Ozaki Tomohiro, Tamura Kenji, Satoh Taroh, Kurata Takayasu, Shimizu Toshio, Miyazaki Masaki, Okamoto Isamu, Nakagawa Kazuhiko, Fukuoka Masahiro
Department of Medical Oncology, Kinki University School of Medicine, Nara Hospital, Otoda, Ikoma, Nara, Japan.
Anticancer Res. 2007 Jul-Aug;27(4C):2657-65.
The primary objective of this study was to determine the maximum tolerated dose (MTD), the toxicity profile and the recommended dose (RD) for phase II of a combination of S-1 and weekly administration of docetaxel.
Patients with histologically diagnosed recurrent or unresectable locally advanced gastric cancer were enrolled. A fixed oral dose of 80 mg/m2 S-1 was given for 3 weeks. Docetaxel was infused intravenously on day 1, 8 and 15, repeated every 5 weeks. A pharmacokinetic study was also performed.
A total of 14 patients were enrolled. One dose-limiting toxicity (DLT) (grade 3 diarrhea with febrile neutropenia) occurred at level 2. DLTs occurred in 3/5 patients at level 3, (grade 3 stomatitis, with febrile neutropenia or continuous grade 4 neutropenia). The pharmacokinetic study suggested no drug interactions. Overall response and disease control rates were 20% and 80%, respectively. The response rate at the RD (level 2) was 50%. Overall survival was 9.4 months.
RD was level 2 (80 mg/m2 of S-1 for 3 weeks and 20 mg/m2 of docetaxel on day 1, 8 and 15, every 5 weeks). Dose intensities of S-1 and docetaxel were 48 mg/m2/week and 12 mg/m2/week, respectively. This regimen showed promising activity for advanced gastric cancer.
本研究的主要目的是确定S-1与多西他赛每周给药联合方案在II期试验中的最大耐受剂量(MTD)、毒性特征和推荐剂量(RD)。
纳入经组织学确诊的复发性或不可切除的局部晚期胃癌患者。口服固定剂量80mg/m²的S-1,持续3周。多西他赛在第1、8和15天静脉输注,每5周重复一次。同时进行了药代动力学研究。
共纳入14例患者。在剂量水平2时发生了1例剂量限制性毒性(DLT)(3级腹泻伴发热性中性粒细胞减少)。在剂量水平3时,3/5的患者出现DLT(3级口腔炎,伴发热性中性粒细胞减少或持续性4级中性粒细胞减少)。药代动力学研究表明无药物相互作用。总体缓解率和疾病控制率分别为20%和80%。推荐剂量(水平2)时的缓解率为50%。总生存期为9.4个月。
推荐剂量为水平2(S-1 80mg/m²,持续3周,多西他赛在第1、8和15天,每5周一次,剂量为20mg/m²)。S-1和多西他赛的剂量强度分别为48mg/m²/周和12mg/m²/周。该方案对晚期胃癌显示出有前景的活性。