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Poster display session

2789 - Phase II study of modified docetaxel, cisplatin and S-1 (mDCS) combination chemotherapy in patients with unresectable metastatic gastric cancer

Date

09 Sep 2017

Session

Poster display session

Topics

Cytotoxic Therapy;  Gastric Cancer

Presenters

Yasushi Sato

Citation

Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369

Authors

Y. Sato1, H. Ohnuma2, K. Okamoto3, H. Miyamoto3, M. Hirakawa2, N. Uemura4, S. Kikuchi2, T. Sagawa4, K. Fujikawa4, Y. Takahashi4, S. Minami5, T. Okuda5, M. Takahashi6, J. Kato2, T. Takayama3

Author affiliations

  • 1 Department Of Community Medicine For Gastroenterology And Oncology, Tokushima University Graduate School of Biomedical Sciences, 770 - Tokushima/JP
  • 2 Medical Oncology And Hematology, Sapporo Medical University, Sapporo/JP
  • 3 Department Of Gastroenterology And Oncology, Tokushima University Graduate School of Biomedical Sciences, 770 - Tokushima/JP
  • 4 Department Of Gastroenterology, Hokkaido Cancer Center, 00 - Sapporo/JP
  • 5 Gastroenterology, Oji General Hospital, Tomakomai/JP
  • 6 Department Of Gastroenterology, Sapporo Kyoritsu-Gorinbashi Hospital, Sapporo/JP
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Resources

Abstract 2789

Background

We have previously conducted phase II studies to evaluate the effect of adding docetaxel to base treatment with S-1 plus cisplatin (DCS) to further improve the therapeutic response; both a very high response rate (87.1%) and a promising median survival time (687 days) in patients with unresectable advanced gastric cancer were noted (Y. Sato et al. Cancer Chemother Pharmacol. 2009); however, it also showed a high incidence of grade 3/4 toxicity. With the aim of reducing toxicities, we conducted a phase II study of modified DCS (mDCS), using a reduced dose of docetaxel, and evaluated the clinical efficacy and adverse events of this regimen.

Methods

Patients with unresectable gastric cancer received chemotherapy with S-1 (40 mg/m2 b.i.d) on days 1–14, and docetaxel (50 mg/m2) plus cisplatin (60 mg/m2) on day 8 every 3 weeks. The primary endpoint was the response rate (RR). Overall (OS) and progression-free survival (PFS), and toxicities were also evaluated.

Results

Forty-nine patients were enrolled from November 2011 to April 2014, and 47 were eligible. The overall RR was 78.8%, including two cases of a complete response (4.3%), and 35 cases of a partial response (74.5%). Ten cases had stable disease (21.3%) but none showed progressive disease. Of the 47 cases, 16 cases (34.0%) underwent curative conversion surgery. The median PFS was 350 days (95% CI; 238–406 days) and median OS was 561 days (95% CI; 401–783 days). Grade 3/4 neutropenia developed in 76.6%, and febrile neutropenia in 31.9%, of patients. Non-hematological grade 3/4 adverse events were anorexia (23.4%), nausea (4.3%), and diarrhea (8.5%).

Conclusions

mDCS therapy showed high clinical efficacy and fewer toxicities, but careful management of these is still essential.

Clinical trial identification

UMIN000002361

Legal entity responsible for the study

Tokushima-Hokkaido cancer therapy clinical trial group, Tetsuji Takayama

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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