Karhan Ogur, İleri Serdar, Urakçı Zuhat, Sezgin Yasin, Yıldırım Ümit, Ünlü Beyza, Demir Hacer, Gür Hasibe Bilge, Demirci Ayşe, Şimşek Melih, Semiz Hüseyin Salih, Gökçek Savaş, Yıldırım Nilgün, Güneş Tuğçe Kübra, Oyman Abdilkerim, Doğan Tolga, Doğu Gamze Gököz, İlhan Yusuf, Tanrıverdi Özgür, İnal Ali, Sever Nadiye, Türkoğlu Ezgi, Avcı Tugay, Okutur Sadi Kerem, Peker Pınar, Bayram Doğan, Balçık Onur Yazdan, Şancı Pervin Can, Saray Seray, Eşdur Pınar Çoban, Beypınar İsmail, Tunç Sezai
Department of Medical Oncology, Harran University Hospital, University of Harran, Osmanbey Campus, Şanliurfa 63200, Turkey.
Department of Medical Oncology, Dicle University Hospital, University of Dicle, Diyarbakir, Turkey.
Ther Adv Med Oncol. 2025 Aug 30;17:17588359251368069. doi: 10.1177/17588359251368069. eCollection 2025.
Metastatic gastric cancer (GC) and gastroesophageal junction (GEJ) cancer are associated with a poor prognosis. Recent advancements in treatment have incorporated trastuzumab, anti-PD-1 agents, and anti-claudin therapies alongside chemotherapy (ChT), significantly improving outcomes. Contemporary studies predominantly employ doublet ChT as the backbone for these regimens, although historically triplet ChT regimens have been favored, particularly in younger patients requiring rapid tumor shrinkage.
The aim of this study was to compare the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of advanced GC and GEJ adenocarcinoma.
This was a retrospective multicenter study.
Patient data were obtained from the databases of 25 hospitals across Turkey. Demographic and clinicopathological characteristics were documented. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and group discrepancies were assessed with log-rank test.
A total of 493 patients were included in the analysis, with similar baseline characteristics between the two groups. The objective response rate was 36.3% in the mDCF group and 38% in the mFOLFOX-6 group ( = 0.7). The median PFS was 6 months for mDCF and 7 months for mFOLFOX-6 ( = 0.2), while the median OS was 12 months for mDCF and 11 months for mFOLFOX-6 ( = 0.4). Grade 3-4 neutropenia occurred in 27.6% of patients treated with mDCF versus 17.8% with mFOLFOX-6 ( = 0.01). Likewise, grade 3-4 anemia was more frequent in the mDCF group (9.5%) compared to the mFOLFOX-6 group (4.8%; = 0.04).
Modified FOLFOX-6 demonstrated comparable efficacy to mDCF in the treatment of advanced GC and GEJ adenocarcinoma. Moreover, mFOLFOX-6 was associated with a lower incidence of hematological adverse effects.
转移性胃癌（GC）和胃食管交界（GEJ）癌预后较差。治疗方面的最新进展包括将曲妥珠单抗、抗程序性死亡蛋白1（PD-1）药物和抗claudin疗法与化疗（ChT）联合使用，显著改善了治疗效果。当代研究主要采用双药ChT作为这些方案的基础，尽管历史上三联ChT方案更受青睐，尤其是在需要肿瘤快速缩小的年轻患者中。
本研究旨在比较mFOLFOX-6和mDCF方案治疗晚期GC和GEJ腺癌的疗效。
这是一项回顾性多中心研究。
从土耳其25家医院的数据库中获取患者数据。记录人口统计学和临床病理特征。采用Kaplan-Meier方法分析总生存期（OS）和无进展生存期（PFS），并通过对数秩检验评估组间差异。
共有493例患者纳入分析，两组基线特征相似。mDCF组的客观缓解率为36.3%，mFOLFOX-6组为38%（P = 0.7）。mDCF组的中位PFS为6个月，mFOLFOX-6组为7个月（P = 0.2），而mDCF组的中位OS为12个月，mFOLFOX-6组为11个月（P = 0.4）。接受mDCF治疗的患者中27.6%发生3-4级中性粒细胞减少，而接受mFOLFOX-6治疗的患者中这一比例为17.8%（P = 0.01）。同样，mDCF组3-4级贫血的发生率（9.5%）高于mFOLFOX-6组（4.8%；P = 0.04）。
改良FOLFOX-6在治疗晚期GC和GEJ腺癌方面显示出与mDCF相当的疗效。此外，mFOLFOX-6的血液学不良反应发生率较低。
