Sunday, January 22, 2012

IP cisplatin, early start of chemotherapy associated with improved efficacy of iceMFP chemotherapy

2012 Gastrointestinal Cancers Symposium
SAN FRANCISCO — Phase 3 results from the AMC 0101 study showed patients treated with iceMFP chemotherapy for serosa-positive advanced gastric cancer had superior outcomes when assigned to intraperitoneal cisplatin and/or early start of chemotherapy.
Patients were assigned to Mf (20 mg/m2 of mitomycin-C and daily oral 460-600 mg/m2 doxifluridine) or iceMFP (mitomycin-C and doxifluridine plus cisplatin). Patients received 100 mg intraperitoneal cisplatin for two hours during surgery, and 15 mg/m2 IV mitomycin-C one day after surgery. Doxifluridine was administered 4 weeks after surgery for a total of 12 months, along with six shots of monthly 60 mg/m2cisplatin.
As of April 2011, a median follow-up of 6.6 years, patients assigned to iceMFP demonstrated superior 5-year recurrence-free survival (HR=0.73; 95% C.I. 0.57-0.93) and 5-year OS (HR=0.77; 95% C.I. 0.60-0.98) compared with patients assigned to Mf chemotherapy.
That represented a 9% improvement in OS compared with 3-year results, said Yoon-Koo Kang, MD, PhD,with the Asan Medical Center in Seoul, South Korea.
I have always wondered if intraperitoneal chemotherapy could improve survival in gastric cancer since the cancer cells are often in the peritoneal cavity.
We will have to see our own trials in the USA.

Tony Talebi, MD

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