Safety, Feasibility, and Efficacy of Capecitabine Maintenance in Patients With Advanced Gastric Cancer: A Retrospective Study

Abstract

Gastric cancer is still one of the cancers with highest mortality. Most patients present with advanced-stage disease. Palliative chemotherapy is usually the only treatment option for patients with advanced gastric cancer (AGC). Maintenance chemotherapy is an evolving concept in medical oncology. Maintenance chemotherapy can be administered with the same drug(s) in the initial regimen or with an alternative agent. In this article, we report our experience with capecitabine as a maintenance agent for patients with AGC. No treatment-related death was observed due to use of capecitabine. Median progression-free survival was 10.4 months, and median overall survival was 19.7 months. Activity and toxicity profile of capecitabine seems favorable as a maintenance agent in AGC. We believe that capecitabine deserves further trials as a maintenance agent for patients with AGC.

Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine, followed by maintenance with capecitabine and bevacizumab, as first‐line treatment of patients with advanced HER2‐negative gastric cancer: A multicenter phase 2 study

“…In patients with colorectal cancer, this theory is supported by data from the CAIRO3 study (Treatment with Capecitabine and Bevacizumab Versus Observation), which demonstrated that maintenance significantly delayed PFS and was associated with a trend toward longer OS compared with observation after induction chemoimmunotherapy . In this study, maintenance treatment was found to be feasible and did not lead to excessive toxicity, a finding that is in keeping with 2 previous studies . Feasibility of the B‐DOC regimen was further demonstrated by adequate RDI for the administered drugs.…”

“…10 In this study, maintenance treatment was found to be feasible and did not lead to excessive toxicity, a finding that is in keeping with 2 previous studies. 11,20 Feasibility of the B-DOC regimen was further demonstrated by adequate RDI for the administered drugs. The achieved RDI for capecitabine during the first 6 cycles was somewhat lower than expected (75%-80%), but is in keeping with a recent study that demonstrated that the RDI was 74% in patients treated with a similar DOC regimen.…”

Evolution of checkpoint inhibitors for the treatment of metastatic gastric cancers: Current status and future perspectives

“…Small studies have suggested that fluoropyrimidine-based maintenance therapy is feasible in patients with GC/GEJC, although data are limited [34][35][36]. Trastuzumab and ramucirumab are administered until disease progression [7]; thus, their clinical efficacy benefits in patients with GC/GEJC may be due in part to maintenance treatment [19].…”

Maintenance Avelumab Versus Continuation of First-Line Chemotherapy in Gastric Cancer: JAVELIN Gastric 100 Study Design

“…Furthermore, reintroduction of the 1L chemotherapy regimen following disease progression on (switch) maintenance treatment is also possible [18]. Although maintenance treatment for advanced GC/GEJC has not been studied extensively, observational and retrospective studies reported to date have shown that maintenance treatment with fluoropyrimidines is feasible and may improve PFS compared with observation [19][20][21]. Moreover, trastuzumab or ramucirumab are administered continuously until disease progression in patients with GC/GEJC [5], suggesting that evaluation of long-term treatment with other agents is warranted.…”