Weekly docetaxel, cisplatin, and 5‐fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer

Overman, Michael J.; Kazmi, Syed Mohammad Ali; Jhamb, Jagriti; Lin, E.; Yao, James C.; Abbruzzese, James L.; Ho, Linus; Ajani, Jaffer A.; Phan, Alexandria T.

doi:10.1002/cncr.24925

Cited by 50 publications

(56 citation statements)

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“…Weekly administration decreased the rate of hematological toxicity, with only 4 % of grade 3-4 neutropenia [16]. However, nonhematologic toxicities were frequent with this regimen, with 23 % of patients hospitalized for non-hematologic toxicity in this retrospective study by Overman et al In a phase II trial reported by Tebbut et al [17], with weekly mDCF there was a high rate of grade 3-4 gastrointestinal toxicity (diarrhea 22 %, stomatitis 18 %, nausea 16 %, asthenia 18 %) as reported earlier by Lorenzen et al [18], who noted a similar toxicity profile.…”

Section: Discussionmentioning

confidence: 99%

Biweekly docetaxel, fluorouracil, leucovorin, oxaliplatin (TEF) as first-line treatment for advanced gastric cancer and adenocarcinoma of the gastroesophageal junction: safety and efficacy in a multicenter cohort

et al. 2013

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Background Docetaxel-cisplatin-5-FU chemotherapy is superior to 5-FU-cisplatin in terms of response rate and survival in advanced gastric cancer (AGC), but is more toxic. Oxaliplatin is better tolerated than cisplatin, which it can effectively replace in this setting. We hypothesize that incorporating docetaxel into a simplified FOLFOX regimen should be a tolerable and effective option in first-line treatment of AGC. Methods Data were collected at six French centers from patients with metastatic or local AGC who received docetaxel, fluorouracil, leucovorin, or oxaliplatin (TEF) as first-line treatment. TEF was administered as follows: docetaxel (50 mg/m 2 ), oxaliplatin (85 mg/m 2 ), and leucovorin (40 mg/m 2 ) on day 1, and 5-FU continuous infusion for 48 h (2400 mg/m 2 ) every 2 weeks.Results Forty-one patients were enrolled. Performance status was grade 0 and 1 in respectively 27 and 58 % of patients; 17 patients had adenocarcinoma of the gastroesophageal junction; 37 patients had metastatic disease, 22 had a poorly differentiated or diffuse type. Objective response rate was 66 %, with a complete response in two patients (5 %). Median progression-free survival and overall survival were respectively 6.3 and 12.1 months. Tolerability was acceptable with no treatment-related deaths. The most frequent grade 3-4 toxicities were neutropenia (30 %) and neuropathy (12.5 %). Curative intent surgery after response to TEF was performed in seven patients (17 %). Conclusion TEF is an effective first-line treatment with an acceptable toxicity profile for patients with AGC. It may allow curative resection in initially unresectable patients. TEF should now be evaluated in prospective randomized trials.

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Section: Discussionmentioning

confidence: 99%

Biweekly docetaxel, fluorouracil, leucovorin, oxaliplatin (TEF) as first-line treatment for advanced gastric cancer and adenocarcinoma of the gastroesophageal junction: safety and efficacy in a multicenter cohort

et al. 2013

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“…The V325 prompted a series of investigations aimed at improving the tolerability of DCF with modified schemes, envisioning the use of weekly schedules. Overman et al [18] retrospectively evaluated data from 95 patients treated with weekly DCF, reporting a dramatic drop in the rate of hematological toxicity and modest activity. Nevertheless, hospitalization was required for 22 patients (23 %) because of nonhematological toxicities.…”

Section: Discussionmentioning

confidence: 99%

“…The pretreatment characteristics of patients are listed in Table 1. None of the patients had previously received chemotherapy for advanced disease; 9 patients had received adjuvant chemotherapy without docetaxel or oxaliplatin with a median disease-free interval of 12 months (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] (Figs. 1, 2).…”

Section: Patient Characteristicsmentioning

confidence: 99%

Docetaxel, oxaliplatin, and capecitabine combination chemotherapy for metastatic gastric cancer

