No survival benefit was observed upon adding cisplatin to irinotecan after S-1 monotherapy failure in patients with advanced gastric cancer, a recent study published online in the European Journal of Cancer has shown.

Because the optimal second-line regimen for treating advanced gastric cancer remains unclear, researchers sought to examine the survival benefit of cisplatin plus irinotecan compared with irinotecan monotherapy in patients initially treated with S-1, an oral fluoropyrimidine, monotherapy.

Researchers enrolled 68 patients with advanced gastric cancer and 95  with recurrent gastric cancer. Patients were randomly assigned to receive cisplatin 30mg/m2 plus irinotecan 60mg/m2 every 2 weeks or irinotecan 150mg/m2 every 2 weeks alone.

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Results showed that the median overall survival was 13.9 months (95% CI: 10.8-17.6) for the combination group versus 12.7 months (95% CI: 10.3-17.2) for the irinotecan group (HR = 0.834; 95% CI: 0.596-1.167; P = 0.288).

Researchers found no significant differences in progression-free survival or response rate between both groups.

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An exploratory subgroup analysis, however, showed that cisplatin plus irinotecan was significantly more effective for those with intestinal-type advanced gastric cancer compared with irinotecan monotherapy (OS: 15.8 vs 14.0 months;P = 0.019).

In regard to safety, the combination group had a higher incidence of grade 3-4 anemia and elevated serum lactate dehydrogenase levels compared with irinotecan alone.


  1. Nishikawa K, Fujitani K, Inagaki H, et al. Randomised phase III trial of second-line irinotecan plus cisplatin versus irinotecan alone in patients with advanced gastric cancer refractory to S-1 monotherapy: TRICS trial. Eur J Cancer. 2015. [Epub ahead of print]. doi: 10.1016/j.ejca.2015.02.009.