Annals of Oncology 11:301-306, 2000
© 2000 European Society for Medical Oncology
research-article |
Docetaxel (Taxotere®)-cisplatin (TC): An effective drug combination in gastric carcinoma
1Oncosurgery, Department of Surgery, Hôpital Cantonal Universitaire Geneva
2SIAK coordinating center Bern, Switzerland
3European Institute of Oncology Milan, Italy
4Division of Oncology, Ospedale San Giovanni Bellinzona
5Division of Oncology, Department of Medicine C, Kantonspital St. Gallen
6Institute of Medical Oncology, Inselspital Bern
7Division of Oncology, Department of Medicine Kanlonspital, Basel
8Institute of Oncology and Haematology. Stadtspital Triemli Zürich
9Division of Oncology, Department of Medicine, Hôpital Cantonal Universitaire Geneva
10Division of Oncology, Ospedale Civico Lugano, Switzerland
Correspondence to: A. D. Roth, MD Oncosurgery Geneva University Hospital 24 Micheli-Du-Crest CH-1211 Geneva 14 Switzerland. E-mail: arnaud.roth{at}dim.hcuge.ch
Purpose: A multi-centric trial was performed to explore the clinical activity, in terms of response and toxicity (primary objectives), duration of response and survival (secondary objectives), of docetaxel with cisplatin in advanced gastric cancer (AGC).
Patients and methods: Patients with measurable unresectable and/or metastatic gastric carcinoma, performance status
1, normal hematological, hepatic and renal functions and not pretreated for advanced disease by chemotherapy received up to eight cycles of TC (docetaxel 85 mg/m2 dl, cisplatin 75 mg/m2 dl) q3w. Dose escalation to 100 mg/m2 was performed in five patients and was discontinued for excessive toxicity.
Results: Forty-eight patients were accrued. A median of 5 cycles/patient was given. We observed 2 complete and 25 partial responses for an overall intent to treat response rate of 56% (95% CI: 41%71%). Twelve patients had stable disease for
9 weeks (3 cycles). The median time to progression and overall survival were 6.6 and 9 months, respectively. Grade
3 toxicities were neutropenia 81%, anemia 32%, thrombocytopenia 4%, alopecia 36%, fatigue 9%, mucositis 9%, diarrhea 6%, nausea/vomiting 4%, neurologic 2%, and one anaphylaxis precluding treatment administration. We recorded nine episodes of non-fatal febrile neutropenia in eight patients, two of them with docetaxel at 100 mg/m2. There were no direct treatment-related deaths.
Conclusions: TC is active in AGC with a high response rate in a multicentric trial. Despite its hematotoxicity, this regimen is well tolerated and can be recycled as originally planned in 78% of the cases. These results may serve as basis for further developments of docetaxel containing regimens in this disease.
chemotherapy, docetaxel, gastric cancer
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