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

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

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

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. METHODS: Data from 117 patients treated at The University of Texas M. D. Anderson Cancer Center from 2002 to 2006 with a weekly formulation of DCF were retrospectively collected. A total of 95 patients received front-line therapy with 20 mg/m2 of cisplatin, 350 mg/m 2 of 5-fluorouracil, and 20 mg/m2 of docetaxel administered once weekly for 6 consecutive weeks followed by a 2-week break. RESULTS: Ninety-five patients (median age, 62 years [range, 33 to 87 years], with an Eastern Cooperative Oncology Group performance status of 1 or 2 in 67%) received a median of 10 weeks of DCF treatment (range, 3-41 weeks). Grade 3 or 4 hematologic toxicity (assessed according to National Cancer Institute Common Toxicity Criteria [version 3.0]) included granulocytopenia (4 patients) and anemia (9 patients). None of the patients developed a febrile neutropenic infection, but grade 3 or 4 non-neutropenic infections occurred in 8 patients. Eighty patients had measurable disease with an objective response rate determined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria of 34% (95% confidence interval [95% CI], 24-45%). The median follow-up was 9 months, with a median time to disease progression of 4.1 months (95% CI, 3.6-5.7 months) and a median overall survival of 8.9 months (95% CI, 7.7-10.8 months). CONCLUSIONS: In patients with advanced gastric and esophageal cancer who were not candidates for every-3-week DCF, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients.

Original languageEnglish (US)
Pages (from-to)1446-1453
Number of pages8
JournalCancer
Volume116
Issue number6
DOIs
StatePublished - Mar 15 2010

Keywords

  • 5-fluorouracil
  • Cisplatin
  • Docetaxel
  • Esophageal cancer
  • Gastric cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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