Capecitabine and Oxaliplatin for Advanced Esophagogastric Cancer

Cunningham, David; Okines, Alicia; Ashley, S.

doi:10.1056/nejmc0911925

Cited by 502 publications

(465 citation statements)

References 3 publications

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“…The median progression-free survival of 6.8 months and the median OS of 11.1 months compare favourably with those obtained with TAX-V325 study [9,10], and this was not the case of our series. At the same time, there were no patients with locally advanced disease in our experience, while they represented a significant subgroup (*22%) in the REAL-2 study [21] that for the first time reported a median OS of more than 11 months for the epirubicin, capecitabine and oxaliplatin arm, and this may have positively affected such results. The safety profile of the sequential treatment was extremely favourable with no toxicities exceeding the incidence of 9% except for neutropenia that was febrile only in one case.…”

Section: Discussionmentioning

confidence: 75%

Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma

Loupakis¹,

Masi²,

Fornaro³

et al. 2010

Cancer Chemother Pharmacol

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, et al.. Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma. Cancer Chemotherapy and Pharmacology, Springer Verlag, 2010, 66 (3), pp.559-566. <10.1007/s00280-009-1196-1>. ORIGINAL ARTICLEPhase II study of sequential cisplatin plus 5-fluorouracil/ leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma Results Forty-six patients were enrolled, median age 60 years, sites of disease (single/multiple) = 9/37, PS 0/1 = 27/19, gastric/gastro-oesophageal junction = 39/7. Median number of cycles was 9. Main grade 3-4 toxicities were neutropenia (37%), febrile neutropenia (2%), diarrhoea (4%), stomatitis (9%). Response rate after the planned 9 cycles was 45% (15 partial and 5 complete responses among 43 evaluable patients). Median PFS and OS: 6.8 and 11.1 months, respectively. Conclusion This sequential treatment is feasible with a favourable safety profile and produced encouraging results in terms of activity and efficacy.

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Section: Discussionmentioning

confidence: 75%

Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma

Loupakis¹,

Masi²,

Fornaro³

et al. 2010

Cancer Chemother Pharmacol

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“…Oxaliplatin-based regimens have become a cornerstone in the treatment of advanced colorectal carcinoma [12][13][14][15] and have demonstrated activity in adenocarcinomas arising in other gastrointestinal sites. 19,20 Despite the widespread use of oxaliplatin-based regimens, there is a surprising lack of information regarding their empiric use for the treatment of CUP. In this study, the combination of oxaliplatin and capecitabine demonstrated significant activity and produced a 19% response rate in this group of patients with refractory disease.…”

Section: Discussionmentioning

confidence: 99%

Oxaliplatin and capecitabine in the treatment of patients with recurrent or refractory carcinoma of unknown primary site

Hainsworth

Spigel

Burris

et al. 2010

Cancer

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BACKGROUND: Despite the widespread use of oxaliplatin-based regimens for colorectal and other gastrointestinal cancers, there is surprisingly little information regarding their empiric use for the treatment of carcinoma of unknown primary site (CUP). In the current study, the combination of oxaliplatin and capecitabine in patients with recurrent and refractory CUP was examined. METHODS: Patients with CUP who had received at least 1 previous chemotherapy regimen were treated with oxaliplatin (130 mg/m 2 intravenously on Day 1) and capecitabine (1000 mg/m 2 orally twice daily on Days 1-14). Treatment cycles were repeated every 21 days. Patients with objective response or stable disease after 2 cycles continued treatment for 6 cycles or until disease progression. RESULTS: Nine of 48 patients (19%) had objective responses to treatment; an additional 22 patients had stable disease at the time of first re-evaluation. After a median follow-up of 17 months, the median progression-free and overall survivals were 3.7 months and 9.7 months, respectively. This regimen was reasonably well tolerated by most patients. CONCLUSIONS: The combination of oxaliplatin and capecitabine was found to have activity as a salvage treatment for patients with CUP. This regimen should be considered in patients with clinical and pathologic features suggesting a primary site in the gastrointestinal tract. Further development of the regimen as a first-line therapy, or with bevacizumab added, is indicated. Cancer 2010;116:2448-54.

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“…For many years, Xuorouracil and cisplatin have been the only active agents for this disease, and a doublet of these compounds has been the reference regimen for treating these patients [1]. However, considering the results of recent trials [5][6][7], triplets have gained consensus as a standard treatment for advanced gastric cancer [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…Only the double drug substitution in the EOX regimen was associated with a prolongation of median OS (11.2 months) in comparison with the ECF regimen, but the 2-year OS was still around 20%. Moreover, no advantage in overall quality of life of patients was reported [6]. On the other hand, addition of docetaxel to cisplatin and Xuorouracil (DCF regimen) demonstrated to signiWcantly increase RR (37 vs. 25%), PFS (median 5.6 vs. 3.7 months), and OS (median 9.2 vs. 8.6 months) of patients in comparison with the CF regimen.…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis showed that combination regimens achieve better survival outcomes than Xuorouracil monotherapy, and that regimens containing Xuorouracil, anthracyclines and cisplatin are the most eVective [3]. Indeed, epirubicin, cisplatin and infusional Xuorouracil (ECF) regimen is one of the most widely used in Europe, while in US the standard regimen has remained for a long time cisplatin and infusional Xuorouracil (CF) [2,[4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Oxaliplatin, irinotecan, and fluorouracil/folinic acid in advanced gastric cancer: a multicenter phase II trial of the Southern Italy Cooperative Oncology Group

Comella

Lorusso²,

Maiorino

et al. 2009

Cancer Chemother Pharmacol

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Purpose This phase II trial assessed the tolerability and eYcacy of a triplet of oxaliplatin, irinotecan, and Xuorouracil/folinic acid in advanced gastric cancer. Methods Patients with unresectable or metastatic gastric cancer, unexposed to palliative chemotherapy, received oxaliplatin 85 mg/m 2 iv and irinotecan 150 mg/m 2 iv on day 1, 6S-folinic acid 250 mg/m 2 iv and Xuorouracil 750 mg/m 2 iv on day 2, every 2 weeks. Response rate (RR) was assessed after a minimum of four cycles, and treatment continued up to 12 cycles. Results Sixty-three patients were treated, with a median of eight (range 1-12) cycles/patient. Two complete and 19 partial responses were registered (RR 33% [95% CI, 22-46%]). Median progression-free survival was 7.5 (95% CI, 5.6-9.4) months, and median overall survival was 12.1 (95% CI, 10.8-13.4) months. Most common grade ¸3 toxicities were neutropenia (59%), febrile neutropenia (7%), vomiting (20%), and diarrhoea (10%). All-grade neurotoxicity aVected 33% of patients. Conclusions Oxaliplatin, irinotecan, and Xuorouracil/folinic acid administered every 2 weeks are safe and active in advanced gastric cancer. Keywords

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Capecitabine and Oxaliplatin for Advanced Esophagogastric Cancer

Cited by 502 publications

References 3 publications

Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma

Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma

Oxaliplatin and capecitabine in the treatment of patients with recurrent or refractory carcinoma of unknown primary site

Oxaliplatin, irinotecan, and fluorouracil/folinic acid in advanced gastric cancer: a multicenter phase II trial of the Southern Italy Cooperative Oncology Group

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