Weekly docetaxel, cisplatin, and 5-fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer
By: Overman MJ, Kazmi SM, Jhamb J, Lin E, Yao JC, Abbruzzese JL, Ho L, Ajani J, Phan A.

Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
Cancer. 2010 Jan 27.

Abstract

Background

Docetaxel, cisplatin, and 5−flurouracil (DCF) administered every 3 weeks produces a high rate of treatment−related adverse events. The objective of the current study was to evaluate the efficacy and tolerability of a weekly formulation of DCF.

Methods

Data from 117 patients treated at The University of Texas M. D. Anderson Cancer Center from 2002 to 2006 with a weekly formulation of DCF were retrospectively collected. A total of 95 patients received front−line therapy with 20 mg/m(2) of cisplatin, 350 mg/m(2) of 5−fluorouracil, and 20 mg/m(2) of docetaxel administered once weekly for 6 consecutive weeks followed by a 2−week break.

Results

Ninety−five patients (median age, 62 years [range, 33 to 87 years], with an Eastern Cooperative Oncology Group performance status of 1 or 2 in 67%) received a median of 10 weeks of DCF treatment (range, 3−41 weeks). Grade 3 or 4 hematologic toxicity (assessed according to National Cancer Institute Common Toxicity Criteria [version 3.0]) included granulocytopenia (4 patients) and anemia (9 patients). None of the patients developed a febrile neutropenic infection, but grade 3 or 4 non−neutropenic infections occurred in 8 patients. Eighty patients had measurable disease with an objective response rate determined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria of 34% (95% confidence interval [95% CI], 24−45%). The median follow−up was 9 months, with a median time to disease progression of 4.1 months (95% CI, 3.6−5.7 months) and a median overall survival of 8.9 months (95% CI, 7.7−10.8 months).

Conclusions

In patients with advanced gastric and esophageal cancer who were not candidates for every−3−week DCF, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients. Cancer 2010. © 2010 American Cancer Society.

PMID: 20108336 [PubMed − as supplied by publisher] Source: National Library of Medicine.






* Albert Einstein College of Medicine has been
awarded Acceditation with Commendation by
the ACCME

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