Second-line Chemotherapy for Previously Treated Metastatic Small Bowel Adenocarcinoma: A Retrospective Analysis

Anticancer Res. 2021 Oct;41(10):5147-5155. doi: 10.21873/anticanres.15332.

Abstract

Background/aim: Metastatic small bowel adenocarcinoma (SBA) is a rare disease with poor prognosis. This study aimed to explore the efficacy and safety of second-line chemotherapy for patients with SBA.

Patients and methods: We retrospectively reviewed the clinical characteristics of 27 metastatic patients with SBA after progression on first-line chemotherapy. The patients were divided into Cohort A, receiving second-line chemotherapy, and Cohort B, receiving best supportive care.

Results: Patients in Cohort B had higher age, worse performance status, and higher neutrophil-to-lymphocyte ratio compared with those in Cohort A. Cohort A showed significantly better overall survival (OS) compared with Cohort B (median OS, 15.6 vs. 3.4 months; p=0.002). Objective response rate, disease control rate, and median progression-free survival (PFS) for Cohort A were 7%, 74%, and 5.0 months, respectively. Patients who underwent irinotecan-based chemotherapy showed longer PFS and OS compared with those who underwent taxane-based chemotherapy. No significant adverse events were reported.

Conclusion: Second-line chemotherapy for metastatic SBA demonstrated clinical activity with acceptable toxicities.

Keywords: Adenocarcinoma; chemotherapy; microsatellite instability; second-line treatment; small bowel cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / mortality*
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Neoplasms / drug therapy
  • Intestinal Neoplasms / mortality*
  • Intestinal Neoplasms / pathology
  • Intestine, Small / drug effects
  • Intestine, Small / pathology*
  • Irinotecan / administration & dosage
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Taxoids / administration & dosage

Substances

  • Taxoids
  • Irinotecan