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Weekly docetaxel, cisplatin, and 5-fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer†
Article first published online: 27 JAN 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 6, pages 1446–1453, 15 March 2010
How to Cite
Overman, M. J., Kazmi, S. M., Jhamb, J., Lin, E., Yao, J. C., Abbruzzese, J. L., Ho, L., Ajani, J. and Phan, A. (2010), Weekly docetaxel, cisplatin, and 5-fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer. Cancer, 116: 1446–1453. doi: 10.1002/cncr.24925
Presented previously in abstract form at the 2008 American Society of Clinical Oncology Annual Meeting (Abstract 15525), Chicago, IL, May 30-June 3; and at the 2009 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (Abstract 68), San Francisco, CA, January 15-17.
- Issue published online: 3 MAR 2010
- Article first published online: 27 JAN 2010
- Manuscript Accepted: 22 JUL 2009
- Manuscript Received: 5 JUN 2009
- Manuscript Revised: 14 JUL 2005
- gastric cancer;
- esophageal cancer;
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.
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/m2 of cisplatin, 350 mg/m2 of 5-fluorouracil, and 20 mg/m2 of docetaxel administered once weekly for 6 consecutive weeks followed by a 2-week break.
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).
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.