title: Epirubicin, cisplatin, and raltitrexed in patients with advanced gastric and hepatobiliary carcinoma: a phase II study.
abstract: The combination of epirubicin, cisplatin, and protracted venous-infusion 5-fluorouracil is the standard treatment of advanced gastric carcinoma in many European countries, and it is also an active regimen in hepatobiliary tumors. Raltitrexed is a specific inhibitor of thymidylate synthase with clinical activity in gastrointestinal malignancies. The aim of the study was to evaluate the clinical activity and toxicity of the combination of epirubicin, cisplatin, and raltitrexed in patients with advanced gastric and hepatobiliary tumors. Twenty consecutive patients with gastric carcinoma, 7 with biliary-tract carcinoma, and 5 patients with hepatocarcinoma were treated with epirubicin (60 mg/m2), cisplatin (60 mg/m2) on day 1, and raltitrexed (1 mg/m2) on days 1 and 8, every 3 weeks. The median age was 63 years (range, 28-76). Eight patients had locally advanced disease and 24 had metastatic tumors. Seven of the 18 evaluable patients (39%) with gastric carcinoma and 2 of the 5 patients with hepatocarcinoma have a partial response; 1 minimal response and 4 stabilization of disease were documented in the 7 patients with biliary-tract carcinoma. The median time to progression of the entire group was 6.8 months, and the median survival was 9.0 months. The toxicity was mild and no toxic death occurred. The combination of epirubicin, cisplatin, and raltitrexed, using this schedule, is tolerable and has clinical activity in gastric and hepatobiliary tumors.
authors.affiliation: Unità Operativa di Oncologia Medica & Fondazione Beretta, Azienda Spedali Civili, Brescia, Italy.
authors.forename: Vittorio D
authors.initials: VD
authors.lastname: Ferrari
authors.forename: Vito
authors.initials: V
authors.lastname: Amoroso
authors.forename: Francesca
authors.initials: F
authors.lastname: Valcamonico
authors.forename: Alberto
authors.initials: A
authors.lastname: Fusi
authors.forename: Edda
authors.initials: E
authors.lastname: Simoncini
authors.forename: Lucia
authors.initials: L
authors.lastname: Vasalli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rangoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Mambrini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Marpicati
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Montini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Marini
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016019:Survival Analysis; D013876:Thiophenes / Q000008:administration & dosage
chemical_list: D011799:Quinazolines; D013876:Thiophenes; D015251:Epirubicin; C068874:raltitrexed; D002945:Cisplatin