J Korean Med Sci.  2007 Sep;22(Suppl):S115-S121. 10.3346/jkms.2007.22.S.S115.

Phase II Study of Low-dose Paclitaxel and Cisplatin as a Second-line Therapy after 5-Fluorouracil/Platinum Chemotherapy in Gastric Cancer

• Lee KW
• Kim JH
• Yun T
• Song EK
• Na II
• Shin H
• Oh SY
• Choi IS
• Oh DY
• Kim DW
• Im SA
• Kim TY
• Lee JS
• Heo DS
• Bang YJ
• Kim NK

• KMID: 1785799
• DOI: http://doi.org/10.3346/jkms.2007.22.S.S115

Abstract

This study was performed to evaluate the efficacy and toxicity of low-dose paclitaxel/cisplatin chemotherapy in patients with metastatic or recurrent gastric cancer that had failed 5-fluorouracil/platinum-based chemotherapy. Thirty-two patients with documented progression on or within 6 months after discontinuing 5-fluorouracil/platinum-based chemotherapy were enrolled. As a second-line treatment, paclitaxel (145 mg/m2) and cisplatin (60 mg/m2) was administered on day 1 every 3 weeks. Among 32 patients enrolled, 8 (25%) responded partially to paclitaxel/cisplatin, 8 (25%) had stable disease, and 14 (44%) had progressive disease. Two patients (6%) were not evaluable. The median time to progression (TTP) and overall survival for all patients were 2.9 months and 9.1 months, respectively. The most common hematologic toxicity was anemia (47%). Grade 3 neutropenia developed in three patients (9%), but no other grade 3/4 hematologic toxicity occurred. The most common non-hematologic toxicities were emesis (31%) and peripheral neuropathy (38%). Three cases (9%) of grade 3/4 emesis and 2 cases (6%) of grade 3 peripheral neuropathy developed. In conclusion, low-dose paclitaxel and cisplatin chemotherapy showed moderate activity with favorable toxicity profiles. However, relatively short TTP of this regimen warrants the development of more effective paclitaxel-based regimens other than combination with cisplatin in these patients as second-line therapies.

Keyword

Chemotherapy; Paclitaxel; Cisplatin, Gastric Cancer

MeSH Terms

Adenocarcinoma/*drug therapy
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse
Cisplatin/administration & dosage/adverse effects
Female
Fluorouracil/administration & dosage/adverse effects
Humans
Leucovorin/administration & dosage/adverse effects
Male
Middle Aged
Organoplatinum Compounds/administration & dosage/adverse effects
Paclitaxel/administration & dosage/adverse effects
Stomach Neoplasms/*drug therapy/mortality
Survival Rate
Treatment Failure

Figure

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  Fig. 1 Time to progression and overall survival curves.

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