Outcome of FOLFOX and Modified DCF Chemotherapy Regimen in Patients with Advanced Gastric Adenocarcinoma

Pourghasemian, Mehdi; Mehr, Amin Danandeh; Molaei, Mohammad Reza; Habibzadeh, Afshin

doi:10.31557/apjcp.2020.21.8.2337

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…Although there are studies comparing FOLFOX and DCF (docetaxel, cisplatin, and fluorouracil) in terms of the side effect profile in metastatic gastric cancer, there is no large-scale study comparing FOLFOX+trastuzumab with CF+trastuzumab. In a study comparing mDCF and FOLFOX-4 in advanced stage gastric adenocarcinoma, hematological side effects (neutropenia, neutropenic fever, and thrombocytopenia) were more common in the mDCF arm, but neuropathy was seen more frequently in the FOLFOX-4 arm [ 25 ]. In the REAL2 trial, triplet therapy with epirubicin and cisplatin+fluorouracil (ECF) or capecitabine (ECX), or triplet therapy with epirubicin and oxaliplatin+fluorouracil (EOF) or capecitabine (EOX) treatment were compared [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal carcinoma

Esen

Ergün

Erol

et al. 2022

Bosn J of Basic Med Sci

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Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, FOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens.

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Section: Discussionmentioning

confidence: 99%

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal carcinoma

Esen

Ergün

Erol

et al. 2022

Bosn J of Basic Med Sci

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“…There are limited studies comparing FOLFOX and DCF/mDCF regimens in metastatic GC. In the study of Pourghasemian et al, mDCF and FOLFOX-4 were compared in advanced stage gastric adenocarcinoma patients, and no difference was found between the group in terms of the objective response rate (46.98% vs. 35.1%, respectively), OS (13.50 ± 5.94 months vs. 12.61 ± 4.05, respectively) [ 22 ]. In addition, while hematological side effects such as neutropenia, neutropenic fever, thrombocytopenia were more common in the mDCF arm, neuropathy was observed more frequently in the FOLFOX-4 arm [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the study of Pourghasemian et al, mDCF and FOLFOX-4 were compared in advanced stage gastric adenocarcinoma patients, and no difference was found between the group in terms of the objective response rate (46.98% vs. 35.1%, respectively), OS (13.50 ± 5.94 months vs. 12.61 ± 4.05, respectively) [ 22 ]. In addition, while hematological side effects such as neutropenia, neutropenic fever, thrombocytopenia were more common in the mDCF arm, neuropathy was observed more frequently in the FOLFOX-4 arm [ 22 ]. Al-Batran et al [ 23 ] compared FLO (oxaliplatin 85 mg/m 2 and leucovorin 200 mg/m 2 , each as a two-hour intravenous infusion, followed by FU 2600 mg/m 2 as a 24-hour continuous infusion every two weeks) and FLP (cisplatin 50 mg/m 2 as a two-hour infusion every two weeks combined with leucovorin 200 mg/m 2 as a two-hour infusion and FU 2000 mg/m 2 as a 24-hour infusion every week for six weeks followed by a two-week rest) treatment regimens in their study and they found no difference between the FLO and FLP groups in terms of treatment response rates (25% vs. 35%, respectively), OS (8.8 vs. 10.7 months, respectively), and PFS (6.0 vs. 3.1 months, respectively).…”

Section: Discussionmentioning

confidence: 99%

The Comparison of mDCF and mFOLFOX-6 as First-Line Treatment in Metastatic Gastric Cancer

