Weekly Taxotere and cisplatin with continuous-infusion 5-fluoruracil for the treatment of advanced gastric and esophageal cancer: a prospective, observational, single-institution experience

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2012, Vol.15 (1), p.106-110
• Main Authors: Piacentini, Paolo, Durante, Emilia, Trolese, Annarita, Mercanti, Anna, Bonetti, Andrea
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; Cisplatin - administration & dosage; Disease Progression; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - pathology; Female; Fluorouracil - administration & dosage; Gastric cancer; Gastroenterology; Humans; Infusions, Intravenous; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Prospective Studies; Short Communication; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Surgical Oncology; Survival Rate; Taxoids - administration & dosage; Treatment Outcome
• ISSN: 1436-3291; 1436-3305
• DOI: 10.1007/s10120-011-0078-5

The combination of Taxotere (docetaxel), cisplatin, and prolonged-infusion 5-fluorouracil (5-FU) has emerged as an active treatment for advanced gastric cancer. However, the regimen proposed by van Cutsem et al. (J Clin Oncol 24:4991–7, 2006 ) is associated with significant toxicity and therefore alternative schedules are needed. In the present study, patients with advanced gastric or esophageal cancer received Taxotere 35 mg/m 2 and cisplatin 25 mg/m 2 on day 1, followed by 5-FU 180 mg/m 2 /day as a 7-day prolonged infusion. Drugs were given weekly for 3 consecutive weeks followed by 1 week’s rest. Cycles were repeated every 4 weeks. Overall, a total of 110 cycles were administered to 27 patients (median age 63 years, range 40–78 years). The median number of cycles per patient was 4 (range 2–6). Nine partial responses were obtained, resulting in an overall response rate of 33% [95% confidence interval (CI) 16–51], a median time to progression of 6.4 months (95% CI 5.4–7.4), and a median overall survival of 10.7 months (95% CI 6.6–14.8). Toxicity was mild; grade III-IV neutropenia was the most frequently observed side effect, in 9 administered cycles (8%); neutropenia was complicated by fever in 2 cycles. Other grade III–IV toxicities observed in >5% of patients were anemia and mucositis.