title: Combination of trastuzumab and triple FLOT chemotherapy (5-fluorouracil/leucovorin, oxaliplatin, and docetaxel) in patients with HER2-positive metastatic gastric cancer: report of 3 cases.
abstract: BACKGROUND
  Trastuzumab in combination with doublet chemotherapy (cisplatin and fluoropyrimidine) is a standard treatment for patients with HER2-positive advanced gastric cancer. There have been no studies evaluating trastuzumab with more intensive triplet chemotherapy regimens in this setting. We report the treatment outcome in 3 patients with HER2-positive metastatic gastric cancer who were treated with trastuzumab plus the triplet FLOT regimen (5-fluorouracil/leucovorin, oxaliplatin, and docetaxel).
  
  
  METHODS
  3 patients with HER2-positive metastatic gastric cancer received trastuzumab plus FLOT. Trastuzumab 4 mg/kg was given with the 2nd chemotherapy cycle and was continued at 2 mg/kg every week with subsequent cycles.
  
  
  RESULTS
  All 3 patients had a dismal prognosis because of their heavy disease burden, most notably extensive hepatic metastatic involvement. Patients tolerated the triple-drug plus trastuzumab combination well. All patients exhibited a dramatic clinical response.
  
  
  CONCLUSIONS
  This report provides the first evidence that the addition of trastuzumab to a docetaxel-based, triple-drug chemotherapy combination is feasible and highly active in patients with HER2-positive metastatic gastric cancer.
authors.affiliation: Institute of Clinical Research at the Krankenhaus Nordwest and Department of Oncology and Hematology, University Cancer Center Frankfurt, Frankfurt/M., Germany. info@al-batran.de
authors.forename: Salah-Eddin
authors.initials: SE
authors.lastname: Al-Batran
authors.forename: Wael
authors.initials: W
authors.lastname: Hozaeel
authors.forename: Elke
authors.initials: E
authors.lastname: Jäger
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D000077143:Docetaxel; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000556:secondary*; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000077143:Docetaxel; D005472:Fluorouracil; D002955:Leucovorin; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D018719:Erb-b2 Receptor Tyrosine Kinases; D043823:Taxoids; D000068878:Trastuzumab; C508053:ERBB2 protein, human