Phase II study of docetaxel, cisplatin and capecitabine as preoperative chemotherapy in resectable gastric cancer.
OBJECTIVE
To investigate the feasibility of preoperative docetaxel, cisplatin and capecitabine (DCC) in patients with resectable gastric cancer.


METHODS
Patients with resectable gastric cancer fulfilling the inclusion criteria, were treated with 4 cycles of docetaxel (60 mg/m2), cisplatin (60 mg/m2) and capecitabine (1.875 mg/m2orally on day 1-14, two daily doses) repeated every three weeks, followed by surgery. Primary end point was the feasibility and toxicity/safety profile of DCC, secondary endpoints were pathological complete resection rate and pathological complete response (pCR) rate.


RESULTS
All of the patients (51) were assessable for the feasibility and safety of the regimen. The entire preoperative regimen was completed by 68.6% of the patients. Grade III/IV febrile neutropenia occurred in 10% of all courses. Three patients died due to treatment related toxicity (5.9%), one of them (also) because of refusing further treatment for toxicity. Of the 45 patients who were evaluable for secondary endpoints, four developed metastatic disease and 76.5% received a curative resection. In 3 patients a pCR was seen (5.9%), two patients underwent a R1 resection (3.9%).


CONCLUSIONS
Four courses of DCC as a preoperative regimen for patients with primarily resectable gastric cancer is highly demanding. The high occurrence of febrile neutropenia is of concern. To decrease the occurrence of febrile neutropenia the prophylactic use of granulocyte colony-stimulating factor (G-CSF) should be explored. A curative resection rate of 76.5% is acceptable. The use of DCC without G-CSF support as preoperative regimen in resectable gastric cancer is debatable.
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Anneriet E
AE
Dassen
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Nienke
N
Bernards
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Valery E P P
VE
Lemmens
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Yes A J
YA
van de Wouw
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Koop
K
Bosscha
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Geert-Jan
GJ
Creemers
Anneriet E Dassen, Koop Bosscha, Department of Gastrointestinal Surgery and Surgical Oncology, Jeroen Bosch Hospital, 5200 ME's-Hertogenbosch, The Netherlands.
Hans J F M
HJ
Pruijt
Capecitabine; Docetaxel; Gastric cancer; Preoperative chemotherapy