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Second-line chemotherapy with paclitaxel and doxifluridine after failure of S-1 in elderly patients with unresectable advanced or recurrent gastric cancer.

AbstractPURPOSE:
There is no standard second-line treatment for patients with unresectable advanced or recurrent gastric cancer (URGC) in the event that first-line treatment fails. Moreover, the benefits of second-line chemotherapy in elderly patients remain uncertain. The aim of this study was to identify the benefits of the second-line paclitaxel (PTX) plus doxifluridine (5'-DFUR) regimen for URGC in elderly patients in comparison to nonelderly patients.
METHODS:
We retrospectively examined the clinical outcomes of the second-line PTX plus 5'-DFUR regimen in patients with URGC, who had previously been treated with S-1-based first-line chemotherapy.
RESULTS:
A total of 27 patients (10 elderly, ≥70 years old; 17 nonelderly, <70 years old) were enrolled in the study. The clinical benefit rate (complete response, partial response, and stable disease) in the elderly group was 6 of 10 (60%), and that of the nonelderly group was 9 of 17 (53%). Age had no statistically significant influence on the response rate, and no grade 4 adverse events were observed in either group. In addition, the median survival time was 12.2 months in both groups.
CONCLUSION:
Although it remains unclear whether second-line chemotherapy contributes to survival in patients with URGC, the combination of PTX plus 5'-DFUR might be the treatment of choice for second-line chemotherapy in both elderly and nonelderly patients who have already received an S-1-based first-line treatment.
AuthorsTomomi Yakabe, Hirokazu Noshiro, Osamu Ikeda, Atsushi Miyoshi, Yoshihiko Kitajima, Seiji Satoh
JournalJournal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 137 Issue 10 Pg. 1499-504 (Oct 2011) ISSN: 1432-1335 [Electronic] Germany
PMID21830159 (Publication Type: Journal Article)
Chemical References
  • Drug Combinations
  • Floxuridine
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid
  • Paclitaxel
  • doxifluridine
Topics
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Drug Combinations
  • Female
  • Floxuridine (administration & dosage)
  • Humans
  • Male
  • Neoplasm Recurrence, Local (drug therapy)
  • Oxonic Acid (therapeutic use)
  • Paclitaxel (administration & dosage)
  • Retrospective Studies
  • Stomach Neoplasms (drug therapy, mortality)
  • Tegafur (therapeutic use)

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