Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
Gastric Cancer. 2012 Oct;15(4):427-32. doi: 10.1007/s10120-011-0135-0. Epub 2012 Jan 18.
Only partial cross-resistance between docetaxel and paclitaxel has been demonstrated in breast and ovarian cancers. Whether weekly paclitaxel is effective in patients with advanced gastric cancer refractory to docetaxel-based chemotherapy remains unclear, and we aimed to clarify the efficacy and safety of weekly paclitaxel in such patients.
Patients who had received docetaxel-based regimens were assigned to the prior-docetaxel group, and those who had never received docetaxel were designated as the non-docetaxel group. Paclitaxel at 80 mg/m(2) was administered by intravenous infusion in all patients, and this was repeated weekly for 3 weeks out of 4.
Between April 2006 and June 2011, 65 patients were studied: 26 in the prior-docetaxel group and 39 patients were non-docetaxel group. The median age, gender, performance status, histological type, history of gastrectomy, and the locations and numbers of metastatic sites did not differ significantly between the two groups. In the prior-docetaxel group, the response rate (RR) was 14.2% (3/21) among patients with measurable lesions, median progression-free survival (PFS) was 79 days [95% confidence interval (CI), 47-135 days], and overall survival (OS) was 123 days (95% CI, 90-215 days) from the initiation of paclitaxel treatment. In the non-docetaxel group, the RR was 11.5% (3/26) among patients with measurable lesions, PFS was 82 days (95% CI, 52-106 days), and OS was 143 days (95% CI, 121-178 days). The efficacy of weekly paclitaxel thus appeared to be similar in the two groups.
Weekly paclitaxel was modestly active in patients with gastric cancer refractory to docetaxel-based chemotherapy.
在乳腺癌和卵巢癌中,仅观察到多西紫杉醇和紫杉醇之间的部分交叉耐药性。每周紫杉醇在对多西紫杉醇为基础的化疗耐药的晚期胃癌患者中是否有效尚不清楚,我们旨在阐明每周紫杉醇在这些患者中的疗效和安全性。
接受多西紫杉醇为基础的方案治疗的患者被分配到先前接受多西紫杉醇组,从未接受过多西紫杉醇的患者被指定为非多西紫杉醇组。所有患者静脉输注紫杉醇 80mg/m2,每 3 周重复一次,4 周为一个周期。
2006 年 4 月至 2011 年 6 月,共纳入 65 例患者:先前接受多西紫杉醇组 26 例,非多西紫杉醇组 39 例。两组患者的中位年龄、性别、体能状态、组织学类型、胃切除术史以及转移灶的位置和数量无显著差异。在先前接受多西紫杉醇组中,可测量病变患者的客观缓解率(RR)为 14.2%(3/21),中位无进展生存期(PFS)为 79 天(95%可信区间[CI]:47-135 天),总生存期(OS)为 123 天(95%CI:90-215 天),从紫杉醇治疗开始计算。在非多西紫杉醇组中,可测量病变患者的 RR 为 11.5%(3/26),PFS 为 82 天(95%CI:52-106 天),OS 为 143 天(95%CI:121-178 天)。因此,每周紫杉醇在两组患者中的疗效似乎相似。
每周紫杉醇在对多西紫杉醇为基础的化疗耐药的胃癌患者中具有一定的活性。