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Phase II study of epirubicin, oxaliplatin and docetaxel combination in metastatic gastric or gastroesophageal junction adenocarcinoma.

Di Lauro L, Giacinti L, Arena MG, Sergi D, Fattoruso SI, Giannarelli D, Lopez M - J. Exp. Clin. Cancer Res. (2009)

Bottom Line: Grade 3/4 neutropenia occurred in 50% of patients with two episodes of febrile neutropenia (5%).Other non-hematological grade 3 toxicities included sensory neuropathy in two patiens (5%), vomiting and mucositis in two patients (5%) and diarrhea in one patient (2.5%).The combination of epirubicin, oxaliplatin and docetaxel was found to be effective and well tolerated in patiens with metastatic gastric or GEJ adenocarcinoma and maybe an appropriate regimen to be used in the neoadjuvant setting and with molecularly targeted agents.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Medical Oncology B, Institute for Cancer Research, Rome, Italy. dilauro@ifo.it

ABSTRACT

Background: This phase II study was designed to evaluate the activity and safety of a combination of epirubicin, oxaliplatin and docetaxel in metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma.

Methods: Forty patients with measurable distant metastases received epirubicin 50 mg/m2, docetaxel 60 mg/m2 followed by oxaliplatin 100 mg/m2 on day 1 of each 21-day cycle. Primary end point was response rates (RR).

Results: All patients were evaluable. The overall RR was 47.5% (95% confidence interval (CI) 32-63). The disease control was 80%. Median time for response was 6 weeks. Median time to progression was 6.3 months (95% CI 5.4-7.2) and the median overall survival time was 12.1 months (95% CI 10.7-13.5). Grade 3/4 neutropenia occurred in 50% of patients with two episodes of febrile neutropenia (5%). Other non-hematological grade 3 toxicities included sensory neuropathy in two patiens (5%), vomiting and mucositis in two patients (5%) and diarrhea in one patient (2.5%).

Conclusion: The combination of epirubicin, oxaliplatin and docetaxel was found to be effective and well tolerated in patiens with metastatic gastric or GEJ adenocarcinoma and maybe an appropriate regimen to be used in the neoadjuvant setting and with molecularly targeted agents.

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Overall survival for all patients.
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Figure 2: Overall survival for all patients.

Mentions: Among 40 assessable patients, we observed two (5%) complete responses (CRs) and 17 (42.5%) partial responses (PRs), for an overall response rate of 47.5% (95% CI, 32–63). The disease control (CRs plus PRs plus SD) was 80% (Table 2). Responses according to predominant site of disease, were as follows: liver, 12 of 24 patients (50%); nodes/peritoneum 5 of 12 patients (41.7%); lung 1 of 2 patients and bone 1 of 2 patients. Response rates did not significantly differ according to number of metastatic sites: one site, 6 of 11 patients (54.5%); two sites, 9 of 19 patients (47.4%); and three or more sites, 4 of 10 patients (40%). Responses were seen in 2 of 6 patients (33.3%) who received adjuvant chemotherapy and in 17 of 34 patients (50%) not previously treated with chemotherapy. Responses were observed also in 13 of 28 patients (46.4%) with primary tumor not resected and in 6 of 12 patients (50%) with primary tumor resected. RR did non differ when patients were evaluated according to the primary site of disease (gastric: 46.7% and GEJ: 50%, respectively). The median time for response was 6 weeks (range, 6–18). Upon disease progression, 22 patients (55%) received a second-line chemotherapy, including irinotecan/fluorouracil-leucovorin (n = 18) and cisplatin/capecitabine (n = 4). Median TTP was 6.3 months (95% CI 5.4–7.2) (Figure 1). Only 8 patients (20%) progressed within the first two months, whereas at the time of this analysis all but one patient had experienced progressive disease. Median OS was 12.1 months (95% CI 10.7–13.5 months) (Figure 2). One- and 2-year survivals were 50.3% and 12.6%, respectively. Thirty-six patients had died at the time of the present evaluation.