Açıkgöz¹,

Esen²,

Uçar³

et al. 2021

Cureus

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Introduction: Fluoropyrimidine and platinum-based chemotherapy regimens are widely accepted for metastatic gastric cancer (GC). Because of drug toxicity, a combined two-drug cytotoxic drug regimen is recommended for first-line therapy, while three-drug cytotoxic regimens are recommended for patients with medically fit and better performance status. In this study, it was aimed to compare modified FOLFOX-6 (mFOLFOX-6) and modified DCF (mDCF) regimens in terms of survival and side effects in first-line treatment in metastatic GC. Methods: We retrospectively reviewed the clinical record of patients with metastatic gastric or gastro-esophageal junction cancer who had received mDCF or mFOLFOX-6 as the first-line treatment, and followed up in our center between February 2013 and December 2020. The data were collected from the patients' registration database of the hospital and oncologic follow-up files of our center. In the mDCF arm, docetaxel 60 mg/m 2 and cisplatin 60 mg/m 2 on day 1 intravenous (i.v.) infusion, and 600 mg/m 2 5-fluorouracil (FU) as a continuous infusion for five days were administrated every three weeks for up to six cycles. In the mFOLFOX-6 arm, 85 mg/m 2 oxaliplatin and 400 mg/m 2 LV as an i.v. infusion over two hours and a 5-FU bolus of 400 mg/m 2 as a 10-minute infusion, followed by 2.400 mg/m 2 5-FU as a 46-hour continuous infusion were administrated every two weeks for up to six cycles. Univariate and multivariate analyses for overall survival (OS) were performed by Cox proportional hazards regression model. Survival analysis was performed by the Kaplan-Meier method with the Long-rank test. P-value <0.05 was considered statistically significant. Results: A total of 70 patients included into the study. Of those, 40 (57%) patients had received mDCF and 30 (43%) had received FOLFOX-6 regimens as first-line treatment. There were no complete responses in both groups. The partial response rate was 28% and 27% for mDCF and mFOLFOX-6, respectively. There was no statistically significant difference regarding treatment response for both groups (p=0.787). The median OS was 13.9 months (95% CI: 7.5-20.4) in the mDCF arm, and 10.4 months (95% CI: 6.4-14.4) in the mFOLFOX-6 arm (p=0.409). The median progression-free survival (PFS) was 5.2 months (95% CI: 3.6-6.9) in the mDCF arm, and 6.4 months (3.2-9.6) in the FOLFOX-6 arm (p=0.126). The ratio of dose reduction, treatment delay, and neutropenic fever were not statistically different between treatment arms. Conclusion: The present study demonstrated that proper patient selection for metastatic GC may give rise to comparable survival rates without increased toxicity. mFOLFOX-6 and mDCF had similar response rates, OS, PFS, and side effect profiles.

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“…The conventional chemotherapy regimen consists of oxaliplatin combined with fluorouracil, where oxaliplatin is an anticancer drug with cytotoxic effects. Fluorouracil is a component of ribonucleic acid, which can play an anti-metabolite role[ 5 , 6 ]. However, studies have shown that treatment with only oxaliplatin combined with fluorouracil is not very effective in advanced gastric cancer[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Short-term efficacy and influencing factors of conventional chemotherapy combined with irinotecan in patients with advanced gastric cancer

Wang¹,

Du²,

Li³

2023

World J Gastrointest Oncol

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BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40 and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female. AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer. METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group ( n = 40) and control group ( n = 40) by the envelope method. The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated. RESULTS The short-term treatment effect in the observation group was better than that in the control group ( P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis (TNM) stage IV patients with ineffective chemotherapy in the observation group were (65.12 ± 5.71) years and 52.94%, respectively, which were notably higher than those of patients with effective chemotherapy ( P < 0.05), while the Karnofsky Performance Scale score was (67.70 ± 3.83) points, which was apparently lower than that of patients with effective chemotherapy ( P < 0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22, and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group ( P < 0.05). The incidence rates of grade III-IV diarrhea and grade III-IV thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group ( P < 0.05). CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.

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Outcome of FOLFOX and Modified DCF Chemotherapy Regimen in Patients with Advanced Gastric Adenocarcinoma

Cited by 8 publications

References 27 publications

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal carcinoma

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal carcinoma

The Comparison of mDCF and mFOLFOX-6 as First-Line Treatment in Metastatic Gastric Cancer

Short-term efficacy and influencing factors of conventional chemotherapy combined with irinotecan in patients with advanced gastric cancer

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