P-0060 - Comparative study between using antracycline based and taxane based regimens as first line therapy for advanced and metastatic gastric cancer

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter Abeer Ibrahium
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors A. Ibrahium1, M. Salem2, A. Hefny3
  • 1South Egypt Cancer Institute, Assiut University, Assiut/EG
  • 2Surgical Oncology - South Egypt Cancer Institute- Assiut University, Assiut/EG
  • 3South Egypt Cancer Institute, Assiut/EG

Abstract

Introduction

ECF with continuous infusional 5-fluorouracil (5-FU) is a well-established chemotherapy regimen in advanced gastric cancer. However, several modifications have been done on this regimen to make more convenient, some of these trials showed comparable results with the original one, others tried to use Taxane instead of Epirubicin the form of Paclitaxel as a first line therapy as it showed also comparable results with Docetaxel, nevertheless it is cheaper and more tolerable regimen.

Methods

The study was conducted to compare the efficacy and toxicity of modified ECF regimen with 5Fu infusional on day (1,8) with paclitaxel containing regimen (PCF) as a first line therapy in advanced gastric cancer. Between Jan. 2011 and Dec 2013, a total 67 patients with advanced unresectable and metastatic gastric adenocarcinoma were included in the study, 42 patients were treated with modified ECF “Epirubicin 50 mg/m2 iv bolus d1, Cisplatin 60 mg/m2 iv d1, 5-FU 1750 mg/m2/d “1 and 8” CIVI over 24 h, Folonic acid 200mg /m2 day 1, 8 repeated every 3 weeks”, and 25 patients were treated with PCF “Paclitaxel 150 mg/m2 IV on day 1; Cisplatin 15 mg/m2 IV on days 1-5 and 5-FU 600mg/m2/day CIVI on days 1-5 every 3 weeks” until disease progression or unacceptable toxicities.

Results

Median response rate for modified ECF was 47% with CR rate of (5%), 3 patients (7%) had total gastrectomy after 5 cycles, the median survival was 12.7 months (95% CI, 8.2-19.2 months). While in PCF arm, median response rate was 33%, CR was 0% p = 0.001.and median survival was 8.2 months (95% CI, 5-14.4 months) p = 0.005, Grade 3 or 4 neutropenic were 30.3%, vs 20% in modified ECF and PCF respectively p = 0.01. There was no significant difference between two arms regarding nausea/anorexia and vomiting. There was no treatment-related death in both arms.

Conclusion

The use of anthracycline based regimen as first line therapy in advanced gastric cancer, showed better outcome and acceptable toxicity when it compared with paclitaxel containing regimen.