Combination chemotherapy with paclitaxel and oxaliplatin as first-line treatment in patients with advanced gastric cancer
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This study is a retrospective analysis evaluating the efficacy and toxicity of combination chemotherapy with Paclitaxel (PTX) and Oxaliplatin (OXA) as first-line treatment for patients with advanced gastric cancer (AGC).
One hundred and seven patients with locally advanced or metastatic gastric adenocarcinoma received intravenous infusions of PTX at 135 mg/m2 and OXA at 85 mg/m2 on day 1 every 14 days.
Among 107 patients enrolled, 9 patients could not be evaluated for a response because of the absence of any measurable lesions. Assessment of the response of 98 patients was made. The overall objective response rate was 42.9% (95% CI 32.9–52.8%), with two complete responses and 40 partial responses. The disease control was 79.6% (95% CI 71.5–87.7%). With 29 months of the median time of follow-up, the median progression-free survival was 5.8 months (95% CI 4.30–7.30 months) and the median overall survival was 11.5 months (95% CI 9.08–13.9 months). The 1-year survival rate was 48.0%. The most common grades 3 and 4 toxicities included neutropenia (32.7%), leucopenia (17.8%), fatigue (5.61%), and anemia (4.67%). Peripheral neuropathy occurred in 23.4% patients and grade 2 or higher peripheral neuropathy occurred in 12.1% of the patients.
Combination chemotherapy with PTX and OXA offers a new, effective and safe regimen for patients with advanced gastric cancer.
KeywordsAdvanced gastric cancer Paclitaxel Oxaliplatin Combination chemotherapy
We wish to thank all the patients who volunteered for this study and the staff of Fujian Medical University Tumor Research Center who contributed to it. We also thank Mr. Cai Dingnan for his assistance in the statistical analysis.
This study was funded by the Foundation of Medical Innovation Project in Fujian Province (Grant no. 2016-CX-26).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 4.Glimelius B, Ekstrom K, Hoffman K, Graf W, Sjoden PO, Haglund U, Svensson C, Enander LK, Linne T, Sellstrom H, Heuman R (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8(2):163–168CrossRefPubMedGoogle Scholar
- 6.Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, Rodrigues A, Fodor M, Chao Y, Voznyi E, Risse ML, Ajani JA (2006) Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol 24(31):4991–4997. https://doi.org/10.1200/jco.2006.06.8429 CrossRefPubMedGoogle Scholar
- 8.Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9(3):215–221. https://doi.org/10.1016/s1470-20145(08)70035-4 CrossRefPubMedGoogle Scholar
- 11.Yamada Y, Shirao K, Ohtsu A, Boku N, Hyodo I, Saitoh H, Miyata Y, Taguchi T (2001) Phase II trial of paclitaxel by three-hour infusion for advanced gastric cancer with short premedication for prophylaxis against paclitaxel-associated hypersensitivity reactions. Ann Oncol 12(8):1133–1137CrossRefPubMedGoogle Scholar
- 12.Qi WX, Shen Z, Lin F, Sun YJ, Min DL, Tang LN, He AN, Yao Y (2013) Paclitaxel-based versus docetaxel-based regimens in metastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials. Curr Med Res Opin 29(2):117–125. https://doi.org/10.1185/03007995.2012.756393 CrossRefPubMedGoogle Scholar
