Oxaliplatin Combined with Continuous Infusion of 5-Fluorouracil as First-Line Chemotherapy in Patients with Metastatic or Recurrent Gastric Adenocarcinoma

Abstract

Background: The aim of this clinical study was to evaluate the efficacy of combination chemotherapy of oxaliplatin, leucovorin and continuous-infusion 5-fluorouracil (5-FU) for advanced gastric cancer. Methods: Patients with previously untreated gastric cancer with measurable disease received oxaliplatin (100 mg/m², day 1), followed by leucovorin (100 mg/m², day 1) and 5-FU (2,400 mg/m², days 1–2), which was repeated every 2 weeks. The primary endpoint was overall response rate (ORR) and secondary endpoints were progression-free survival (PFS), overall survival (OS) and toxicity. Results: Forty-eight patients were enrolled, and 45 were evaluable for response. A total of 320 cycles of chemotherapy were administered (median 6 cycles per patient). One complete response (2.1%) and 19 partial responses (39.6%) were noted, resulting in an ORR of 41.7% (95% confidence interval, CI: 27.7–55.6%) by intent-to-treat analysis. With a median follow-up duration of 22 months, the median PFS was 5.3 (95% CI: 2.8–7.8) months and the median OS was 13.6 (95% CI: 9.3–17.9) months. There was 1 treatment-related death, and the most common grade 3/4 toxicity was neutropenia (36.1%). Three patients discontinued treatment because of serum creatinine elevation. Conclusion: This study reaffirms the efficacy of oxaliplatin in advanced gastric cancer, but its dose of 100 mg/m² remains to be reconsidered in Korean patients.

Enhancement of Antiproliferative and Proapoptotic Effects of Cadmium Chloride Combined with hSmac in Hepatocellular Carcinoma Cells

“…Moreover, as the liver was the major target organ for acute cadmium exposure, and metallothionein expression was lower in hepatomas than that in normal liver tissues, such characteristics made it possible to develop cadmium as a potential antihepatoma drug. Nowadays, the combined treatment is proven to be beneficial in lowering the administered dosage of chemotherapeutic drugs while maintaining or even enhancing the antitumor effects [25]. …”

Predictors of Timing and Patterns of Recurrence after Curative Resection for Gastric Cancer

“…No consensus has yet been reached regarding an optimal follow-up schedule and no study has shown a survival benefit for any particular follow-up program over another [22,23,24]. However, new chemotherapeutic agents, such as taxane, irinotecan, oxaliplatin, a new oral fluoropyrimidine, and targeted agents, are expected to provide effective treatment options for recurrences detected early [25,26,27,28]. A large prospective randomized controlled clinical trial is needed to verify the advantages of intensive follow-up program and new therapeutic agents.…”

A Phase II Study of Capecitabine plus Oxaliplatin as First-Line Chemotherapy in Elderly Patients with Advanced Gastric Cancer

“…The adducts of oxaliplatin appear to be more effective than cisplatin adducts with regard to the inhibition of DNA synthesis. In published phase II trials, the oxaliplatin-based regimens demonstrated a response rate ranging from 40 to 50% in chemotherapy-naive AGC patients [9,10,11]. Also, oxaliplatin/5-FU/leucovorin combinations have proved to be active and tolerable in elderly AGC patients [12,13,14,15].…”