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Carboplatin, Capecitabine and Docetaxel Combination Shows Favourable Results in Patients With Advanced Gastric or Gastroesophageal Adenocarcinoma: Presented at ESMO
By Thomas Buckingham, MD
VIENNA, AUSTRIA -- November 2, 2004 -- The combination of cisplatin, epirubicin, and 5-fluorouracil, used in many countries for treatment of advanced gastric or gastroesophageal adenocarcinoma, has shown significant toxicity, but the optimal treatment remains to be identified.
Researchers now report, however, that a combination of carboplatin, capecitabine, and docetaxel is feasible with acceptable toxicity levels.
For their evaluation, the researchers, led by Lars Dalmstrup, MD, consultant in oncology, Finsen Center, University of Copenhagen, Copenhagen, Denmark, enrolled 36 patients with advanced gastric or gastroesophageal adenocarcinoma, performance status 0-2, age 18 to 75 years. Treatment combined carboplatin at an area under the curve of 5, capecitabine 1000 mg/m2 twice daily, and docetaxel 60 mg/m2 every 4 weeks.
Speaking here on October 30th at the 29th European Society for Medical Oncology Congress, Dr. Dalmstrup remarked that the combination of carboplatin, capecitabine, and docetaxel can result in a substantial rate of remission and overall survival.
The rate of response was 61.9% among the 21 evaluable patients, and close to complete clinical remission has been seen, he said. Patients were then referred for surgery or concomitant chemoradiation and showed an encouraging response. Six patients had toxicity that required dose modification, and 10 required hospital admission due to toxicity.
The regimen, Dr. Dalmstrup said, is well tolerated, with toxicity -- including leucopaenia (n = 2), thrombocytopaenia (n = 1), palmar-plantar erythrodysesthesia (n = 2), vomiting (n = 1), and diarrhoea (n = 1) -- noted in small numbers of patients.
These findings suggest the possibility that this combination may have a potential for cure, the researchers stated, but cautioned that further follow-up and study are required as well as prospective-randomised trials to confirm the potential of this treatment regimen.
[Presentation title: Carboplatin, Capecitabine and Docetaxel (CACD) in Patients With Advanced Gastric or Gastro-Esophageal (GE) Adenocarcinoma. Single Institutional Experience. Abstract 895P]
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