Adding Docetaxel Improves Survival in Stomach CancerKey Words
Stomach (gastric) cancer, chemotherapy, docetaxel (Taxotere®). (Definitions of many terms related to cancer can be found in the Cancer.gov Dictionary.)
Summary
Addition of the drug docetaxel (Taxotere®) to other chemotherapy drugs used to treat advanced stomach cancer increased the number of patients surviving for at least two years. This finding offers a new treatment option for patients with this disease.
Source
American Society of Clinical Oncology annual meeting, Orlando, Florida, May 15, 2005.
Background
The outlook is poor for patients with stomach cancer that has spread to other organs. At this advanced stage, the cancer is inoperable (cannot be removed with surgery). Although a variety of single drugs and drug combinations are used to treat such patients, none has been shown to improve their chances of living very long. Only about 11.5 percent of such patients survive for two years.
The drug docetaxel has been shown to extend median survival by two months when given in combination with prednisone to patients with advanced prostate cancer. In combination with other chemotherapy drugs, docetaxel has been shown to lengthen time to disease progression in breast cancer patients and to offer some benefit to patients with advanced, inoperable lung cancer. Researchers with the current study wondered whether docetaxel might also prove beneficial to patients with advanced, inoperable stomach cancer.
The Study
This international study involved 457 patients with advanced stomach cancer who had received no previous chemotherapy. They were randomly assigned to receive either chemotherapy with the drugs cisplatin and 5-fluorouracil (5-FU), which is one of the treatments used for this disease, or the same regimen plus docetaxel. Patients were followed for a median of almost two years. The study's principal investigator was Vladimir M. Moiseyenko, M.D., of the Cancer Research Institute in St. Petersburg, Russia.
Results
Eighteen percent of patients treated with docetaxel survived for two years, compared with nine percent of those treated with cisplatin and 5-FU alone. Put another way, said Moiseyenko, patients who received docetaxel had a 23 percent reduction in the risk of death from their disease.
Disease progression was delayed significantly longer in patients in the docetaxel group compared to those who received cisplatin and 5-FU alone. Additionally, the number of patients whose tumors shrank by at least half was higher in the docetaxel group.
Side effects were more common in the docetaxel group. Those patients were more likely to have a low white blood cell count, diarrhea, and infections. Patients treated with cisplatin and 5-FU alone were more likely to experience anemia and a low platelet count.
(Note: final results from this study were subsequently published in the Nov. 1, 2006, issue of the Journal of Clinical Oncology - see the journal abstract.)
Limitations
Robert J. Mayer, M.D., of the Dana-Farber Cancer Institute in Boston, cautioned that although the combination of docetaxel, cisplatin, and 5-FU was “clearly therapeutically superior” to cisplatin and 5-FU alone, it was also associated with higher rates of adverse effects - in particular, a low white blood cell count.
Comments
The combination of docetaxel with cisplatin and 5-FU “offers a new therapeutic option” for patients with advanced stomach cancer, said Moiseyenko.
The best results in the treatment of advanced stomach cancer have been achieved with regimens involving cisplatin, 5-FU, and either docetaxel or epirubicin, Mayer said. However, he concluded, no single chemotherapy regimen for advanced stomach cancer has yet been shown to be superior to the other options.
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