More recently, a wave of randomized clinical trials with superiority design was successfully completed, and novel

active drugs such as docetaxel [6], S1 [7] and trastuzumab [8] changed the landscape of the clinical management of gastric cancer. Other agents including CP-868596 molecular weight capecitabine [9], oxaliplatin [10] and this website irinotecan [11] have proven antitumor activity, thus expanding the spectrum of therapeutic options available in the first-line setting. Even though novel active drugs and combinations entered the therapeutic scenario, second-line treatment has been historically considered largely empirical. Furthermore, geographic distributions exist in chemotherapy administration beyond first-line, being prevalently adopted in Asian countries. Indeed, the rates of administration of subsequent

chemotherapy significantly differed among phase III studies conducted in front-line, spanning from 14% in the UK REAL 2 study [9] to 75% in the Japanese SPIRITS trial [7]. The clinical proof-of-concept for second-line chemotherapy stemmed from two recent randomized phase III trials, demonstrating the superiority of second-line monotherapy (docetaxel or irinotecan) over BSC [12, 13]. Nevertheless, it is foreseeable that a widespread adoption of second-line chemotherapy will further be limited by Geneticin concentration multiple factors. Firstly, the non-Asian study was prematurely closed when only one-third of the preplanned 120 patients were enrolled [12]. As a result, evidence supporting second-line chemotherapy in non-Asian patients are

still scattered being mostly extrapolated from the Korean study. Secondly, the different biological background of gastric cancer arising in Asian and Western patients must be taken into account as a potential confounding factor [14]. Finally, single-agent therapy may result suboptimal, at least for patients with good performance status. On this basis, we conducted a retrospective study in order to evaluate the activity and safety of FOLFIRI given as a second-line therapy in a cohort Thalidomide of docetaxel-pretreated metastatic gastric cancer patients. Methods The study population was composed by patients with metastatic gastric or GEJ cancer who experienced disease progression on or after first-line docetaxel-containing chemotherapy. Patients were treated at three Italian cancer centers between 2005 and 2012. The majority of patients was selected from the “Regina Elena” National Cancer Institute, Rome. Medical records were reviewed in order to obtain information on demography, treatment received, safety and outcomes. Patients with histologically confirmed, docetaxel-pretreated metastatic gastric cancer who received FOLFIRI in second line were eligible for the study.