Weekly docetaxel, cisplatin, and 5‐fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer

BACKGROUND: Docetaxel, cisplatin, and 5‐flurouracil (DCF) administered every 3 weeks produces a high rate of treatment‐related adverse events. The objective of the current study was to evaluate the efficacy and tolerability of a weekly formulation of DCF. METHODS: Data from 117 patients treated at The University of Texas M. D. Anderson Cancer Center from 2002 to 2006 with a weekly formulation of DCF were retrospectively collected. A total of 95 patients received front‐line therapy with 20 mg/m 2 of cisplatin, 350 mg/m 2 of 5‐fluorouracil, and 20 mg/m 2 of docetaxel administered once weekly for 6 consecutive weeks followed by a 2‐week break. RESULTS: Ninety‐five patients (median age, 62 years [range, 33 to 87 years], with an Eastern Cooperative Oncology Group performance status of 1 or 2 in 67%) received a median of 10 weeks of DCF treatment (range, 3‐41 weeks). Grade 3 or 4 hematologic toxicity (assessed according to National Cancer Institute Common Toxicity Criteria [version 3.0]) included granulocytopenia (4 patients) and anemia (9 patients). None of the patients developed a febrile neutropenic infection, but grade 3 or 4 non‐neutropenic infections occurred in 8 patients. Eighty patients had measurable disease with an objective response rate determined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria of 34% (95% confidence interval [95% CI], 24‐45%). The median follow‐up was 9 months, with a median time to disease progression of 4.1 months (95% CI, 3.6‐5.7 months) and a median overall survival of 8.9 months (95% CI, 7.7‐10.8 months). CONCLUSIONS: In patients with advanced gastric and esophageal cancer who were not candidates for every‐3‐week DCF, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients. Cancer 2010. © 2010 American Cancer Society.