title: Feasibility study of triplet combination chemotherapy of paclitaxel, cisplatin and S-1 for advanced gastric cancer.
abstract: BACKGROUND
  Docetaxel combined with cisplatin and 5-fluorouracil (5-FU) is active in advanced gastric cancer, but not generally accepted because of its substantial toxicities. We conducted a feasibility study of a triplet combination using paclitaxel, cisplatin and S-1 for advanced gastric cancer.
  
  
  METHODS
  Patients were given paclitaxel 160 mg/m² infused over 2 hours on day 1, followed by cisplatin 60 mg/m² in a 2-hour infusion on day 14, and S-1 80 mg/m²/day for 14 consecutive days, followed by a 2-week rest, repeated every 4 weeks. Treatment was continued until disease progression or unacceptable toxicity occurred, the patient refused the therapy, or a surgical procedure was performed.
  
  
  RESULTS
  Twenty-one patients were prospectively enrolled. A total of 53 courses were administered, with a median of 2 courses (range: 1-7). Leucopenia, neutropenia, and anemia of grade 3 or more occurred in 3, 12, and 3 patients, respectively. Non-hematological toxicities were all grade 2 or less. Planned treatment was delivered with relative dose intensity for paclitaxel, cisplatin, and S-1 as 91.1%, 81.1% and 90.6%, respectively. The overall response rate was 67% with 1 complete response, 13 partial responses, and 6 with stable disease, while 6 out of 13 surgically resected specimens showed a histologic response graded ≥ 1b. Median survivals of all patients and of 13 patients who underwent curative resection were 543 and 871 days, respectively.
  
  
  CONCLUSIONS
  Triplet combination chemotherapy with paclitaxel, cisplatin and S-1 demonstrated superior feasibility and promising antitumor activity for advanced gastric cancer.
authors.affiliation: Department of Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, Japan. fujitani@onh.go.jp
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fujitani
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Tsujinaka
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy*; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel; D002945:Cisplatin