A dose-escalation study of docetaxel, oxaliplatin, and S-1 (DOS) as a first-line therapy for patients with unresectable metastatic gastric cancer

Sato, Yasushi; Sagawa, Tamotsu; Ohnuma, Hiroyuki; Hirakawa, Masahiro; Takahashi, Yasuo; Hamaguchi, Kyoko; Fujikawa, Koshi; Nobuoka, Takayuki; Okamoto, Koichi; Miyamoto, Hiroshi; Muguruma, Naoki; Takemasa, Ichiro; Takayama, Tetsuji

doi:10.1007/s00280-018-3719-0

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…However, the high-grade 3/4 hematological side effects limit its scope of application. Although the dose-adjusted DOS regimen has achieved a certain balance in terms of efficacy and toxicity [ 17 , 18 ], hematological toxicity remains the main adverse event compared with the two-drug regimens. In this study, more than 50% of patients in the DOS group developed grade 4 neutropenia, compared with 28% of patients in the D-SOX group.…”

Section: Discussionmentioning

confidence: 99%

SOX combined with intraperitoneal perfusion of docetaxel compared with DOS regimen in the first-line therapy for advanced gastric cancer with malignant ascites: a prospective observation

Bin

Liu

Bao

et al. 2022

Trials

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Objective This study aimed to verify the survival superiority of the combination of intraperitoneal perfusion and systemic chemotherapy over standard systemic chemotherapy. Methods A total of 78 advanced gastric cancer patients with malignant ascites were randomly divided into D-SOX group (intraperitoneal infusion of docetaxel 30 mg/m2 on d1 and d8, intravenous oxaliplatin 100 mg/m2 on d1, and oral administration of S-1 on d1-d14) and DOS group (intravenous docetaxel 60 mg/m2 on d1, intravenous oxaliplatin 100 mg/m2 on d1, and oral administration of S-1 on d1-d14). Efficacy of both groups was evaluated every 2 cycles with 21 days as a cycle. The primary endpoint was overall survival, and the secondary endpoints were objective response rate, ascites control rate, negative conversion rate of ascites cytology, and side effects. Results The median overall survival in D-SOX group was significantly higher than that in the DOS group (11.7 vs 10.3 months, HR 0.52, 95%CI 0.31–0.86, P = 0.005). The ascites control rate in the D-SOX group was 58.9% and 30.8% in DOS group (95%CI 42.8–75.1% vs 95%CI 15.6–45.9%, P = 0.012). Besides, the adverse reactions were tolerable in both groups, and patients in the D-SOX group had lower grade 3/4 blood toxicity than that in the DOS group (26% vs 54%, P = 0.01). Conclusion Compared with traditional systemic chemotherapy, docetaxel intraperitoneal infusion combined with chemotherapy has better therapeutic effect on gastric cancer ascites, with better survival benefit and tolerance and less hematological toxicity, which is worthy of further research and clinical application.

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Section: Discussionmentioning

confidence: 99%

SOX combined with intraperitoneal perfusion of docetaxel compared with DOS regimen in the first-line therapy for advanced gastric cancer with malignant ascites: a prospective observation

Bin

Liu

Bao

et al. 2022

Trials

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“…Oxaliplatin has lower risk of renal function than cisplatin, and oxaliplatin-based chemotherapy has been found to be particularly effective for patients with AGC intolerant to cisplatin (33). Sato et al reported that a chemotherapy regimen comprising docetaxel, oxaliplatin, and S-1 for unresectable AGC achieved a median OS of 19.6 months (10). Specifically, the regimen comprised docetaxel at 50 mg/m 2 and oxaliplatin at 100 mg/m 2 on day 8, with S-1 at 80 mg/m 2 on days 1-14 of a 21-day cycle (10).…”

Section: Discussionmentioning

confidence: 99%

“…Sato et al reported that a chemotherapy regimen comprising docetaxel, oxaliplatin, and S-1 for unresectable AGC achieved a median OS of 19.6 months (10). Specifically, the regimen comprised docetaxel at 50 mg/m 2 and oxaliplatin at 100 mg/m 2 on day 8, with S-1 at 80 mg/m 2 on days 1-14 of a 21-day cycle (10).…”

Section: Discussionmentioning

confidence: 99%

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S-1, Oxaliplatin, Nab-paclitaxel and Itraconazole for Conversion Surgery for Advanced or Recurrent Gastric Cancer

et al. 2020

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Aim: To evaluate the efficacy of chemotherapy with itraconazole for advanced or recurrent gastric cancer. Patients and Methods: Patients with human epidermal growth factor receptor 2 (HER2) negative unresectable gastric cancer referred to our hospital were included. The regimen comprised 160 mg/m 2 nab-paclitaxel i.v. and 100 mg/m 2 oxaliplatin i.v. on day 1, 60 mg/m 2 S-1 orally on days 1-3, and 400 mg itraconazole orally on days −2 to 2, repeated every 2 weeks for 6-8 cycles. Results: Twenty-three patients aged 40-80 years (median age=68 years) were enrolled, of whom 21 had stomach cancer and two gastroesophageal junction cancer. Regarding stage, two, one, and 20 patients had stage IIIA, IIIB, and IV, respectively. Among patients with liver metastases, 2/10 had simultaneous lung metastases. Nine patients had peritoneal dissemination, and five patients with stage IV disease developed recurrence after primary surgery followed by adjuvant S-1. The other 18 patients had no history of surgery or chemotherapy. The response rate was 70% (complete response in two; partial response in 14). Among 12 patients (67%) who underwent conversion surgery, R0 resection was conducted in eight, and no residual tumour was observed in two. For the population overall, the median overall survival was 24 months (95% confidence intervaI=21 months-not reached) and the 1-year overall survival rate was 95% (95% confidence intervaI=67-98%). Grade 3/4 neutropenia and grade 2 peripheral sensory neuropathy occurred in five (22%) and six (26%) patients, respectively, while no patient developed grade 3/4 thrombocytopenia. Conclusion: Chemotherapy with itraconazole is promising for patients with unresectable gastric cancer.

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“…They found neoadjuvant DOS, as part of perioperative chemotherapy, improved PFS of patients with advanced gastric cancer, and treatments were well tolerated [25]. Other studies also showed that the preoperative DOS regimen is effective and safe in patients with locally advanced gastric adenocarcinoma [26] and metastatic gastric cancer [27,28].…”

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confidence: 99%

Does resection after neoadjuvant chemotherapy of Docetaxel, oxaliplatin, and S-1 (DOS regimen) benefit for gastric cancer patients with single non-curable factor? A multicenter, prospective cohort study (Neo-REGATTA)

Cui

Zheng

et al. 2023

Preprint

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Background The Neo-REGATTA study evaluated the effectiveness and safety of Docetaxel, oxaliplatin, and S-1 (DOS regimen) followed by radical resection vs. chemotherapy in advanced gastric adenocarcinoma patients with single non-curable factor. Methods This cohort study prospectively enrolled advanced gastric adenocarcinoma patients with single non-curable factor between November 2017 and June 2021. Patients without progression after four cycles of DOS were divided into resection group and chemotherapy group. The outcomes included overall survival (OS), progression-free survival (PFS) and safety. Effectiveness analysis was also performed by propensity score matching (PSM). Results A total of 73 patients were enrolled and 13 patients were withdrawn due to disease progression after 4 cycles of DOS. Afterwards, 35 and 25 participants were in the resection and chemotherapy groups, respectively. After a median follow-up time of 19.5 months (5–48 months), the median PFS and OS were 9.0 months, and 18.0 months for the chemotherapy group, but not reached in the resection group. After PSM, 19 matched participants were in each group. The OS was longer in resection group than that in chemotherapy group (HR = 0.19, 95% CI: 0.05–0.70, P = 0.013). The PFS was longer in resection group than that in chemotherapy group (HR = 0.22, 95% CI: 0.07–0.68, P = 0.009). The most common grade 3 or 4 adverse events in both groups were neutropenia (5.7%, 8.0%) and leukopenia (5.7%, 8.0%), respectively. Conclusions Radical resection might provide survival benefit compared with continuous chemotherapy alone in advanced gastric adenocarcinoma patients who had a disease control after DOS, with a good safety profile. Trial registration: The study protocol was registered on ClinicalTrial.gov (NCT03001726, 23/12/2016).

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A dose-escalation study of docetaxel, oxaliplatin, and S-1 (DOS) as a first-line therapy for patients with unresectable metastatic gastric cancer

Cited by 6 publications

References 23 publications

SOX combined with intraperitoneal perfusion of docetaxel compared with DOS regimen in the first-line therapy for advanced gastric cancer with malignant ascites: a prospective observation

SOX combined with intraperitoneal perfusion of docetaxel compared with DOS regimen in the first-line therapy for advanced gastric cancer with malignant ascites: a prospective observation

S-1, Oxaliplatin, Nab-paclitaxel and Itraconazole for Conversion Surgery for Advanced or Recurrent Gastric Cancer

Does resection after neoadjuvant chemotherapy of Docetaxel, oxaliplatin, and S-1 (DOS regimen) benefit for gastric cancer patients with single non-curable factor? A multicenter, prospective cohort study (Neo-REGATTA)

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