Lauro¹,

Vici²,

Belli³

et al. 2013

Gastric Cancer

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Background The incorporation of docetaxel into the cisplatin and fluorouracil backbone has been demonstrated to be an active combination in metastatic gastric cancer. Nevertheless, this regimen is burdened by nonnegligible toxicity. We hypothesized that replacing cisplatin and fluorouracil with oxaliplatin and capecitabine should be an active and safe option for metastatic gastric cancer patients. Methods In this phase II study, we tested the activity of docetaxel in combination with oxaliplatin and capecitabine (DOC) as a first-line treatment. DOC was administered as follows: docetaxel (60 mg/m 2 ) and oxaliplatin (100 mg/ m 2 ) on day 1, and capecitabine (500 mg/m 2 ) was administered orally twice daily given continuously, with cycles repeated every 3 weeks. The primary endpoint was the overall response rate. Results Forty-eight patients entered the study. All patients had metastatic disease (stage IV). None of the patients had previously received chemotherapy for advanced disease. Performance status was 0, 1, and 2 in 25, 58, and 17 % of patients, respectively; 13 patients (27 %) had adenocarcinoma of the gastroesophageal junction, and 29 patients (60.5 %) had two or more metastatic sites. The overall response rate was 52.1 %. Progression-free survival and overall survival were 6.9 and 12.6 months, respectively. The treatment was well tolerated with no treatmentrelated deaths. The most common grade 3-4 toxicity was neutropenia (41 %). Conclusions DOC is an effective and tolerated first-line treatment, and the lower dose of docetaxel and oxaliplatin used in this study compared with other similar regimens does not seem to hamper the antitumor activity.

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“…Currently, many other studies that tested the different DCF regimens have been published [37][38][39][40][41][42][43][44][45]. The standard DCF regimen used by Van Cutsem et al was a 5-day regimen.…”

Section: Discussionmentioning

confidence: 99%

Bimonthly regimen of high-dose leucovorin, infusional 5-fluorouracil, docetaxel, and cisplatin (modified DCF) in advanced gastric adenocarcinoma

et al. 2012

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Background The combination of docetaxel, cisplatin, and 5-fluorouracil (DCF) is an effective but highly toxic regimen for the treatment of advanced gastric cancer. To improve tolerability while maintaining the efficacy of the DCF regimen, we developed a modified DCF regimen including an infusional 5-fluorouracil administration according to the de Gramont regimen. Methods In this study, 70 patients with advanced gastric cancer were treated. Each 2-week cycle consisted of docetaxel (60 mg/m 2 ), cisplatin (50 mg/m 2 ), a 5-fluorouracil (400 mg/m 2 ) IV bolus, and 5-fluorouracil (2,400 mg/m 2 ) IV over 46 h plus leucovorin (400 mg/m 2 ) IV over 2 h. Results The median progression-free survival and overall survival were 9.0 months (95 % CI, 7.1-10.9) and 10.8 months (95 % CI, 7.4-14.2), respectively; the 1-year and 2-year overall survival rates were 46.3 and 18.4 %, respectively. Twenty-nine (41.4 %) partial responses, 19 (27.1 %) stable disease, and 22 (31.4 %) progression of disease were observed. Grade 3-4 toxicities included neutropenia (37.1 %), febrile neutropenia (15.7 %), thrombocytopenia (10.0 %), anemia (8.6 %), nausea and vomiting (10.0 %), stomatitis (5.7 %), infection (8.6 %), and diarrhea (2.9 %). ConclusionsOur results show that a de Gramont-based DCF regimen may have tolerable toxicities and be an effective and convenient palliative treatment for advanced gastric cancer.

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Weekly docetaxel, cisplatin, and 5‐fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer

Abstract: BACKGROUND: 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.

Cited by 50 publications

References 51 publications

Biweekly docetaxel, fluorouracil, leucovorin, oxaliplatin (TEF) as first-line treatment for advanced gastric cancer and adenocarcinoma of the gastroesophageal junction: safety and efficacy in a multicenter cohort

Biweekly docetaxel, fluorouracil, leucovorin, oxaliplatin (TEF) as first-line treatment for advanced gastric cancer and adenocarcinoma of the gastroesophageal junction: safety and efficacy in a multicenter cohort

Docetaxel, oxaliplatin, and capecitabine combination chemotherapy for metastatic gastric cancer

Bimonthly regimen of high-dose leucovorin, infusional 5-fluorouracil, docetaxel, and cisplatin (modified DCF) in advanced gastric adenocarcinoma

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