The impact of cross-resistance between paclitaxel and docetaxel for metastatic gastric cancer.

BACKGROUND

Paclitaxel and docetaxel show similar anticancer mechanisms, but cross-resistance for gastric cancer chemotherapy remains unclear.

PATIENTS AND METHODS

Among 484 patients with metastatic gastric cancer, who had received chemotherapy in 4 Japanese hospitals, we identified 28 patients who had received either paclitaxel- or docetaxel-containing chemotherapy and who were refractory to the other taxane.

RESULTS

The median age was 65 years, and target lesions were present in 20 patients and absent in 8. The first taxane was administered to 16 patients as first-line chemotherapy and to 12 patients as second-line chemotherapy, while the second taxane was administered to 5 patients as second-line, 13 as third-line, and 10 as fourth-line or beyond. The median survival time was 456 days (95% confidence interval (CI) 145-767 days), and the median survival time and median progression-free survival after the second taxane were 119 days (95% CI 85-153 days) and 50 days (95% CI 42-58 days), respectively. The second taxane chemotherapy achieved a response rate of 5% (1/20 patients) and an overall disease control rate of 17.9% (5/28 patients).

CONCLUSIONS

Paclitaxel and docetaxel might show a large degree of cross-resistance for gastric cancer. Paclitaxel and docetaxel should not be routinely administered for metastatic gastric cancer after failure of the other taxane.