Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Gastric Cancer. 2010 Jun;13(2):95-100. doi: 10.1007/s10120-010-0545-4. Epub 2010 Jul 3.
The present study evaluated the efficacy and safety of oxaliplatin, UFT, and leucovorin in metastatic gastric cancer.
Patients received intravenous oxaliplatin 130 mg/m(2) on day 1, followed by oral UFT capsules (350 mg/m(2) per day) and leucovorin tablets (90 mg/day), every 8 h, for 14 days, in a 3-week cycle.
Twenty-three patients (61% with > or = 2 metastatic sites), median age of 60 years (range, 39-69 years) were entered. Based on intention-to-treat analysis, one complete response and seven partial responses were found, resulting in an overall response rate (RR) of 35% (95% confidence interval [CI], 16-54), a median time to progression of 4 months (95% CI, 0.5-7.5), and a median overall survival (OS) of 8 months (95% CI, 4.5-11.5). The 1-year survival rate was 26%. Three patients did not complete the first course of 2 weeks; 1 died suddenly on day 16 with fatal lung embolism; 1 had rapid progressive disease and 1 experienced gastric hemorrhage on day 15 - both these patients withdrew. In the 20 patients assessable for toxicity no grade 4 toxicity occurred, grade 3 toxicity consisted of anemia in 1, diarrhea in 2, and neurotoxicity in 3 patients. No hand-foot syndrome (HFS) occurred.
Oxaliplatin is an effective drug in gastric cancer, but, as previously reported, its feasibility in combination with capecitabine is hampered due to combined hand-foot-based toxicity. The present phase II study of a combination of oxaliplatin with UFT and leucovorin appears to have efficacy and tolerability comparable to two other drug regimens used in gastric cancer, without the HFS problem.
本研究评估了奥沙利铂、UFT 和亚叶酸在转移性胃癌中的疗效和安全性。
患者接受静脉注射奥沙利铂 130mg/m²,第 1 天,随后口服 UFT 胶囊(每天 350mg/m²)和亚叶酸片(每天 90mg),每 8 小时一次,持续 14 天,每 3 周为一个周期。
23 例患者(61%有≥2 个转移灶),中位年龄 60 岁(范围,39-69 岁)。根据意向治疗分析,发现 1 例完全缓解和 7 例部分缓解,总缓解率(RR)为 35%(95%置信区间[CI],16-54%),中位无进展时间为 4 个月(95%CI,0.5-7.5 个月),中位总生存期(OS)为 8 个月(95%CI,4.5-11.5 个月)。1 年生存率为 26%。3 例患者未完成第 1 个 2 周疗程;1 例在第 16 天死于致命性肺栓塞;1 例疾病迅速进展,1 例在第 15 天发生胃出血,这两例患者均退出。在可评估毒性的 20 例患者中,无 4 级毒性,3 级毒性包括 1 例贫血、2 例腹泻和 3 例神经毒性。无手足综合征(HFS)发生。
奥沙利铂在胃癌中是一种有效的药物,但正如先前报道的那样,由于联合手足毒性,其与卡培他滨联合应用的可行性受到限制。本研究的奥沙利铂联合 UFT 和亚叶酸的 II 期研究结果显示,其疗效和耐受性与其他两种用于胃癌的药物方案相当,且没有 HFS 问题。