- 14.Al-Batran SE, Hartmann JT, Probst S, Schmalenberg H, Hollerbach S, Hofheinz R, Rethwisch V, Seipelt G, Homann N, Wilhelm G, Schuch G, Stoehlmacher J, Derigs HG, Hegewisch-Becker S, Grossmann J, Pauligk C, Atmaca A, Bokemeyer C, Knuth A, Jager E (2008) Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkologie. J Clin Oncol 26(9):1435–1442. https://doi.org/10.1200/jco.2007.13.9378 CrossRefPubMedGoogle Scholar
- 15.Sumpter K, Harper-Wynne C, Cunningham D, Rao S, Tebbutt N, Norman AR, Ward C, Iveson T, Nicolson M, Hickish T, Hill M, Oates J (2005) Report of two protocol planned interim analyses in a randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer receiving ECF. Br J Cancer 92 (11):1976–1983. https://doi.org/10.1038/sj.bjc.6602572 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Gu J, Yamamoto H, Lu X, Ngan CY, Tsujino T, Konishi K, Takemasa I, Ikeda M, Nagata H, Hashimoto S, Matsuzaki T, Sekimoto M, Takagi A, Monden M (2006) Low-dose oxaliplatin enhances the antitumor efficacy of paclitaxel in human gastric cancer cell lines. Digestion 74(1):19–27. https://doi.org/10.1159/000095826 CrossRefPubMedGoogle Scholar
- 20.Kim JG, Sohn SK, Song HS, Kwon KY, Do YR, Lee KH, Hyun MS, Ryoo HM, Bae SH, Park KU, Baek JH, Lee WS, Chung JS, Cho GJ, Sohn CH, Jang JS, Chung HY, Yu W (2007) Multicenter phase II study of weekly paclitaxel plus cisplatin combination chemotherapy in patients with advanced gastric cancer. Cancer Chemother Pharmacol 60(6):863–869. https://doi.org/10.1007/s00280-007-0433-8 CrossRefPubMedGoogle Scholar
- 21.Honecker F, Kollmannsberger C, Quietzsch D, Haag C, Schroeder M, Spott C, Hartmann JT, Baronius W, Hempel V, Kanz L, Bokemeyer C (2002) Phase II study of weekly paclitaxel plus 24-h continuous infusion 5-fluorouracil, folinic acid and 3-weekly cisplatin for the treatment of patients with advanced gastric cancer. Anticancer Drugs 13(5):497–503CrossRefPubMedGoogle Scholar
- 24.Koizumi W, Akiya T, Sato A, Yamaguchi K, Sakuyama T, Nakayama N, Tanabe S, Higuchi K, Sasaki T, Sekikawa T (2009) Second-line chemotherapy with biweekly paclitaxel after failure of fluoropyrimidine-based treatment in patients with advanced or recurrent gastric cancer: a report from the gastrointestinal oncology group of the Tokyo cooperative oncology group, TCOG GC-0501 trial. Jpn J Clin Oncol 39(11):713–719. https://doi.org/10.1093/jjco/hyp099 CrossRefPubMedGoogle Scholar
- 25.Yamada Y, Higuchi K, Nishikawa K, Gotoh M, Fuse N, Sugimoto N, Nishina T, Amagai K, Chin K, Niwa Y, Tsuji A, Imamura H, Tsuda M, Yasui H, Fujii H, Yamaguchi K, Yasui H, Hironaka S, Shimada K, Miwa H, Hamada C, Hyodo I (2015) Phase III study comparing oxaliplatin plus S-1 with cisplatin plus S-1 in chemotherapy-naive patients with advanced gastric cancer. Ann Oncol Off J Eur Soc Med Oncol 26(1):141–148. https://doi.org/10.1093/annonc/mdu472 CrossRefGoogle Scholar
- 26.Lee HH, Hur H, Kim SH, Park AR, Kim W, Jeon HM (2010) Outcomes of modified FOLFOX-6 as first line treatment in patients with advanced gastric cancer in a single institution; retrospective analysis. Cancer Res Treat 42(1):18–23. https://doi.org/10.4143/crt.2010.42.1.18 CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Kim HS, Kim JH, Kim HJ, Jang HJ, Kim JB, Kim JW, Jung SY, Kim BC, Yang DH, Park S, Kim KJ, Lee SI, Zang DY (2012) Oxaliplatin, 5-fluorouracil and leucovorin (modified FOLFOX-6) as first-line chemotherapy for advanced gastric cancer patients with poor performance status. Oncol Lett 3(2):425–428. https://doi.org/10.3892/ol.2011.496 CrossRefPubMedGoogle Scholar