Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer

Abstract

A phase II trial was performed to determine the antitumour efficacy and tolerance of combined paclitaxel and cisplatin with or without hematopoetic growth factor support in patients with advanced gastric cancer. Forty-five patients with histologically confirmed metastatic gastric cancer were entered in this trial. Treatment consisted of 2-weekly courses of paclitaxel 160 mg per m 2 and cisplatin 60 mg per m 2 both given on day 1. Depending on absolute neutrophil counts on the days of scheduled chemotherapeutic drug administration (1000 -2000 per ml), a 5-day course of human granulocyte colony-stimulating factor 5 mg kg 71 per day was given subcutaneously; in addition, if haemoglobin was 512.0 mg dl 71 , erythropoietin 10 000 IU was administered subcutaneously three times per week. The confirmed overall response rate (intent-to-treat) was 44%, including five complete (11%) and 15 partial remissions (33%). Twelve patients had stable disease (27%), 11 (24%) progressed while on chemotherapy, and two patients were not evaluable. The median time to response was 3 months, the median time to progression 7.0 months, and the median survival time was 11.2 months with 12 patients currently alive. Haematologic toxicity was common, though WHO grade 4 neutropenia occurred in only five patients (11%). Apart from total alopecia in 16 patients (36%), severe non-haematologic adverse reactions included grade 3 peripheral neuropathy in six (13%) and anaphylaxis in two patients. In addition, there was one patient each who experienced grade 3 emesis, diarrhea, and infection, respectively. Our data suggest that the combination of paclitaxel and cisplatin with or without G-CSF and/or erythropoietin has promising therapeutic activity in patients with advanced gastric cancer.

A Phase II Study of Paclitaxel and Cisplatin as Salvage Therapy for Patients with Advanced or Metastatic Gastric Cancer

“…Promising results have also been reported with a regimen of paclitaxel and cisplatin (18), with an overall response rate of 44%, with a median time to progression and an overall survival of 7 and 11.2 months, respectively.…”

Salvage chemotherapy with irinotecan, 5-fluorouracil and leucovorin for taxane- and cisplatin-refractory, metastatic gastric cancer

“…Taxane and cisplatin has been used as a first-line chemotherapy with various schedules and doses since the late 1990s (Roth et al, 2000;Ridwelski et al, 2001;Kornek et al, 2002;Lee et al, 2004). Taxane and cisplatin chemotherapy has produced 30 -50% of RRs as a first-line treatment, but the diseases of responding and nonresponding patients eventually progress (Roth et al, 2000;Ridwelski et al, 2001;Kornek et al, 2002;Lee et al, 2004).…”

“…Taxane and cisplatin chemotherapy has produced 30 -50% of RRs as a first-line treatment, but the diseases of responding and nonresponding patients eventually progress (Roth et al, 2000;Ridwelski et al, 2001;Kornek et al, 2002;Lee et al, 2004). A randomised phase III trial showed a higher RR (39 vs 23%) and longer time to progression (TTP; 5.2 vs 3.7 months) in DCF (docetaxel, cisplatin, 5-fluorouracil) arm when compared to CF (cisplatin, 5-fluorouracil) arm (Ajani et al, 2003).…”

Randomized, Multicenter, Phase III Trial of Heptaplatin 1-hour Infusion and 5-Fluorouracil Combination Chemotherapy Comparing with Cisplatin and 5-Fluorouracil Combination Chemotherapy in Patients with Advanced Gastric Cancer

“…The combination of paclitaxel and 5-FU showed a response rate of 65% and a median survival of 12 months in 31 patients with advanced gastric cancer (54). Promising results were also reported with a regimen of paclitaxel and cisplatin (55), with an overall response rate of 44% and a median time to progression and an overall survival of 7 and 11.2 months, respectively.…”