Sequential chemotherapy with dose-dense docetaxel, cisplatin, folinic acid and 5-fluorouracil (TCF-dd) followed by combination of oxaliplatin, folinic acid, 5-fluorouracil and irinotecan (COFFI) in metastatic gastric cancer: results of a phase II trial |
| |
Authors: | Matteo Dalla Chiesa Gianluca Tomasello Sebastiano Buti Rodrigo Kraft Rovere Matteo Brighenti Silvia Lazzarelli Gianvito Donati Rodolfo Passalacqua |
| |
Institution: | 1. Departments of Medical Oncology and Biostatistics, Azienda Ospedaliera di Cremona, Cremona, Italy 2. Medical Oncology Division, Azienda Istituti Ospitalieri, Viale Concordia 1, 26100, Cremona, Italy
|
| |
Abstract: | Purpose To evaluate a new strategy of two sequential, intensified chemotherapy regimens in metastatic gastric cancer. Patients and methods Chemo-na?ve patients with metastatic gastric cancer were enrolled to receive 4 cycles of TCF-dd (docetaxel initially 85?mg/m2 and cisplatin initially 75?mg/m2 on day 1 later modified due to toxicity: 70 and 60?mg/m2 respectively], l-folinic acid 100?mg/m2 on days 1 and 2, 5-fluorouracil 400?mg/m2 bolus and then 600?mg/m2 as a 22?h continuous infusion on day 1 and 2, every 14?days). Subsequently, patients with CR, PR or SD received 4 cycles of COFFI (oxaliplatin 85?mg/m2, irinotecan 140?mg/m2, l-folinic acid 200?mg/m2, 5-fluorouracil bolus 400?mg/m2 on day 1 followed by 2,400?mg/m2 as a 48?h continuous infusion, every 14?days). In both regimens pegfilgrastim 6?mg subcutaneously on day 3 was included. Results Forty consecutive patients were enrolled. TCF-dd regimen achieved an ORR of 55% (95% CI, 40?C70). Twenty-three patients proceeded to COFFI. After this regimen the ORR was then increased to 60% (95% CI, 45?C75). Among the 21 patients treated with TCF-dd after the protocol amendments, main grade 3?C4 toxicities were: neutropenia (29%), thrombocytopenia (19%), asthenia (24%) and diarrhea (14%). COFFI caused grade 3?C4 neutropenia (all not febrile) and diarrhea in 35% and 17% of patients respectively. Conclusions A sequential strategy with TCF-dd followed by COFFI is very active and may be of special interest in selected patients. |
| |
Keywords: | |
本文献已被 SpringerLink 等数据库收录! |
|