Bi-weekly docetaxel and 5-fluorouracil: an effective and feasible treatment for advanced gastric cancer with poor performance status

Abstract

Background: The survival benefits from cytotoxic chemotherapy have been demonstrated in advanced gastric cancer (AGC). A large proportion of AGC patients initially present poor performance status (PS); however, most of the clinical evidence comes from trials on patients with good PS. A better-designed regimen is greatly needed for AGC patients with poor PS.Objective: To evaluate the efficacy and safety of a modified combination regimen with docetaxel plus 5-fluorouracil (5-FU) every two weeks as first-line treatment in AGC patients with poor PS.Methods: From September 2011 to December 2013, 12 patients diagnosed with AGC with Eastern Cooperative Oncology Group (ECOG) PS scores of 3 or 4 were included in this study. All the patients received docetaxel 60 mg/m2 on Day 1, 5-FU 400 mg/m2 intravenous (i.v.) bolus on Day 1, and a 46-hour continuous i.v. infusion of 5-FU 2400 mg/m2 every two weeks, until disease progressed or patients experienced unacceptable toxicity or declined treatment. Detailed clinical, pathologic and survival data were all recorded.Results: Eleven out of 12 patients were assessable for responses, whereas nine cases (75%) achieved partial response, one (8.3%) achieved stabilized disease, and one (8.3%) had progressive disease. The median progression-free survival was 6.5 months (95% CI: 4.8–8.2). The median overall survival was 12.0 months (95% CI: 9.0–15.0). The most common Grade 3/4 toxicities were anemia in seven patients (58.3%). No patient experienced febrile neutropenia.Conclusion: The novel modification of bi-weekly docetaxel and 5-FU is a promising treatment option for AGC with poor PS, showing great efficacy and acceptable toxicity.

CISD2 enhances the chemosensitivity of gastric cancer through the enhancement of 5‐FU‐induced apoptosis and the inhibition of autophagy by AKT/mTOR pathway

“…Among the many types of drugs that are used to treat GC, 5‐fluorouracil (5‐FU) and 5‐FU‐based chemotherapy regimens are the mainstream treatments that have been widely used up to now . Due to the rapid development of 5‐FU resistance and that high doses of drugs will result in several side effects on healthy cells, new adjuvant drugs such as Oxaliplatin, Paclitaxel, and Docetaxel combined with 5‐FU have led to an increased response rate in advanced GC . The identification of new therapeutic strategies and more sensitive screening systems toward patient subpopulations who are most likely to respond to chemotherapy will be the keys to improve the curative effect of chemotherapy and the prognosis of gastric cancer.…”

Dose-dense biweekly docetaxel combined with 5-fluorouracil as first-line treatment in advanced gastric cancer: a phase II trial

“…However, most available studies administered docetaxel every 3 weeks with a high dose intensity, which in turn resulted in poor tolerability. Weekly regimens of docetaxel were relatively easy to tolerate but the patients' costs and overall burden of participating increased as well [13].…”