Phase II study of epirubicin, oxaliplatin and docetaxel combination in metastatic gastric or gastroesophageal junction adenocarcinoma.

Di Lauro L, Giacinti L, Arena MG, Sergi D, Fattoruso SI, Giannarelli D, Lopez M - J. Exp. Clin. Cancer Res. (2009)

Overall survival for all patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2657908&req=5

Figure 2: Overall survival for all patients.
Mentions: Among 40 assessable patients, we observed two (5%) complete responses (CRs) and 17 (42.5%) partial responses (PRs), for an overall response rate of 47.5% (95% CI, 32–63). The disease control (CRs plus PRs plus SD) was 80% (Table 2). Responses according to predominant site of disease, were as follows: liver, 12 of 24 patients (50%); nodes/peritoneum 5 of 12 patients (41.7%); lung 1 of 2 patients and bone 1 of 2 patients. Response rates did not significantly differ according to number of metastatic sites: one site, 6 of 11 patients (54.5%); two sites, 9 of 19 patients (47.4%); and three or more sites, 4 of 10 patients (40%). Responses were seen in 2 of 6 patients (33.3%) who received adjuvant chemotherapy and in 17 of 34 patients (50%) not previously treated with chemotherapy. Responses were observed also in 13 of 28 patients (46.4%) with primary tumor not resected and in 6 of 12 patients (50%) with primary tumor resected. RR did non differ when patients were evaluated according to the primary site of disease (gastric: 46.7% and GEJ: 50%, respectively). The median time for response was 6 weeks (range, 6–18). Upon disease progression, 22 patients (55%) received a second-line chemotherapy, including irinotecan/fluorouracil-leucovorin (n = 18) and cisplatin/capecitabine (n = 4). Median TTP was 6.3 months (95% CI 5.4–7.2) (Figure 1). Only 8 patients (20%) progressed within the first two months, whereas at the time of this analysis all but one patient had experienced progressive disease. Median OS was 12.1 months (95% CI 10.7–13.5 months) (Figure 2). One- and 2-year survivals were 50.3% and 12.6%, respectively. Thirty-six patients had died at the time of the present evaluation.

Bottom Line: Grade 3/4 neutropenia occurred in 50% of patients with two episodes of febrile neutropenia (5%).Other non-hematological grade 3 toxicities included sensory neuropathy in two patiens (5%), vomiting and mucositis in two patients (5%) and diarrhea in one patient (2.5%).The combination of epirubicin, oxaliplatin and docetaxel was found to be effective and well tolerated in patiens with metastatic gastric or GEJ adenocarcinoma and maybe an appropriate regimen to be used in the neoadjuvant setting and with molecularly targeted agents.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Medical Oncology B, Institute for Cancer Research, Rome, Italy. dilauro@ifo.it

ABSTRACT

Background: This phase II study was designed to evaluate the activity and safety of a combination of epirubicin, oxaliplatin and docetaxel in metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma.

Methods: Forty patients with measurable distant metastases received epirubicin 50 mg/m2, docetaxel 60 mg/m2 followed by oxaliplatin 100 mg/m2 on day 1 of each 21-day cycle. Primary end point was response rates (RR).

Results: All patients were evaluable. The overall RR was 47.5% (95% confidence interval (CI) 32-63). The disease control was 80%. Median time for response was 6 weeks. Median time to progression was 6.3 months (95% CI 5.4-7.2) and the median overall survival time was 12.1 months (95% CI 10.7-13.5). Grade 3/4 neutropenia occurred in 50% of patients with two episodes of febrile neutropenia (5%). Other non-hematological grade 3 toxicities included sensory neuropathy in two patiens (5%), vomiting and mucositis in two patients (5%) and diarrhea in one patient (2.5%).

Conclusion: The combination of epirubicin, oxaliplatin and docetaxel was found to be effective and well tolerated in patiens with metastatic gastric or GEJ adenocarcinoma and maybe an appropriate regimen to be used in the neoadjuvant setting and with molecularly targeted agents.

Show MeSH
Related in: MedlinePlus