Medical Oncology

, Volume 27, Issue 1, pp 65–72 | Cite as

An explorative randomised phase II study of sequential chemotherapy in advanced upper gastrointestinal cancer

  • Åke Berglund
  • Per Byström
  • Birgitta Johansson
  • Peter Nygren
  • Jan-Erik Frödin
  • Dorte Pedersen
  • Henry Letocha
  • Bengt Glimelius
Original Paper

Abstract

The feasibility, safety, and efficacy of planned sequential administration of docetaxel and irinotecan with 5-fluorouracil (5-FU)/leucovorin in advanced upper gastrointestinal adenocarcinoma (UGIA) are unknown. Seventy-three patients with gastric (GC; n = 22), pancreatic (PC; n = 28) or biliary cancer (BC; n = 23) were randomised to start with 45 mg/m2 docetaxel or 180 mg/m2 irinotecan combined with 5-FU/leucovorin every 2nd week. After every 2nd course, the patients were crossed over to the other combination. Treatment was given for a maximum of 12 courses. Quality-of-life (QoL) was evaluated during the first two months using the EORTC QLQ-C30. Eighteen patients (25%; GC 32%, PC 21%, BC 22%) demonstrated partial response (PR) and 21 (29%) had prolonged stable disease. Mean QoL scores were low at baseline. Twenty-three (32%) patients had improved QoL using a summary measure and 13 were stable. Median time to progression was 4.4 months and overall survival 8.2 months. The treatments were reasonably well tolerated. Grade 3–4 toxicities were slightly more common for the docetaxel combination. There were two treatment-related deaths. Planned sequential treatment with docetaxel or irinotecan with 5-FU/leucovorin is feasible, reasonably tolerable and appears active in advanced UGIA.

Keywords

Biliary cancer Gastric cancer Palliative chemotherapy Pancreatic cancer Sequential therapy Quality-of-life 

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Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • Åke Berglund
    • 1
  • Per Byström
    • 2
  • Birgitta Johansson
    • 1
  • Peter Nygren
    • 1
  • Jan-Erik Frödin
    • 2
  • Dorte Pedersen
    • 3
  • Henry Letocha
    • 4
  • Bengt Glimelius
    • 1
    • 2
  1. 1.Department of Oncology, Radiology and Clinical ImmunologyAkademiska sjukhuset, University of UppsalaUppsalaSweden
  2. 2.Department of Oncology and PathologyKarolinska InstitutetStockholmSweden
  3. 3.Department of OncologyCounty HospitalKarlstadSweden
  4. 4.Department of OncologyCounty HospitalVästeråsSweden

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