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Low-dosed docetaxel showed equivalent efficacy but improved tolerability compared with oxaliplatin in the S-1-based first-line chemotherapy regimen for metastatic or recurrent gastric adenocarcinoma

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Abstract

Platinum–fluoropyrimidine combinations are the preferred first-line options for advanced gastric cancer (AGC) in East Asia. On the other hand, docetaxel-containing regimens without platinum have demonstrated promising activity in AGC. However, dose-related toxicity of docetaxel has limited its clinical adoption. This study compared the efficacy and safety of a modified low-dosed docetaxel plus S-1 (mDS) with oxaliplatin plus S-1 (SOX) in Chinese patients with AGC. Patients were assigned to receive either oxaliplatin (100 mg/m2) in the SOX arm or docetaxel (40 mg/m2) in the mDS arm on day 1 of every 3-week cycle. S-1 80–120 mg/day was administered orally on days 1–14 in the 3-week cycle in both groups. One hundred and eighty-eight patients (mDS regimen 101; SOX 87) showed similar overall survival (OS; 13.1 vs 12.8 months, P = 0.878), progression-free survival (PFS; 5.8 vs 5.5 months, P = 0.924), and overall response rate (39.7 vs 44.2 %, P = 0.569) in the mDS and SOX arms, respectively. mDS was associated with significantly less grade 3/4 toxicities in thrombocytopenia (5.9 vs 16.1 %) and gastrointestinal disturbances (1.0 vs 8.0 %). Furthermore, in patients who had ever received oxaliplatin-based adjuvant chemotherapy (N = 40), mDS resulted in significantly superior OS (17.8 vs 9.5 months, P = 0.015) and PFS (7.0 vs 4.2 months, P = 0.008) compared with SOX. In conclusion, mDS was as effective as SOX in Chinese patients with AGC, but it resulted in a significantly improved tolerability. In patients who received oxaliplatin-based adjuvant chemotherapy before, mDS was associated with improved efficacy in the first-line setting.

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Acknowledgments

The authors would like to thank all the patients and colleagues in our department. This work was supported by Grants from the National Natural Science Foundation of China (No: 81273187).

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    Authors and Affiliations

    1. Department of Medical Oncology, Zhongshan Hospital, Fudan University, Room 411, Building 4, 180 Fenglin Road, Xuhui District, Shanghai, China

      Mengzhou Guo, Yiyi Yu, Yan Wang, Yuehong Cui, Qian Li, Yi Feng, Wei Li, RongYuan Zhuang & Tianshu Liu

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    1. Mengzhou Guo
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    Correspondence to Tianshu Liu.

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    Mengzhou Guo and Yiyi Yu contributed equally to this work.

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    Guo, M., Yu, Y., Wang, Y. et al. Low-dosed docetaxel showed equivalent efficacy but improved tolerability compared with oxaliplatin in the S-1-based first-line chemotherapy regimen for metastatic or recurrent gastric adenocarcinoma. Med Oncol 32, 230 (2015). https://doi.org/10.1007/s12032-015-0675-y

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