Second-line treatment of metastatic gastric cancer: Current options and future directions

Table 1 Phase II studies on second-line therapy (Monotherapy) in metastatic gastric cancer

II line agent	Total/eval pts	Performance status, n	Doses(mg/m2)	TreatmentORR	MedianTTP (mo)	MedianPFS(mo)	MedianOS (mo)	Toxicity,grade3-4 (%)	Ref.
Irinotecan	37/35	ECOG 0/1 - 3/34	Iri - 125 d1 weekly × 4 wk, q42	20.0%	2.6	NR	5.2	A/L/N/T/N-E/D/FN/I - 56.8/45.9/67.6/8.1/ 18.9/18.9/16.2/8.1	Chun et al[19], 2004
Irinotecan	39/30	ECOG 0/1/2 - 18/10/2	Iri - 100 d1,d8,d15 q28	15.3%	2.9	NR	8.8	A/N/Leu/Ano/D/F/- 13/30/17/23/17/13	Mochizuki et al[20], 2013
Paclitaxel	36/36	ECOG 0/1/2 - 7/20/9	Ptx - 225 d1 q21	22.2%	5.0	NR	8.0	L/T - 17/17	Cascinu et al[21], 1998
Paclitaxel	38/25	ECOG 0/1/2 - 12/15/11	Ptx - 80 d1, 8, 15 q28	24.0%	2.1	NR	5.0	L/N/T/Nau/Ano/D/ Neu - 29/32/8/3/3/3/6	Hironaka et al[22], 2006
Paclitaxel	45/44	ECOG 0/1/2 - 26/13/6	Ptx - 80 d1, 8, 15 q28	16.0%	NR	2.6	7.8	A/N/L/D/N-E/As/Neu - 11/16/18/2/4/11/2	Kodera et al[23], 2007
Docetaxel	30/29	KPS Median 70 (R 60-100%)	Dtx - 100 d1 q21	17.0%	NR	NR	6.0	A/L/N - 7/7/18	Giuliani et al[24], 2003
Docetaxel	154/86	ECOG 0-1/2 - 130/24	Dtx - 75 d1 q21	14.0%	2.6	NR	7.2	A/N/FN/As - 10.5/12.5/9.9/13.6	1Jo et al[25], 2007
Docetaxel	49/49	ECOG 0/1/2 - 9/36/4	Dtx - 75 d1 q21	16.5%	2.5	NR	8.3	A/L/N/FN/B/As/D/Neu - 5.4/4.8/5.4/5.4/1.2/ 10.8/2.4/8.4	Lee et al[26], 2008
Nab-Paclitaxel	56/54	ECOG 0/1 - 33/23	Nab-Ptx 250 d1 q21	27.8%	NR	2.9	9.2	A/L/N/Ly/Neu - 7.3/20/49.1/10.9/23.6	Sasaki et al[27], 2014
Pemetrexed	34/30	ECOG 0/1/2 - 7/20/7	Pem - 500 d1 q 21	63.6%	NR	2.3	6.4	A/N/T/As - 2.9/2.9/2.9/5.8	Zhang et al[28], 2015
Sunitinib	78/69	ECOG 0/1 - 26/52	Sun - 50 mg/d × 4 wk, q42	2.6%	2.3	2.3	6.8	A/L/N/T/E/D/HFS/S - 16.7/11.5/29.4/34.6/ 3.8/2.6/6.4/1.3	Bang et al[29], 2010
Everolimus	54/53	ECOG 0/1 - 32/21	Ev - 10 mg/d d1-28	0%	NR	2.7	10.1	P (gr 1-2)/A/Ly/As/S/ Ano/HyG/HyP/HyN/ - 15.1, 9.4/7.5/5.7/ 5.7/ 5.7/3.8/3.8/9.6	Doi et al[30], 2010

¹Retrospective study. Dtx: Docetaxel; Ev: Everolimus; F: 5-fluorouracil; FA: Leucovorin; Iri: Irinotecan; MMC: MitomycinC; Nab-Ptx: Nab-paclitaxel; Pem: Pemetrexed; Ptx: Paclitaxel; Sun: Sunitinib; ECOG: Eastern co-operative oncology group; KPS: Karnoffsky performance status; NR: Not reported; ORR: Objective response rate; OS: Overall-survival; Pts: Patients; PFS: Progression-free survival; R: Range; TTP: Time-to-progression; A: Anemia; As: Asthenia; Ano: Anorexia; B: Bilirubin; D: Diarrhea; E: Emesis; FN: Febrile neutropenia; HFS: Hand-foot syndrome; HyG: Hyperglycemia; HyN: Hyponatremia; HyP: Hypophosphatemia; I: Infection; L: Leucocytopenia; Ly: Lymphopenia; M: Mucositis; N: Neutropenia; Neu: Sensory neuropathy; Nau: Nausea; N-E: Nausea and vomiting; T: Thrombocytopenia.