Docetaxel: its role in current and future treatments for advanced gastric cancer

Abstract

regimen are undetermined [1][2][3][4]. Both CF (cisplatin [CDDP]/5-fl uorouracil ) and ECF (epirubicin/ CDDP/5-FU) have been considered as reference regimens to date [5][6][7][8], but the median survival time (MST) of the regimens does not exceed 7-10 months.Recently, several active agents have been used in gastric cancer therapy: the taxanes, irinotecan (CPT-11), oxaliplatin, S-1, and capecitabine, and more recently, biological agents such as cetuximab and bevacizumab have been used [1][2][3][4][5][6][7][8]. Current studies have thus focused on "new-generation agents," and much effort has been directed towards the development of the best regimen in various treatment settings. A series of these trials have provided several regimens that could become a standard treatment: the regimens include docetaxel/CDDP/5-FU (DCF) and CDDP/S-1 for advanced and metastatic cancer, and S-1 monotherapy in the adjuvant setting [9][10][11]. The advent of these newgeneration agents offers hope for improving patient outcomes.Among the new-generation agents, docetaxel now appears to be one of the most extensively investigated [12]. Docetaxel has demonstrated promising activity in gastric cancer, both as monotherapy [13,14] and in combination with other agents [15][16][17]. To date, docetaxel combinations, especially the DCF regimen, seem to be pivotal [9,10], and further, a taxane has been suggested to be the best potential partner of new oral 5-FU analogues and prodrugs such as S-1 and capecitabine [16,17]. This review will focus on the taxane, docetaxel, as a key agent in gastric cancer chemotherapy. Docetaxel as a single agent Mechanisms of action and metabolismDocetaxel is a semisynthetic analogue of paclitaxel, an extract from the rare Pacifi c yew tree Taxus brevifolia [18]. The chemical structure of docetaxel differs from

Relevance of Surgery in Stage IV Gastric Carcinoma

“…Recently, the Japanese ACTS-GC trial demonstrated the efficacy of S-1 for Stage II-III gastric cancer patients after a curative resection with a D2 lymphadenectomy, where S-1 was found to improve the 3-year overall survival (OS) from 70.1% for surgery alone to 80.1% [11]. Several novel chemotherapeutic agents, including irinotecan (CPT-11), taxanes (paclitaxel and docetaxel), and oxaliplatin in combination with S-1, have demonstrated beneficial activity against gastric cancer and offer hope for improving patient outcomes [12][13][14]. Several chemotherapy regimens, such as S-1 plus cisplatin of the SPIRITS trial, have recently shown a remarkably high response rate [15], and this regimen is frequently used as first-line chemotherapy, with good results in advanced cases [16].…”

Docetaxel, oxaliplatin, and capecitabine combination chemotherapy for metastatic gastric cancer

“…The pretreatment characteristics of patients are listed in Table 1. None of the patients had previously received chemotherapy for advanced disease; 9 patients had received adjuvant chemotherapy without docetaxel or oxaliplatin with a median disease-free interval of 12 months (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] (Figs. 1, 2).…”

“…During the past few years platinum salts, docetaxel, and trastuzumab have entered the therapeutic arena, demonstrating improved outcomes in randomized trials with a superiority design [10][11][12]. The incorporation of docetaxel to cisplatin/fluorouracil chemotherapy (DCF) showed superiority over cisplatin/fluorouracil in a randomized phase III trial [8].…”

Reduced Doses of Docetaxel and Cisplatinum Plus 5 Fluorouracil Combination Chemotherapy in Metastatic Esophagogastric Adenocarcinoma: The Impact on Outcomes

“…cisplatin-5-FU (CF) combination. 21,22 Although TAX 325 demonstrated that in patients with metastatic gastroesophageal cancer, the addition of docetaxel to CF combination increased disease free survival and overall survival rates, it also had high dose limiting toxicity. Standard dose DCF regimen started to be new reference regimen in metastatic gastroesophageal cancer.…”