Skip to main content
Top
Published in: Cancer Chemotherapy and Pharmacology 5/2013

01-05-2013 | Original Article

Phase II trial of paclitaxel and cisplatin as neoadjuvant chemotherapy for locally advanced gastric cancer

Authors: Akira Tsuburaya, Naoki Nagata, Haruhiko Cho, Naoki Hirabayashi, Michiya Kobayashi, Hiroshi Kojima, Yasuhiro Munakata, Ryoji Fukushima, Yoichi Kameda, Tadakazu Shimoda, Koji Oba, Junichi Sakamoto

Published in: Cancer Chemotherapy and Pharmacology | Issue 5/2013

Login to get access

Abstract

Purpose

Paclitaxel–cisplatin (TC) combination is effective and well tolerated in patients with unresectable gastric cancer. We investigated the efficacy and safety of TC for locally advanced gastric cancers in a neoadjuvant setting.

Methods

Patients received 2–4 courses of paclitaxel (80 mg/m2) and cisplatin (25 mg/m2) on days 1, 8, and 15 in a 4-weekly schedule, followed by radical gastrectomy. Primary endpoint was the pathological response rate: percentage of tumors in which one-third or more parts were affected.

Results

All 52 patients enrolled were eligible. Thirty-six (69.7 %) patients completed two or more courses of chemotherapy. Forty-three patients (82.7 %) underwent surgery, 33 (63.5 %) had R0 resection, and there was no treatment-related death. The pathological response was 34.6 % (95 % CI 22.0–49.1) for all registered patients; the null hypothesis of tumor response ≤10 % was rejected (p < 0.0001). The 3-year overall survival was 41.5 % (95 % CI 27.4–55.0).

