Hubertus Wald Tumor Center, University Cancer Center Hamburg, Department of Oncology, Hematology, BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
Acta Oncol. 2014 Mar;53(3):392-8. doi: 10.3109/0284186X.2013.833346. Epub 2013 Sep 12.
Three drug taxane-based regimens have shown activity in patients with metastatic or locally advanced gastric or gastro-esophageal cancer (GC/GEC). Limited tolerability of these regimens warrants treatment modification, particularly in regard of the proven equivalence of oxaliplatin and cisplatin as well as capecitabine and 5FU. Thus, a regimen with docetaxel (T), oxaliplatin (E) and capecitabine (X) was established and evaluated.
Patients with metastatic or locally advanced GC/GEC, adequate organ function, ECOG PS 0-2 were enrolled. TEX regimen was administered as defined by the phase I trial with T 35 mg/m(2) and E 70 mg/m(2) on days (d) 1, 8 and X 800 mg/m(2) bid on d 1-14 every 22 days. Primary endpoint was progression free survival (PFS) rate after 6 months.
Altogether 70 patients (15 phase I; 55 phase II) were eligible for analysis. Results of the phase II part were as follows: most common grade toxicities diarrhea (30%), nausea/vomiting and infections, PFS rate after 6 months 56.3%, response rate 43%, median PFS 6.9 and overall survival 13 months, respectively.
The TEX regimen show similar efficacy compared to other infusional 5FU-based taxane and platinum containing triplets, but the reduced tolerability, in particular grade 3 diarrhea, limits the feasibility.
三种基于紫杉烷的药物方案在转移性或局部晚期胃或胃食管交界癌(GC/GEC)患者中显示出活性。这些方案的耐受性有限,需要进行治疗修改,特别是在奥沙利铂和顺铂以及卡培他滨和 5FU 的等效性已被证实的情况下。因此,建立并评估了一种含多西紫杉醇(T)、奥沙利铂(E)和卡培他滨(X)的方案。
入组患者为转移性或局部晚期 GC/GEC,器官功能正常,ECOG PS 0-2。TEX 方案按照 I 期试验定义给药,T 为 35mg/m²,E 为 70mg/m²,第 1、8 天给药,X 为 800mg/m²,bid,第 1-14 天,每 22 天一次。主要终点是 6 个月时无进展生存(PFS)率。
共 70 例患者(15 例 I 期;55 例 II 期)符合分析条件。II 期部分的结果如下:最常见的 3 级毒性为腹泻(30%)、恶心/呕吐和感染,6 个月时 PFS 率为 56.3%,反应率为 43%,中位 PFS 为 6.9 个月,总生存为 13 个月。
TEX 方案与其他含氟尿嘧啶的紫杉烷和铂类三联方案相比疗效相似,但耐受性降低,特别是 3 级腹泻,限制了其可行性。