Cancer Res Treat.  2012 Dec;44(4):235-241.

Outcomes of Third-Line Docetaxel-Based Chemotherapy in Advanced Gastric Cancer Who Failed Previous Oxaliplatin-Based and Irinotecan-Based Chemotherapies

• Lee MJ
• Hwang IG
• Jang JS
• Choi JH
• Park BB
• Chang MH
• Kim ST
• Park SH
• Kang MH
• Kang JH

Abstract

PURPOSE
Little is known about outcomes in the use of third-line chemotherapy in cases of advanced gastric cancer (AGC). The primary aim of this retrospective study was to evaluate outcomes of docetaxel-based chemotherapy in patients with AGC that progressed after both oxaliplatin-based and irinotecan-based regimens.
MATERIALS AND METHODS
Eligible patients were those with AGC who had previous chemotherapy including fluoropyrimidine and oxaliplatin as well as fluoropyrimidine and irinotecan and who received subsequent docetaxel-based chemotherapy. Thirty-five patients were retrospectively recruited from 5 medical centers in Korea. Patients received either weekly or 3 weekly with docetaxel +/- cisplatin.
RESULTS
Thirty-one out of 35 patients were evaluated for treatment response. A total of 94 cycles of chemotherapy (median, 2; range, 1 to 7) were administered. The overall response rate was 14.3%, and the disease control rate was 45.7%. The median progression-free survival (PFS) was 1.9 months (95% confidence interval [CI], 1.1 to 2.7 months). The median overall survival (OS) was 3.6 months (95% CI, 2.8 to 4.4 months). PFS and OS were significantly prolonged in patients of the Eastern Cooperative Oncology Group, with performance status of 0 or 1 in multivariate analysis (PFS: hazard ratio[HR], 0.411; 95% CI, 0.195 to 0.868; p=0.020 and OS: HR, 0.390; 95% CI, 0.184 to 0.826; p=0.014, respectively). Four of the 35 patients enrolled in the study died due to infection associated with neutropenia.
CONCLUSION
Our findings suggest that salvage docetaxel-based chemotherapy is a feasible treatment option for AGC patients with good performance status (PS), whereas chemotherapy for patients with poor PS (PS< or =2) should be undertaken with caution for those who previously failed oxaliplatin- and irinotecan-based regimens.

Keyword

Stomach neoplasms; Docetaxel; Oxaliplatin; Irinotecan

MeSH Terms

Camptothecin
Disease-Free Survival
Humans
Korea
Multivariate Analysis
Organoplatinum Compounds
Retrospective Studies
Stomach Neoplasms
Taxoids
Camptothecin
Organoplatinum Compounds
Taxoids

Figure

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  Fig. 1 Progression-free survival (PFS) (A) and overall survival (OS) (B) curves for patients treated with 3rd line docetaxel according to Eastern Cooperative Oncology Group performance status (PS).

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