Background: Previous studies suggest that the combination of docetaxel and capecitabine are worthy of further testing in patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction. We therefore undertook this phase II study to test this combination in a multi-institutional, first-line clinical trial. Patients and methods: Forty-four eligible patients with histologic or cytologic confirmation of the above malignancy were recruited. The cohort had Eastern Cooperative Oncology Group performance scores of 0, 1 and 2 in 59%, 39% and 2% of patients, respectively. Median age was 57 years (range 32-77 years). Adequate organ function was a requirement for study entry. All patients were prescribed docetaxel 75 mg/m2 intravenously on day 1 and capecitabine 825 mg/m2 orally twice a day on days 1-14 of a 21-day cycle. Results: The tumor response rate was 39% [95% confidence interval (CI) 23% to 55%]. There were two complete responses and the rest were partial. Median survival was 9.4 months (95% CI 6.3-10.7 months) and median time-to-tumor progression was 4.2 months (95% CI 3.6-5.6 months). There was one treatment-related death from a myocardial infarction and dysrhythmia. Commonly occurring grade 3 adverse events included neutropenia (11 patients), infection (five patients), constipation (three patients), thrombosis (three patients), dyspnea (three patients) and hand-foot syndrome (three patients). In addition, 24/45 patients developed grade 4 neutropenia. Conclusions: The regimen docetaxel and capecitabine shows activity in patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction. This regimen merits further study.
Bibliographical noteFunding Information:
This study was conducted as a collaborative trial of the North Central Cancer Treatment Group and Mayo Clinic and was supported in part by Public Health Service grants: CA-25224, CA-37404, CA-15083, CA-63826, CA-35103, CA-35431, CA-63849, CA-35267, CA-35269, CA-35195, CA-52352, CA-60276, CA-63844, CA-35101, CA-35448, CA-35113, and CA-35103. Participating institutions included: Carle Cancer Center CCOP, Urbana, IL 61801 (K. M. Rowland); Cedar Rapids Oncology Project CCOP, Cedar Rapids, IA 52403 (M. Wiesenfeld); Abbott Northwestern Hospital, Minneapolis, MN 55407 (D. J. Schneider); Scottsdale CCOP, Scottsdale, AZ 85259 (T. R. Fitch); Hawaii Minority-Based CCOP, Honolulu, HI 96813 (W. J. Loui); Medcenter One Health Systems, Bismarck, ND 58506 (E. J. Wos); Iowa Oncology Research Association CCOP, Des Moines, IA 50309 (R. F. Morton); Geisinger Clinic and Medical Center CCOP, Danville, PA 17822 (A. Bernath); Illinois Oncology Research Association, Peoria, IL 61615 (J. W. Kugler); Rapid City Regional Oncology Group, Rapid City, SD (L. P. Ebbert); Siouxland Hematology-Oncology Associates, Sioux City, IA 51105 (D. B. Wender).
- Gastric cancer
- Gastroesophageal Junction