Abstract
Purpose
The aim of this retrospective study (from January 2007 to December 2011) was to investigate the efficacy and tolerability of mDCF schedule for chemotherapy-naïve AGC patients.
Patients
Patients (n = 54) with locally inoperable or distant metastasis and performance status of 0–2 were eligible. The triplet combination chemotherapy consisting of docetaxel 60 mg/m2 on day 1, cisplatin 60 mg/m2 on day 1, and 5-fluorouracil 600 mg/m2 for 5 days of continuous infusion were administered every 21 days, up to nine cycles. Prophylactic G-CSF was not allowed.
Results
In all, 36 (67 %) patients were male and 18 (33 %) were female; median age was 59 years. The majority of patients (n = 46, 85 %) had metastatic disease and 8 (15 %) of them had locally advanced disease. Liver metastasis and peritonitis carcinomatosa were found in 20 (43 %) and 18 (39 %) of the 46 cases, respectively. The median cycle of chemotherapy was 6. In assessing 50 patients for response evaluation, one had complete response. Partial response was achieved in 27 (54 %) patients. Seventeen patients (34 %) had stable disease and 5 (10 %) had progressive disease, while 4 % (n = 2) and 11 % (n = 6) of the patients developed severe (grade 3–4) neutropenia and anemia, respectively. During the median follow-up time (6.9 months, range 0.4–24), 28 (52 %) patients died. The overall and progression-free survival were 10.7 [95 % CI 8.9–12.4] and 6.8 [95 % CI 5.8–7.8] months, respectively.
Conclusions
Although this was not a prospective comparative study, the mDCF regimen seems to be as effective as the original DCF in AGC with acceptable and manageable side effects.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Van Cutsem E, Dicato M, Geva R et al (2011) The diagnosis and management of gastric cancer: expert discussion and recommendations from the 12th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2010. Ann Oncol 22(Suppl 5):v1–v9
Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150
Patel SH, Kooby DA (2011) Gastric adenocarcinoma surgery and adjuvant therapy. Surg Clin North Am 91:1039–1077
Ajani JA (2007) Recent developments in cytotoxic therapy for advanced gastric or gastroesophageal carcinoma: the phase III trials. Gastrointest Cancer Res 1:S16–S21
Bohanes P, Courvoisier DS, Perneger TV et al (2011) Survival predictors for second-line chemotherapy in Caucasian patients with metastatic gastric cancer. Swiss Med Wkly 141:w13249
Allum WH, Blazeby JM, Griffin SM et al (2011) Guidelines for the management of oesophageal and gastric cancer. Gut 60:1449–1472
Glimelius B, Ekstrom K, Hoffman K et al (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168
Pyrhonen S, Kuitunen T, Nyandoto P et al (1995) Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer 71:587–591
Nishiyama M, Wada S (2009) Docetaxel: its role in current and future treatments for advanced gastric cancer. Gastric Cancer 12:132–141
Van Cutsem E, Moiseyenko VM, Tjulandin S et al (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 24:4991–4997
Kang YK, Kang WK, Shin DB et al (2009) Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomised phase III noninferiority trial. Ann Oncol 20:666–673
Roth AD, Fazio N, Stupp R et al (2007) Docetaxel, cisplatin, and fluorouracil; docetaxel and cisplatin; and epirubicin, cisplatin, and fluorouracil as systemic treatment for advanced gastric carcinoma: a randomized phase II trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol 25:3217–3223
Tomasello G, Chiesa MD, Buti S et al (2010) Dose-dense chemotherapy in metastatic gastric cancer with a modified docetaxel–cisplatin–5-fluorouracil regimen. Tumori 96:48–53
Shah AM, Shibata S, Stoller RG et al (2010) Random assignment multicenter phase II study of modified docetaxel, cisplatin, fluorouracil (mDCF) versus DCF with growth factor support (GCSF) in metastatic gastroesophageal adenocarcinoma (GE). J Clin Oncol 28(Suppl):15s (abstr 4014)
Wang B, Zhang W, Hong X et al (2009) Phase I dose-escalating study of 24-h continuous infusion of 5-fluorouracil in combination with weekly docetaxel and cisplatin in patients with advanced gastric cancer. Cancer Chemother Pharmacol 63:213–218
Piacentini P, Durante E, Trolese A et al (2012) Weekly Taxotere and cisplatin with continuous-infusion 5-fluoruracil for the treatment of advanced gastric and esophageal cancer: a prospective, observational, single-institution experience. Gastric Cancer 15:106–110
Overman MJ, Kazmi SM, Jhamb J et al (2010) Weekly docetaxel, cisplatin, and 5-fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer. Cancer 116:1446–1453
Kos FT, Uncu D, Ozdemir N et al (2011) Comparison of cisplatin-5-fluorouracil-folinic acid versus modified docetaxel-cisplatin-5-fluorouracil regimens in the first-line treatment of metastatic gastric cancer. Chemotherapy 57:230–235
Inal A, Kaplan MA, Kucukoner M et al (2012) Docetaxel and cisplatin plus fluorouracil compared with modified docetaxel, cisplatin, and 5-fluorouracil as first-line therapy for advanced gastric cancer: a retrospective analysis of single institution. Neoplasma 59:233–236
Ajani JA, Fodor MB, Tjulandin SA et al (2005) Phase II multi-institutional randomized trial of docetaxel plus cisplatin with or without fluorouracil in patients with untreated, advanced gastric, or gastroesophageal adenocarcinoma. J Clin Oncol 23:5660–5667
Ben Aharon I, Purim O, Kundel Y et al (2012) The combination of docetaxel, cisplatin, and 5-fluorouracil in advanced gastric cancer: a single-institution experience. Anticancer Drugs 23:313–320
Park SR, Chun JH, Kim YW et al (2005) Phase II study of low-dose docetaxel/fluorouracil/cisplatin in metastatic gastric carcinoma. Am J Clin Oncol 28:433–438
Oh DY, Kim TY, Kwon JH et al (2005) Docetaxel + 5-fluorouracil + cisplatin 3-day combination chemotherapy as a first-line treatment in patients with unresectable gastric cancer. Jpn J Clin Oncol 35:380–385
Tebbutt NC, Cummins MM, Sourjina T et al (2010) Randomised, non-comparative phase II study of weekly docetaxel with cisplatin and 5-fluorouracil or with capecitabine in oesophagogastric cancer: the AGITG ATTAX trial. Br J Cancer 102:475–481
Conflict of interest
The authors declare that there are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Keskin, S., Yıldız, I., Sen, F. et al. Modified DCF (mDCF) regimen seems to be as effective as original DCF in advanced gastric cancer (AGC). Clin Transl Oncol 15, 403–408 (2013). https://doi.org/10.1007/s12094-012-0942-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12094-012-0942-8