Article
Docetaxel as salvage therapy in highly pretreated and chemo-resistant gastrointestinal tumors
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Authors
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Martin Sprinzl
- Universitätsklinikum, Mainz, Deutschland
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Sonia Schleef
- Universitätsklinikum, Mainz
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Anja Dahmen
- Universitätsklinikum, Mainz
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Peter Galle
- Universitätsklinikum, Mainz
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Stephan Kanzler
- Universitätsklinikum, Mainz
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Markus Moehler
- Universitätsklinikum, Mainz
| Published: | March 20, 2006 |
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Outline
Text
Introduction: Despite chemotherapy for gastrointestinal cancer, overall prognosis is still fatal. Particularly after failure of first-line therapy in gastric and pancreatic cancer, many patients deserve alternative protocols. Since weekly docetaxel was effective in breast cancer, we analysed its toxicity and efficacy in highly pretreated and chemo-resistant gastrointestinal cancer patients.
Methods: After informed consent 20 patients received Docetaxel based regimes (35-40 mg/m² weekly, plus 1 week rest after 4 weeks). Docetaxel was mainly given in 3rd line therapy with 50% (10/20), and 2nd, 4th or 5th line therapy in 20% and 15%, respectively. Tumor progression was diagnosed using RECIST criteria or when clinical evident. Toxicity was graded based on NCI CTC, version 2. Most patients had gastric cancer (n=12/20). The remaining entities comprised of pancreatic (n=7/20) or cholangio-cellular carcinoma (n=1/20).
Results: Median docetaxel dosage was 35 mg/m² once weekly. Mean therapy duration was 14,7 weeks. Docetaxel weekly caused only few therapy-associated grade 3/4 toxicities, with nausea (15%), polyneuropathy (10%), neutropenia (15%), anorexia (10%) and leukopenia (5%). One sepsis-related death occurred, not prompted by chemotherapy. With regard to clinical efficacy, tumor control was achieved in 42.1%, with 5.3% partial responses (PR) and stable disease (SD) in 36.8 %. For all patients, progression-free survival (TTP), mean survival form start of docetaxel and of first palliative therapy were 3.2, 3.6 and 20.4 months, respectively. For the gastric cancer subgroup, TTP, survival form start of docetaxel and start of any chemotherapy were 3.1, 4.3, and 24.3 months, respectively.
Discussion: In this highly pretreated and chemo-resistant GI tumors patient population, weekly docetaxel was well tolerated, presented tumor control in about half of all patients and a remarkably good survival, especially for gastric cancer. Therefore, weekly docetaxel is a salvage treatment option in selected GI cancer patients.
