A New Option for Advanced Gastric Cancer -Docetaxel and Novel Oral Fluoropyrimidine Combination Chemotherapy-

Article information

J Korean Med Assoc. 2007;50(6):556-560

Publication date (electronic) : 2009 June 30

doi : https://doi.org/10.5124/jkma.2007.50.6.556

Department of Internal Medicine, Hallym University College of Medicine, Korea. fhdzang@hallym.or.kr

Abstract

Although gastric cancer is the most common cancer and the second leading cause of cancer deaths in Korea, the prognosis for advanced gastric cancer remains poor, and there is no established standard front-line chemotherapy for advanced stage. However, many clinical trials have been developed to improve the response rate and survival in patients with advanced gastric cancer. Novel oral fluoropyrimidines, capecitabine and S-1, are substituting inconvenient 5-FU continuous infusions. These oral fluoropyrimidines combined with docetaxel (1-hour infusion) lead to improve anticancer efficacy and convenience. Capecitabine and docetaxel combination regimens showed response rates 39~60% with median survival 9.5~12 months, and major adverse reactions were hand-foot syndrome and neutropenia. Also, S-1 and docetaxel combination regimens showed response rates 46~56% with median survival 14~14.9 months, and major adverse reaction was neutropenia. The combination of docetaxel and novel oral fluoropyrimidine is highly active and well tolerated in patients with advanced gastric cancer. Large randomized clinical trials are warranted to confirm the efficacy of those regimens. Also, we are looking forward to having the results from studies of new chemotherapeutic agents and modalities.

Keywords: Advanced Gastric Cancer; Docetaxel; Oral Fluoropyrimidine

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Article information Continued

Figure 1

Survival data of conventional chemotherapeutic regimens in patients with advanced gastric cancer.

FAM, fluorouracil, adriamycin, mitomycin; FAMTX, fluorouracil, adriamycin, methotrexate; ECF, epirubicin, cisplatin, fluorouracil; CF cisplatin, fluorouracil

Figure 2

Enzymatic activation of capecitabine.

5'-DFCR, 5'-deoxy-5-fluorocytidine; 5'-DFUR, 5'-deoxy-5-fluorouridine; CE, carboxylesterase; CyD, cytidine deaminase