Bulletin du Cancer


Epirubicin-docetaxel in advanced gastric cancer: two phase II studies as second and first line treatment Volume 93, issue 1, Janvier 2006

Service d’oncologie, Centre hospitalier, 40 avenue Léon-Blum, 60021 Beauvais Cedex, France, Service d’oncologie, CHU, Grenoble, France, Service d’oncologie, Hôpital Saint-Antoine, Paris, France, Clinique de Drevon, Dijon, France, Service d’oncologie, Hôpital de Montfermeil, France, Service d’oncologie, Hôpital Tenon, Paris, France, Centre de lutte contre le cancer Val d’Aurelle, Montpellier, France, Centre de lutte contre le cancer Paul Papin, Angers, France, Centre hospitalier, Senlis, France

Methods: We evaluated the Epitax combination (epirubicin 60 mg/m 2 and docetaxel 75 mg/m 2, every 3 weeks) in advanced gastric cancer (AGC) as second-line treatment after fluorouracil and platinum in 50 patients, then as first-line treatment in 36 patients. We report here the results of these two phase II studies. Results: In the second-line treatment, the response rate (RR) was 15.5%. Grade 3-4 neutropenia was observed in 68% (febrile neutropenia in 40%, one treatment-related death). Median time to progression (TTP) and overall survival (OS) were 2.4 and 5.0 months, respectively. In the first-line treatment, the RR was 19.4%. With prophylactic granulocyte colony-stimulating factor, grade 3-4 neutropenia was reported in 38.9%. Then 22 patients received a second-line and 11 patients a third-line treatment. Median TTP and OS were 4.5 and 12 months, respectively. Conclusion: Epitax showed moderate activity in AGC. RR in both trials suggests a non-cross resistance with fluorouracil /platinum combination. The 12-month OS in the first-line treatment could be partly explained by early evaluation and active non-cross resistant second-line therapy.