Abstract
Chemotherapy is of crucial importance in advanced gastric cancer (AGC) patients, in order to obtain palliation of symptoms and improve survival. To date, no standard chemotherapy regimen has been established for AGC. The purpose of the present study was to evaluate the efficacy and toxicity of the combination regimen of paclitaxel and capecitabine (PX) as first-line chemotherapy in patients with advanced or recurrent gastric cancer. Patients with advanced or recurrent gastric cancer who were treated with PX as first-line chemotherapy between January 2001 and December 2012 at the Zhejiang Cancer Hospital (Hangzhou, China) were retrospectively investigated. Survival was evaluated using the Kaplan-Meier method. In total, 36 patients were enrolled, with a median age of 53.5 years and a Karnofsky performance status (KPS) score of ≥80. A median of 4 PX cycles were administered (range, 2–8 cycles). The median progression-free survival time was 3.7 months [95% confidence interval (CI), 2.9–4.5 months) and the median overall survival time was 12.0 months (95% CI, 9.8–14.1 months). From the 36 patients evaluated, one (2.8%) achieved a complete response, seven (19.4%) achieved a partial response, 24 (66.7%) exhibited stable disease and four (11.1%) exhibited progressive disease. The objective response rate was 22.2% (8/36), and the disease control rate was 88.9% (32/36). All 36 patients were assessed for treatment toxicity. Grade 3 or 4 adverse events included neutropenia (2.8% of patients), hand-foot syndrome (2.8%) and vomiting (2.8%). No neutropenic fever or treatment-related mortalities were observed. PX combination chemotherapy may be a valuable first-line therapy for advanced or recurrent gastric cancer.
Highlights
Recurrent or advanced gastric cancer (AGC) is one of the leading causes of cancer‐related mortalities worldwide [1,2,3], with a high incidence rate in Asia [4]
The present study retrospectively investigated AGC patients who were treated with paclitaxel and capecitabine (PX) as first‐line chemotherapy between January 2001 and December 2012 at the Zhejiang Cancer Hospital
In the AGC patients treated with PX as first‐line chemotherapy, the objective response and disease control rates were 22.2 and 88.9%, respectively, and the overall median survival time was 12.0 months
Summary
Recurrent or advanced gastric cancer (AGC) is one of the leading causes of cancer‐related mortalities worldwide [1,2,3], with a high incidence rate in Asia [4]. In V325, a large randomized phase III study, the combination of docetaxel, cisplatin and 5‐FU (DCF) was shown to significantly improve the time to progression (TTP), the survival time and the response rate (RR) in untreated AGC patients compared with cisplatin and 5‐FU (CF). Further studies have demonstrated that paclitaxel plus 5‐FU (PF) and docetaxel plus 5‐FU (DF) appear to have similar efficacy against advanced or recurrent gastric cancer, with different, but acceptable, safety profiles [15,16]. Capecitabine has been shown to be active in previously untreated AGC patients, as a single agent [20] or in combination with other drugs, including cisplatin, oxaliplatin, epirubicin and docetaxel [20,21,22,23]. The combination of paclitaxel and capecitabine (PX) in AGC, has rarely been reported
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