P-0057 - Chemotherapy and target therapy of advanced stomach cancer

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter Olga Kuznetsova
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors O. Kuznetsova1, N. Marcinkovskaya2
  • 1Odessa National Medical University, Odessa/UA
  • 2Odessa Regional Oncology Dispensary, Odessa/UA

Abstract

Introduction

Stomach cancer is the 2th most common cancer amongst adults in Ukraine. 70-80% of patients present with advanced disease and are therefore not suitable for surgical treatment. Advanced stomach cancer is incurable and the aim of palliative chemotherapy is to increase survival, prevent symptomatic deterioration and improved quality of life. Chemotherapy and target therapy of advanced stomach cancer increase chance of life extension.

Methods

We included in this study 15 patients with histologically proven unresectable and/or metastatic stomach cancer (adenocarcinoma). 6 patients (40%) had primary metastatic disease with single - 1 patient (6%) and multiple metastasis - 8 patients (53%). Median age of patients was 45,3 year (32-61 year), 4 females and 11 males, ECOG 0/1/2 was 40%/53%/6%. Oxaliplatin 85 mg/m2 biweekly (q2w) and irinotecan 125 mg/m2 biweekly 9q2w) are administered for the first three months followed by docetaxel 50 mg/m2 biweekly 9q2w) for three months. Chemotherapy for 6 month is combined with bevacizumab 5 mg/kg biweekly (q2w) witch is administered until progression.

Results

Radical gastrectomy with D2 lymphodissection was completed in 2 patients after 6 cycles of chemotherapy with therapeutically pathomorphosis grade III-IV. Frequently reported adverse events were predominantly grade 1 and 2 and included: neutropenia - 7 patients (46%), anemia - 5 patients (33%), nausea - 12 patients (80%), vomiting - 9 patients (60%), polyneuropathy - 7 patients (47%), diarrhea - 4 patients (27%). 5 patients (30%) had toxicity grade 3 and 4 included: neutropenia - 2 patients (13%, anemia - 1 patient (6%), abdominal pain - 2 patients (13%). Objective response was done after 3 and 6 cycles of chemotherapy and included: clinical examination, CT of chest/abdomen/pelvis, gastoscopy with biopsy. After 6 month of chemotherapy with bevacizumab in 15 included patients: CR - 2 patients (13%), PR - 6 patients (40%), SD - 5 patients (30%), PD - 2 patients (13%).

Conclusion

Combination of oxaliplatin and irinotecan with bevacizumab has a very good objective response in advanced stomach cancer. In this initial safety analysis, the incidence and severity of adverse events were acceptable as primary-line treatment of advanced stomach cancer.