753 - Docetaxel, cisplatin and fluorouracil as perioperative chemotherapy in resectable gastroesophageal carcinoma: a retrospective analysis

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Oesophageal Cancer
Presenter frédéric Fiteni
Authors F. Fiteni1, Z. Lakkis2, T. Nguyen3, C. Borg4, B. Benzidane4, V. Nerich5, B. Heyd2, X. Pivot1, C.H.S. Kim1
  • 1Medical Oncology, Hopital Minjoz, 25000 - Besançon/FR
  • 2Digestive Surgery, hopital Minjoz, 25000 - Besançon/FR
  • 3Medical Oncology, hopital Minjoz, 25000 - Besançon/FR
  • 4Medical Oncology, Hopital Minjoz, 25000 - besançon/FR
  • 5Pharmacy, hopital Minjoz, 25000 - Besançon/FR

Abstract

Introduction

Perioperative chemotherapy has demonstrated a survival benefit versus surgery alone in resectable gastroesophageal adenocarcinoma (RGC). The association Docetaxel, cisplatin, and fluorouracil (DCF) is superior to cisplatin and fluorouracil in advanced gastric cancer. The efficacy and safety of perioperative DCF regimen in patients with RGC was retrospectively analyzed.

Patients and methods

All patients with RGC assigned by the staff to receive perioperative DCF regimen were included in the analysis. Chemotherapy consisted of three preoperative cycles of intravenous docetaxel 75 mg/m2 and cisplatin 75 mg/m2 (day 1) plus fluorouracil 750 mg/m2 (days 1 to 5) every 3 weeks followed by 3 postoperative cycles of this regimen.

Results

Forty-nine patients with gastric cancer were analysed (38 adenocarcinoma subtype and 11 Signet Ring Cell (SRC)). A total of 37 patients (76%) completed the 3 preoperative planned cycles of DCF, and 45 (92%) undergone to surgery. Then 16 patients (33%) underwent postoperative chemotherapy based on DCF nevertheless 5 patients only (10%) completed 3 cycles. Among patients with adenocarcinoma, pathological complete response (pCR) rate was 8% and 45 % had a partial response (PR) above 50% (grade 1a/1b/2 according to Becker's classification). Among patients with SRC, no pCR and 9% of PR were observed. Histological complete resection rate was 89% among patients with adenocarcinoma and 55% among patients with SRC. Median overall survival and progression-free survival were 58 months (95% CI, 58-non achieved) and 43 months (95% CI, 16-non achieved) respectivelly.

Conclusion

In patients with RGC, DCF perioperative regimen is feasible and significantly active. Prospective assessment is justified. One could consider to exclude SRC taking into account the poor activity observed.

Disclosure

All authors have declared no conflicts of interest.