A phase II trial evaluating capecitabine and irinotecan as second line treatment in patients with oesophago-gastric cancer who have progressed on, or within 3months of platinum-based chemotherapy

Rationale: There is no standard second line therapy for relapsed oesophago-gastric (O-G) cancer. Methods: We recruited 29 eligible patients with relapsed O-G cancer who had progressed during or within 3months of prior chemotherapy to assess the efficacy and toxicity of capecitabine [2,000mg/(m super(2)day) on days 1-14] and irinotecan (250mg/m super(2)) given every 3weeks. Results: Five patients (17%) demonstrated objective response, while a further seven patients (24%) achieved disease stabilisation. Median progression-free survival and overall survival were 3.1months (95% CI=2.2-4.1months) and 6.5months (95%CI=6-7.1months), respectively. Among symptomatic patients, palliation of tumour-related symptoms included resolution of reflux (5/12 pts), dysphagia (3/9 pts) and weight loss (4/9 pts), improvements in anorexia (4/10 pts), nausea (3/4 pts), vomiting (4/6 pts) and pain (4/16 pts). Grade 3-4 toxicities were diarrhoea (15%), nausea and vomiting (7%), lethargy (31%), neutropenia (31%), anemia (14%) and thrombocytopenia (7%). Conclusions: Capecitabine and irinotecan has anti-tumour activity as second line treatment for relapsed O-G cancer, and provides an important improvement in disease related symptoms.