693P - Efficacy and safety of dose-dense chemotherapy with modified TCF regimen (TCF-DD) in elderly patients with metastatic gastric cancer (mGC)

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Geriatric Oncology
Presenter Gianluca Tomasello
Authors G. Tomasello1, W. Liguigli1, S. Lazzarelli1, R. Poli1, F.M. Negri2, L. Toppo1, M. Brighenti1, M. Ratti1, F. Gerevini1, R. Passalacqua3
  • 1Oncology Division, Istituti Ospitalieri di Cremona, 26100 - Cremona/IT
  • 2Oncology, Istituti Ospitalieri di Cremona, 26100 - Cremona/IT
  • 3Division Of Oncology, Istituti Ospitalieri di Cremona, 26100 - Cremona/IT



GC is more common in elderly patients (pts). Most oncologists are reluctant to treat this pts population with the most active poli-chemotherapy combinations because of safety concerns. Subgroup analysis of elderly pts enrolled in European studies show limited and conflicting data. We previously reported on the feasibility and high activity of a dose-dense TCF regimen (TCF-dd) (Tomasello 2010). This study aims to evaluate the efficacy and safety of this schema in the elderly pts subgroup (≥ 65 years).


From 11/04 to 05/12, 111 consecutive pts with MGC (median age 65, range 31-81) were enrolled in a single-centre phase II study. Pts received Docetaxel 70 mg/m2 d1, CDDP 60 mg/m2 d1, l-AF 100 mg/m2 d1-2 followed by 5-FU 400 mg/m2 bolus d1-2, and then 600 mg/m2 as a 22h c.i. d1-2, q2w, plus G-CSF d3. Pts ≥ 65y (56) received the same schedule reduced by 30%.


96 pts evaluable for response and all for toxicity. In pts ≥ 65y we observed 4 CR (7%) 25 PR (45%) 10 SD (18%) 7 PD (13%); in younger pts: 2 CR (4%) 30 PR (55%) 9 SD (16%) 9 PD (17%); ORR by ITT 56% (95% IC 45-64). Median OS was 11.9 months (9,4-14,8); in elderly and younger pts 11,2 (8,4-11,1) and 12,7 (9-16,5) respectively. Out of 48 evaluable pts ≥ 65y, 26 (54%) were treated at full doses without any delay. In the elderly most frequent G3-4 toxicities were neutropenia (14%) thrombocytopenia (15%) febrile neutropenia (7%) asthenia (27%) and hypokalemia (17%); in the younger: neutropenia (56%) thrombocytopenia (21%) febrile neutropenia (16%) asthenia (43%) hypokalemia (21%).


This study shows that elderly pts can be treated with a TCF-dd regimen reduced by 30% achieving similar efficacy results of younger patients with lesser toxicity.


All authors have declared no conflicts of interest.