In advanced gastric cancer, we aimed to evaluate the effectiveness of mEOX regimen as second line therapy after failure of mDCF regimen.
In between 2009 and 2016, the patients who were progressed after mDCF (docetaxel 60 mg/m2 on day 1, cisplatin 60 mg/m2 on day 1, Fluorouracil 600 mg/m2/day for 5 days) and received mEOX (epirubicin 50 mg/m2 on day 1, oxaliplatin 85 mg/m2 day 1 and capecitabine twice-daily dose of 625 mg/m2, p.o. for 2 weeks) every 3 weeks until progression or unacceptable toxicity, were retrospectively analyzed. Progression-free survival (PFS) was defined as the time interval from the day of progression on mDCF therapy to the date of disease progression or death after first cycle of EOX therapy.
Total 129 patients were included to study population. Median age was 55 years (range= 27-78 years). Most of the patients were male (76%). Undifferentiated signet ring cell carcinoma was the most frequent histological subtype (72.1%). The most of the patients had eastern cooperative oncology group (ECOG) performance status 0-1 (72.9%). The most frequent regions of metastasis were; non-regional lymp nodes (55.8%), liver (45.7%), peritoneum (39.5%). Most of the patients (75.2%) had ≥ 2 regions of metastasis. The median number of chemotherapy courses was five (range= 2–9). Forty-nine patient achieved a partial response and 33 patients showed stable disease, resulting in a ORR (overall response rate) of 38% and a DCR (disease control rate) of 63.6%. Most frequent grade 3-4 hematological and non-hematological toxicity was neutropenia (8.5%) and nausea/vomiting (5.4%). None of the patients had toxic death. The median PFS was 4.7 months (95% confidence interval [CI], 4.1–5.3), and OS was 7.4 months (95% CI, 6.3–8.5). In multivariate analysis age ≥ 60 years and ECOG performance status (0-1) were independent prognostic factors that affect PFS and OS.
In advanced gastric cancer patients, who were progressed after first line chemotherapy and having ECOG performance status 0-1, mEOX was well tolerated triple regimen with promising OS and PFS.
Clinical trial identification
Legal entity responsible for the study
Ankara Numune Training and Research Hospital
All authors have declared no conflicts of interest.