Conclusions

The neoadjuvant chemotherapy with TC was safe and effective for patients with locally advanced gastric cancer, and further study is needed to confirm the effectiveness of this regimen.
Literature
1.
go back to reference Brenner B, Shah MA, Karpeh MS, Gonen M, Brennan MF, Coit DG, Klimstra DS, Tang LH, Kelsen DP (2006) A phase II trial of neoadjuvant cisplatin–fluorouracil followed by postoperative intraperitoneal floxuridine–leucovorin in patients with locally advanced gastric cancer. Ann Oncol 17:1404–1411PubMedCrossRef Brenner B, Shah MA, Karpeh MS, Gonen M, Brennan MF, Coit DG, Klimstra DS, Tang LH, Kelsen DP (2006) A phase II trial of neoadjuvant cisplatin–fluorouracil followed by postoperative intraperitoneal floxuridine–leucovorin in patients with locally advanced gastric cancer. Ann Oncol 17:1404–1411PubMedCrossRef
2.
go back to reference Clopper CJ, Pearson ES (1934) The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 26 Clopper CJ, Pearson ES (1934) The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 26
3.
go back to reference Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scarffe JH, Lofts FJ, Falk SJ, Iveson TJ, Smith DB, Langley RE, Verma M, Weeden S, Chua YJ, Participants MT (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20PubMedCrossRef Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scarffe JH, Lofts FJ, Falk SJ, Iveson TJ, Smith DB, Langley RE, Verma M, Weeden S, Chua YJ, Participants MT (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20PubMedCrossRef
4.
go back to reference Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer
5.
go back to reference Habermann CR, Weiss F, Riecken R, Honarpisheh H, Bohnacker S, Staedtler C, Dieckmann C, Schoder V, Adam G (2004) Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radiology 230:465–471PubMedCrossRef Habermann CR, Weiss F, Riecken R, Honarpisheh H, Bohnacker S, Staedtler C, Dieckmann C, Schoder V, Adam G (2004) Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radiology 230:465–471PubMedCrossRef
6.
go back to reference A Japanese Gastric Cancer (1998) Japanese Classification of Gastric Carcinoma—2nd English Edition. Gastric Cancer 1:10–24CrossRef A Japanese Gastric Cancer (1998) Japanese Classification of Gastric Carcinoma—2nd English Edition. Gastric Cancer 1:10–24CrossRef
7.
go back to reference Kobayashi M, Sakamoto J, Namikawa T, Okamoto K, Okabayashi T, Ichikawa K, Araki K (2006) Pharmacokinetic study of paclitaxel in malignant ascites from advanced gastric cancer patients. World J Gastroenterol 12:1412–1415PubMed Kobayashi M, Sakamoto J, Namikawa T, Okamoto K, Okabayashi T, Ichikawa K, Araki K (2006) Pharmacokinetic study of paclitaxel in malignant ascites from advanced gastric cancer patients. World J Gastroenterol 12:1412–1415PubMed
8.
go back to reference Kurokawa Y, Sasako M, Ando N, Sano T, Igaki H, Iwasaki Y, Tsuburaya A, Fukuda H (2009) Validity of response criteria in neoadjuvant chemotherapy against gastric and esophageal cancer: Correlative analyses of multicenter JCOG trials. Gastrointestinal Cancers Symposium, Orland. p. Abst 11 Kurokawa Y, Sasako M, Ando N, Sano T, Igaki H, Iwasaki Y, Tsuburaya A, Fukuda H (2009) Validity of response criteria in neoadjuvant chemotherapy against gastric and esophageal cancer: Correlative analyses of multicenter JCOG trials. Gastrointestinal Cancers Symposium, Orland. p. Abst 11
9.
go back to reference Macdonald JS (2005) Role of post-operative chemoradiation in resected gastric cancer. J Surg Oncol 90:166–170PubMedCrossRef Macdonald JS (2005) Role of post-operative chemoradiation in resected gastric cancer. J Surg Oncol 90:166–170PubMedCrossRef
10.
go back to reference Nagata N, Kimura M, Hirabayashi N, Tuburaya A, Murata T, Kondo K, Fukuda Y, Kobayashi M, Miyashita Y, Nakao A, Sakamoto J (2008) Phase II study of weekly paclitaxel and cisplatin combination therapy for advanced or recurrent gastric cancer. Hepatogastroenterology 55:1846–1850PubMed Nagata N, Kimura M, Hirabayashi N, Tuburaya A, Murata T, Kondo K, Fukuda Y, Kobayashi M, Miyashita Y, Nakao A, Sakamoto J (2008) Phase II study of weekly paclitaxel and cisplatin combination therapy for advanced or recurrent gastric cancer. Hepatogastroenterology 55:1846–1850PubMed
11.
go back to reference Paoletti X, Oba K, Burzykowski T, Michiels S, Ohashi Y, Pignon JP, Rougier P, Sakamoto J, Sargent D, Sasako M, Van Cutsem E, Buyse M (2010) Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA 303:1729–1737PubMedCrossRef Paoletti X, Oba K, Burzykowski T, Michiels S, Ohashi Y, Pignon JP, Rougier P, Sakamoto J, Sargent D, Sasako M, Van Cutsem E, Buyse M (2010) Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA 303:1729–1737PubMedCrossRef
12.
go back to reference Sakamoto J, Matsui T, Kodera Y (2009) Paclitaxel chemotherapy for the treatment of gastric cancer. Gastric Cancer 12:69–78PubMedCrossRef Sakamoto J, Matsui T, Kodera Y (2009) Paclitaxel chemotherapy for the treatment of gastric cancer. Gastric Cancer 12:69–78PubMedCrossRef
13.
go back to reference Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, Furukawa H, Nakajima T, Ohashi Y, Imamura H, Higashino M, Yamamura Y, Kurita A, Arai K (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357:1810–1820PubMedCrossRef Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, Furukawa H, Nakajima T, Ohashi Y, Imamura H, Higashino M, Yamamura Y, Kurita A, Arai K (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357:1810–1820PubMedCrossRef
14.
go back to reference Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ (2010) Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 11:439–449PubMedCrossRef Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ (2010) Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 11:439–449PubMedCrossRef
15.
go back to reference Tsuburaya A, Sakamoto J, Morita S, Kodera Y, Kobayashi M, Miyashita Y, Macdonald JS (2005) A randomized phase III trial of post-operative adjuvant oral fluoropyrimidine versus sequential paclitaxel/oral fluoropyrimidine; and UFT versus S1 for T3/T4 gastric carcinoma: the stomach cancer adjuvant multi-institutional trial group (Samit) trial. Jpn J Clin Oncol 35:672–675PubMedCrossRef Tsuburaya A, Sakamoto J, Morita S, Kodera Y, Kobayashi M, Miyashita Y, Macdonald JS (2005) A randomized phase III trial of post-operative adjuvant oral fluoropyrimidine versus sequential paclitaxel/oral fluoropyrimidine; and UFT versus S1 for T3/T4 gastric carcinoma: the stomach cancer adjuvant multi-institutional trial group (Samit) trial. Jpn J Clin Oncol 35:672–675PubMedCrossRef
16.
go back to reference Yoshikawa T, Sasako M, Yamamoto S, Sano T, Imamura H, Fujitani K, Oshita H, Ito S, Kawashima Y, Fukushima N (2009) Phase II study of neoadjuvant chemotherapy and extended surgery for locally advanced gastric cancer. Br J Surg 96:1015–1022PubMedCrossRef Yoshikawa T, Sasako M, Yamamoto S, Sano T, Imamura H, Fujitani K, Oshita H, Ito S, Kawashima Y, Fukushima N (2009) Phase II study of neoadjuvant chemotherapy and extended surgery for locally advanced gastric cancer. Br J Surg 96:1015–1022PubMedCrossRef
17.
go back to reference Yoshikawa T, Tsuburaya A, Morita S, Kodera Y, Ito S, Cho H, Miyashita Y, Sakamoto J (2010) A comparison of multimodality treatment: two or four courses of paclitaxel plus cisplatin or S-1 plus cisplatin followed by surgery for locally advanced gastric cancer, a randomized Phase II trial (COMPASS). Jpn J Clin Oncol 40:369–372PubMedCrossRef Yoshikawa T, Tsuburaya A, Morita S, Kodera Y, Ito S, Cho H, Miyashita Y, Sakamoto J (2010) A comparison of multimodality treatment: two or four courses of paclitaxel plus cisplatin or S-1 plus cisplatin followed by surgery for locally advanced gastric cancer, a randomized Phase II trial (COMPASS). Jpn J Clin Oncol 40:369–372PubMedCrossRef
Metadata
Title
Phase II trial of paclitaxel and cisplatin as neoadjuvant chemotherapy for locally advanced gastric cancer
Authors
Akira Tsuburaya
Naoki Nagata
Haruhiko Cho
Naoki Hirabayashi
Michiya Kobayashi
Hiroshi Kojima
Yasuhiro Munakata
Ryoji Fukushima
Yoichi Kameda
Tadakazu Shimoda
Koji Oba
Junichi Sakamoto
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Cancer Chemotherapy and Pharmacology / Issue 5/2013
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-013-2130-0

Other articles of this Issue 5/2013

Cancer Chemotherapy and Pharmacology 5/2013 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine