A Phase II Trial of Epirubicin, Oxaliplatin, and Capecitabine (EOX) as First-Line Chemotherapy in Advanced Gastric Cancer: A Chinese Single-Center Experience

Abstract

Objective: This study aimed at evaluating the efficacy and safety of epirubicin, oxaliplatin, and capecitabine (EOX) in advanced gastric cancer (AGC) patients in the Chinese population. Patients and Methods: Patients with previously untreated advanced measurable gastric cancer received epirubicin (50 mg/m², day 1), oxaliplatin (130 mg/m² 2-hour infusion, day 1) and capecitabine (625 mg/m² orally, twice daily, days 1–21) every 3 weeks.Results: Of 48 enrolled patients, 47 were evaluable for efficacy and 48 for toxicity. A median of five cycles (range 1–8) was administered. The overall response rate was 51.1% (95% CI 36–66) with two complete responses, 22 partial responses, 16 stable diseases, and 7 progressions. Median progression-free survival was 6.5 months (95% CI 5.6–7.4) and median overall survival was 10.4 months (95% CI 8.8–12.0). Grade 3–4 neutropenia and anemia were observed in 22.9 and 6.3% of patients, respectively. Grade 3–4 nonhematological toxicities included alopecia (18.9%), nausea (8.3%), vomiting (6.3%), diarrhea (6.3%), hand-foot syndrome (4.2%) and neurological toxicity (2.1%). Conclusion: In our experience, the EOX regimen was highly effective, well tolerated and conveniently delivered as first-line chemotherapy for AGC patients in the Chinese population.

The Efficacy and Safety of Modified Docetaxel, Cisplatin, and 5-Fluorouracil Vs. Epirubicin, Oxaliplatin, and Capecitabine Regimen in the Advanced Gastric Cancer: A Randomized Controlled Clinical Trial

“…In our study, the most common side effect in the EOX group was reduction of WBC, neutrophil, and platelet count (10.53%). In a clinical trial by Xiang et al on advanced gastric cancer patients in China, the most common toxicity was grade III or IV neutropenia (22.9%) in the EOX regimen, which is almost similar to the present study (Xiang et al, 2010). In another study, Cunningham et al showed that the most common toxicity was grade III/IV neutropenia in the EOX group (27.6%) (Cunningham et al, 2008).…”

A Retrospective Study of the Safety and Efficacy of a First-Line Treatment with Modified FOLFOX-4 in Unresectable Advanced or Recurrent Gastric Cancer Patients

“…Epirubicin, cisplatin and 5-FU have been widely used as a combination regimen. Also, epirubicin, cisplatin and 5-FU as well as docetaxel, cisplatin and 5-FU or epirubicin, oxaliplatin and capecitabine regimens are some of the currently recommended regimens in first-line chemotherapy in advanced gastric cancer, but severe hematological toxicity renders the compliance of patients difficult [3,4,5]. Based on favorable response rates, 5-FU- and platinum-containing combinations are considered to represent one of the standard therapies for patients with advanced gastric cancer, with more efficacy and less toxicity encountered in patients with advanced gastric cancer in some phase II [3,4,6] and retrospective [7] studies.…”

Bimonthly Regimen of High-Dose Leucovorin, Infusional 5-Fluorouracil, Epirubicin and Cisplatin (Modified ECF) as Adjuvant Chemotherapy in Resected Gastric Adenocarcinoma

“…A number of studies with the combinations of cisplatin, epirubicin and 5-FU, which is modulated by LV or by means of prolonged IV infusion, have shown high activity in advanced gastric cancer [30,47,48,49,50,51,52,53,54,55]. The use of ECF in an adjuvant setting is supported by the results of the MAGIC trial.…”