Non-randomized comparison between irinotecan plus mitomycin C and irinotecan alone in patients with advanced gastric cancer refractory to fluoropyrimidine and platinum

Background: Irinotecan alone and plus mitomycin C have been proven to be effective as second-line chemotherapy for advanced gastric cancer. The objective of the present study was to compare the efficacy and safety of irinotecan alone (CA) and with mitomycin C (CM) in clinical practice. Patients and Methods: Between November 2006 and December 2011, 46 patients with advanced gastric cancer refractory to fluoropyrimidine and platinum were treated with CM (n=22) or CA (n=24). Results: Baseline characteristics of the patients were similar in the two treatment groups, with the exception of the sex ratio. The median progression-free survival was 3.9 months in the CM arm and 3.7 months in the CA arm (p=0.25), and the median overall survival was 9.6 and 8.7 months (p=0.36), respectively. The overall response rate was 18% in the CA arm and 9% in the CM arm (p=0.38). Grade 3/4 neutropenia (45% vs. 25%), anemia (36% vs. 4%), febrile neutropenia (14% vs. 8%), anorexia (14% vs. 8%) tended to be higher in the CM arm than in the CA arm. Conclusion: Although the efficacy of CM and CA for advanced gastric cancer refractory to fluoropyrimidine and platinum was not significantly different, CM tended to lead to greater incidence of adverse events in clinical practice.