Efficacy and safety of taxane monotherapy in advanced gastric cancer refractory to triplet chemotherapy with docetaxel, cisplatin, and S-1: a multicenter retrospective study
Efficacy and safety of taxane monotherapy in advanced gastric cancer refractory to triplet chemotherapy with docetaxel, cisplatin, and S-1: a multicenter retrospective study
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DOI：
10.1007/s00280-017-3397-3
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发表时间：
2017-09-01
影响因子：
3
通讯作者：
Boku, Narikazu
中科院分区：
文献类型：
--
作者：
Iizumi, Sakura;Takashima, Atsuo;Boku, Narikazu
紫杉烷单药治疗被广泛用于晚期胃癌（AGC），在标准的一线化疗失败后，氟嘧啶和顺铂。多西他赛、顺铂和替吉奥三联方案是一种有前途的AGC一线化疗方案。本研究的目的是评估紫杉烷单药治疗难治性DCS患者的疗效。我们回顾性评估了2010年1月至2015年4月期间紫杉烷单药治疗难治性DCS一线治疗的AGC患者的疗效和安全性。入选标准为：ECOG PS评分0-2分，伊立替康二线或三线治疗失败后接受紫杉烷单药治疗，无大量腹水，器官功能良好，共纳入30例患者。其中，15名患者接受紫杉醇治疗，而另外15名患者接受纳米粒白蛋白结合紫杉醇二线或三线治疗。二线/三线治疗组的中位年龄为64.0/62.0（范围27-75/42-75）; 14/13（93.3/86.7%）例患者的ECOG PS为0或1。没有患者达到完全或部分缓解，在二线/三线患者中观察到37.5/35.7%的患者病情稳定。二线治疗组的中位无进展生存期和总生存期分别为3.4和5.8个月，三线治疗组分别为2.0和4.5个月。二线组和三线组任何AE 3级不良事件的发生率分别为60.0%和33.3%。无治疗相关性死亡，DCS失败后紫杉烷单药治疗的毒性可接受，但对AGC患者无效。
Taxane monotherapy is widely used for advanced gastric cancer (AGC) after failure of standard first-line chemotherapy with fluoropyrimidine and cisplatin. Triplet chemotherapy with docetaxel, cisplatin, and S-1 (DCS) is a promising regimen for first-line chemotherapy of AGC. The aim of this study was to evaluate the efficacy of taxane monotherapy in patients refractory to DCS.We retrospectively evaluated the efficacy and safety of taxane monotherapy in patients with AGC refractory to first-line therapy with DCS between January 2010 and April 2015. Selection criteria were as follows: ECOG PS of 0-2, treatment with taxane monotherapy in second-line or third-line therapy after failure of second-line irinotecan, absence of massive ascites, and adequate organ function.A total of 30 patients were included in this study. Of these, 15 patients received paclitaxel while another 15 received nanoparticle albumin-bound paclitaxel in either second- or third-line treatment. Median age for the second/third-line group was 64.0/62.0 (range 27-75/42-75); 14/13 (93.3/86.7%) had ECOG PS of 0 or 1. No patients achieved complete or partial response and stable disease was observed in 37.5/35.7% of the patients in the second/third line. Median progression-free survival and overall survival were 3.4 and 5.8 months in the second-line group, and 2.0 and 4.5 months in the third-line group, respectively. The incidences of any grade ae3 adverse events in the second-line group and the third-line group were 60.0 and 33.3%, respectively. There was no treatment-related death.Taxane monotherapy after DCS failure had acceptable toxicities but was ineffective in AGC patients.