Korean J Intern Med.  2013 May;28(3):314-321. 10.3904/kjim.2013.28.3.314.

Third-line docetaxel chemotherapy for recurrent and metastatic gastric cancer

• Lee JH
• Kim SH
• Oh SY
• Lee S
• Lee H
• Lee HJ
• Kim HJ

• KMID: 1776453
• DOI: http://doi.org/10.3904/kjim.2013.28.3.314

Abstract

BACKGROUND/AIMS
To determine the efficacy and toxicity of docetaxel as a third-line therapy for patients with relapsed gastric cancer who have undergone modified oxaliplatin-fluorouracil (m-FOLFOX)-4 and modified irinotecan-fluorouracil (m-FOLFIRI) regimens.
METHODS
We analyzed 33 patients who had been histologically diagnosed with adenocarcinoma of the stomach and who had progressed after m-FOLFOX-4 and m-FOLFIRI regimens. Patients were treated with cycles of 75 mg/m2 docetaxel on day 1 every 3 weeks.
RESULTS
The median age of the patients was 56.0 years (range, 31.0 to 74.0), and 73% of the patients (24/33) had an Eastern Cooperative Oncology Group performance status of 0 or 1. All patients were evaluated in terms of tumor response: five (15%), nine (27%), and 19 (58%) patients experienced a partial response, stable disease, and progressive disease, respectively. The median time to progression was 2.1 months (95% confidence interval [CI], 1.63 to 2.58), and overall survival was 4.7 months (95% CI, 3.20 to 6.20), from the start of the docetaxel regimen. Assessing patients' toxicity profiles, the median number of cycles was 2.0 (range, 1.0 to 12.0). The major hematologic toxicities included grade 3 to 4 neutropenia (19/33, 58%), grade 3 to 4 thrombocytopenia (2/33, 6%), and grade 3 to 4 anemia (5/33, 15%). Neutropenic fever developed in three patients (3/33, 9%). The nonhematological toxicities were nausea and vomiting (10/33, 30%), abdominal pain (4/33, 12%), skin rash (1/33, 3%), and fluid retention (3/33, 9%).
CONCLUSIONS
Docetaxel is a feasible third-line therapy regimen for patients with advanced gastric cancer after m-FOLFIRI and m-FOLFOX-4 regimens.

Keyword

Advanced gastric cancer; Docetaxel; Salvage therapy

MeSH Terms

Adenocarcinoma/*drug therapy/mortality
Adult
Aged
Antineoplastic Agents/adverse effects/*therapeutic use
Antineoplastic Protocols
Female
Humans
Male
Middle Aged
Neoplasm Recurrence, Local/*drug therapy
Republic of Korea/epidemiology
Salvage Therapy
Stomach Neoplasms/*drug therapy/mortality
Taxoids/adverse effects/*therapeutic use
Antineoplastic Agents
Taxoids