761 - Second-line docetaxel (D) in metastatic gastric cancer (mGC)

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter Chiara Caparello
Authors C. Caparello1, M. Lencioni1, E. Vasile2, S. Caponi3, S. Santi4, M.G. Fabrini5, L. Ginocchi1, M. Lucchesi3, S. Ricci1, A. Falcone6
  • 1Oncologia, Trapianti E Nuove Tecnologie In Medicina, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 2Oncology, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 3Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 4Department Of Gastroenterology, Esophageal Surgery Unit, Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal Disease, Pisa, Italy, Pisa/IT
  • 5Division Of Radiation Oncology, S. Chiara Pisa Hospital, Pisa, Italy, Pisa/IT
  • 6Dept. Of Oncology-presidio Ospedaliero, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT

Abstract

Background

Although second-line chemotherapy with irinotecan or docetaxel seemed to confer an improvement in overall survival over best supportive care, at today no standard second-line chemotherapy regimen is approved in MGC. Methods: The objective of our retrospective analysis was to evaluate the activity of a second-line taxane-based treatment in MGC patients (pts).

Results

A total of forty-eight pts (M/F 40/8; ECOG PS at second-line treatment 0/1/2: 23/22/3) were included in the study; median age 67 years (range 38-86). All pts received a first-line fluoropyrimidine-based chemotherapy; 42 in combination with platinum compounds (9 received a triplet with anthracyclines and 2 with Herceptin) and 6 in monochemotherapy. 46 pts were evaluable for analysis: 37 pts received a docetaxel monochemotherapy (16 weekly, 5 biweekly and 16 three-weekly schedule), 10 a combination of docetaxel with fluorouracil, 1 with cisplatin. Grade 3 or 4 toxicities included: anemia 3 pts, neutropenia 6 pts, diarrhea 1 patient, fatigue, vomiting and neurotoxicity 1 patient each, stomatitis 2 pts; 13 pts needed a delay of treatment and 5 a reduction of doses. Among 46 evaluable pts 7 (15.2%) experienced a partial response, 13(28.3%) a stable disease, 26(56.5%) a progression of disease. 24 pts received a third-line chemotherapy, 21 of these an irinotecan-based treatment. Median progression-free survival was 4.3 months and median overall survival was 8.6 months from the start of second-line treatment. No significant differences were found in mPFS, RR and toxicity profile between different treatment schedules. mPFS seemed to be longer in patients with PS 0 than in patients with PS 1 or 2 (5.4 months versus 2.1 and 0.95 respectively; p = 0.046). No difference in mPFS was detected according to RR at first-line therapy.

Conclusions

Docetaxel in MGC second-line setting seems to have an encouraging activity with an acceptable toxicity profile.

Disclosure

All authors have declared no conflicts of interest.