Efficacy of weekly paclitaxel in patients with advanced gastric cancer with prior docetaxel-containing chemotherapy.

Abstract

127 Background: Efficacy of paclitaxel for docetaxel-refractory gastric cancer is not known, although partial cross-resistance between docetaxel and paclitaxel has been demonstrated in breast and ovary cancers. Therefore, we retrospectively evaluated the efficacy of paclitaxel in gastric cancer patients who had been refractory to docetaxel-containing chemotherapy. Methods: The patients who had received docetaxel-containing regimen were categorized as prior-docetaxel group, and the patients who had never received docetaxel were categorized as non-docetaxel group. Paclitaxel at 80 mg/m2 was administered by intravenous infusion in all patients, and this was repeated weekly for 3 weeks out of 4. The response rate (RR), median progression-free survival (PFS) and overall survival (OS) were evaluated in two groups. Results: 65 patients were included between April 2006 and June 2011. Among them, 26 patients were prior-docetaxel group, and 39 patients were non-docetaxel group. The median age, gender, performance status, histology, history of gastrectomy, metastatic site, and the number of metastatic sites were not statistically different between two groups. In prior-docetaxel group, the RR was 14.2% (3/21) among the patients with measurable lesions, the median PFS was 79 days (95%CI, 47-135 days), and the OS was 123 days (95% CI, 90-215 days) from the initiation of paclitaxel administration. In non-docetaxel group, the RR was 11.5% (3/26) among the patients with measurable lesions, the PFS was 82 days (95% CI, 52-106 days), and the OS was 143 days (95% CI, 121-178 days). There were no significant differences in the RR (P = 0.78), PFS (P = 0.98), and OS (P = 0.51) between two groups. Conclusions: Weekly paclitaxel was modestly active in gastric cancer patients who had been refractory to docetaxel containing chemotherapy. This represents that there was incomplete cross-resistance between docetaxel and paclitaxel in gastric cancer chemotherapy, as previously reported in other cancers.