Cancer Res Treat.  2005 Aug;37(4):201-207.

Efficacy and Safety Study of Docetaxel as Salvage Chemotherapy in Metastatic Gastric Cancer Failing Fluoropyrimidine and Platinum Combination Chemotherapy

• Lee JL
• Ryu MH
• Chang HM
• Kim TW
• Yook JH
• Oh ST
• Kim BS
• Lee JS
• Kang YK

Abstract

PURPOSE
Fluoropyrimidine (F) and platinum (P) combination chemotherapy has been widely used for the first line treatment of advanced gastric cancer (AGC). Docetaxel (D) has shown promising activity in this disease. The present study retrospectively investigated the efficacy of D monotherapy as salvage chemotherapy for AGC that is failing F and P combination chemotherapy. MATERIALS AND METHODS: A total of 34 patients, fitting the eligibility criteria, were included in this study. D was administered at a dose of 75 mg/m2 IV every 3 weeks, with dexamethasone prophylaxis. Twenty-nine patients had measurable lesions. The median treatment-free interval was 38.5 days, and 91.2% of patients had progressed within 4 months of withdrawal of the first line chemotherapy. RESULTS: A total of 133 cycles of D were administered, with a median of 3.5 (1~8) cycles. From an intention-to-treat analysis, 6 patients achieved partial responses (PR), with a response rate of 20.7% (95% CI, 6.0~35.4). The duration of objective PRs in these six were 2.3+, 2.5+, 2.9, 3.0+, 6.2 and 6.8 months, respectively. Six patients showed a stable disease, but 15 showed progression. The median time to progression was 4.2 months (95% CI, 2.8~5.5), with a median overall survival since the start of D monotherapy of 8.4 months (95% CI, 5.5~11.3). Grade 3/4 neutropenia and febrile neutropenia occurred in 12.9% of patients and 3.1% of cycles. The incidence of grade 3 or worse non-hematological toxicities were as follows; peripheral sensory neuropathy 9.7%, asthenia 3.2% and allergic reaction 2.7%. CONCLUSION: Docetaxel, 75 mg/m2, is active in AGC as second-line chemotherapy after failure of prior exposure to the F and P combination chemotherapy, with a favorable toxicity profile.

Keyword

Stomach neoplasms; Docetaxel; Salvage therapy; Drug therapy

MeSH Terms

Asthenia
Dexamethasone
Drug Therapy*
Drug Therapy, Combination*
Febrile Neutropenia
Humans
Hypersensitivity
Incidence
Neutropenia
Platinum*
Retrospective Studies
Salvage Therapy
Stomach Neoplasms*
Dexamethasone
Platinum

Figure

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  Fig. 1 Time to progression (gray solid line) and overall survival (black solid line) for the 34 patients with advanced gastric cancer treated with docetaxel monotherapy after having failed fluoropyrimidine and platinum combination chemotherapy.

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