guimbaud disclosed financial ties with Roche; many of the coauthors also disclosed relationships with Roche and other pharmaceutical companies.
On Twitter @alz_gal
A fluorocuracil-based first-line chemotherapy regimen demonstrated acceptable response and survival outcomes and was less toxic and better tolerated than an epirubicin-based regimen for patients with advanced gastric cancers, Dr. Rosine Guimbaud and her colleagues reported in the October issue of the Journal of Clinical Oncology.
In a trial, conducted at 71 centers in France, 416 patients with advanced or metastatic gastric adenocarcinomas were randomized to receive fluorouracil, leucovorin, and irinotecan (FOLFIRI) or epirubicin, cisplatin, and capecitabine (ECX). After a median follow-up of 31 months, the median time to treatment failure was significantly longer with FOLFIRI than with ECX (5.1 vs. 4.2 months; P = .008), though there was no significant difference between the two groups in median progression-free or overall survival.
The rate of grade 3-4 toxicity was signficantly lower with FOLFIRI (69% vs. 84%; P less than .001), Toxicity leading to discontinuation occurred in 4% of the FOLFIRI group and 14.5% of the ECX group. Toxicity-related deaths occurred in two patients taking FOLFIRI and seven taking ECX.
The findings of the trial support retiring the use of the epirubicin-based regimen for patients with advanced gastric cancers, wrote Dr. Guimbaud of the Centre Hospitalier Universitaire de Toulouse (France) and her coauthors (J. Clin. Oncol. 2014 [doi:10.1200/JCO.2013.54.1011]).
“The utility of epirubicin is called into question; many continue to debate whether anthracyclines should be used for therapy, given their toxicity. Our results support abandoning their use,” they said.
Dr. Guimbaud disclosed financial ties with Roche; many of the coauthors also disclosed relationships with Roche and other pharmaceutical companies.
On Twitter @alz_gal
FROM THE JOURNAL OF CLINICAL ONCOLOGY
Key clinical point: A fluorocuracil-based first-line chemotherapy regimen demonstrated acceptable response and survival outcomes and was less toxic and better tolerated than an epirubicin-based regimen for patients with advanced gastric cancers.
Major finding: The median time to treatment failure was significantly longer in the fluorouracil arm than in the epirubicin arm (5.1 vs. 4.2 months).
Data source: A randomized controlled trial involving 416 patients.
Disclosures: Dr. Guimbaud declared financial relationships wit Roche. Many coauthors had relationships with multiple pharmaceutical companies.