Feasibility study of docetaxel, oxaliplatin and capecitabine combination regimen in advanced gastric or gastroesophageal adenocarcinoma

BACKGROUNDAt present, there is no standard regimen for the treatment of gastroesophageal cancer. Docetaxel, cisplatin and fluorouracil (DCF) has been shown to be an effective regimen; however, toxicity is an area of concern in the palliative case setting. Capecitabine and oxaliplatin have been shown to be as effective as fluorouracil and cisplatin, respectively. To reduce the toxicity of DCF while maintaining efficacy, we conducted this study to evaluate the efficacy of docetaxel, oxaliplatin and capecitabine (DOX) combination in advanced gastroesophageal cancer.METHODSPatients with histologically confirmed metastatic or locally advanced adenocarcinoma of the stomach or gastroesophageal junction received docetaxel 25mg/m2 and oxaliplatin 50mg/m2 on days 1 and 8 with capecitabine 625mg/m2 twice daily from day 1–14, in 21 -day cycles. The primary endpoint was overall response rate (ORR).RESULTSOf 21 patients, there were 1 6 males and 5 females with a median age of 57 years, range 37–80 years. The primary tumor was located at the gastroesophageal junction in 7 patients and in other parts of the stomach in the remaining 14 patients. One patient had locally advanced tumor without distant metastases and 20 patients presented with metastatic disease. Grade 3/4 toxicities included diarrhea (24%), hand-foot syndrome (5%) and febrile neutropenia (5%). The ORR was 29%. The median survival was 8.4months. At the time of analysis, 5 of the 21 patients (24%) were alive.CONCLUSIONSThe DOX combination is tolerable, active and a promising day-care regimen for advanced gastroesophageal cancer