Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 15525
© 2008 American Society of Clinical Oncology

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Abstract

Retrospective review of docetaxel, cisplatin, and 5FU (DCF) given on a weekly basis for the treatment of advanced gastric or esophageal cancer

University of Texas M. D. Anderson Cancer Center, Houston, TX

15525

Background: DCF administered every three weeks results in a high rate of treatment-related adverse events. At M.D. Anderson Cancer Center (MDACC) a weekly formulation of DCF has been utilized in patients who were not considered candidates for every three week dosing. Methods: A single institution retrospective review of patients with metastatic or locally advanced gastric or esophageal cancer treated with weekly DCF from 1/2002 to 3/2007 was conducted. Over this time period a standard order-set was in place in which cisplatin 20 mg/m², 5FU 350 mg/m² and docetaxel 20 mg/m² was given once weekly for 6 consecutive weeks every 8 weeks (one cycle). Only patients who were treated at MDACC, received 3 weeks of treatment and had follow-up evaluation were included. Tumor response was calculated retrospectively using RECIST criteria. Results: Fifty-seven patients were identified: tumor type: gastric (20), esophageal (18) or gastroesophageal cancer (19); histology: adenocarcinoma (44) or squamous cell carcinoma (13); disease status: metastatic (42) or locally advanced (15). The median age was 60 years (33 to 81), 67% were male, and 94% were chemo-naive. The average number of cycles administered was 1.8 (1 to 4). Hematological toxicity was minimal with grade 3/4 granulocytopenia in 1 patient, grade 3/4 thrombocytopenia in 0 patients, and grade 3/4 anemia in 5 patients. No patient had a neutropenic infection but grade 3/4 non-neutropenic infections occurred in 4 patients. Fatigue was reported by 29 patients, nausea/vomiting by 26 patients, and diarrhea by 17. A total of 16 patients had dose delays or dose reductions related to toxicity. Forty-nine patients had measurable disease with a partial response occurring in 27% (95% CI 15% to 41%) and stable disease occurring in 45%. Forty-nine patients have died with median follow-up of 8.8 months. Progression-free survival was 4 months (95% CI 3 to 6.2 m) and overall survival was 8.9 months (95% CI 7 to 10.8 m). Conclusions: Weekly DCF according to this schedule has minimal hematological toxicity and overall excellent tolerance in this population of patients who were not considered candidates for DCF administered every three weeks.

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