Comparison of efficacy and safety of 5-FU or capecitabine combined with cisplatin and docetaxel (mDCF and mDCX) as a first-line chemotherapy regimen in her 2-negative metastatic gastric cancer patients: A retrospective study

Author:

Demirci Nebi Serkan1,Azizy Abdulmunir2ORCID,Paksoy Nail3,Doğan İzzet4,Karabulut Senem2,Karahan Latif5,Tastekin Didem2

Affiliation:

1. Department of Medical Oncology, Cerrahpasa University Faculty of Medicine, Istanbul, Turkey

2. Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey

3. Department of Medical Oncology, Tekirdağ Dr. Ismail Fehmi Cumalioğlu City Hospital, Tekirdağ, Turkey

4. Department of Medical Oncology, Basaksehir Çam and Sakura City Hospital, Istanbul, Turkey

5. Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.

Abstract

The prognosis of metastatic gastric cancer (GC) is poor, with a median survival time of less than a year. Capecitabine is a prodrug, metabolized by thymidine phosphorylase to its cytotoxic metabolite (5-FU). Few studies have compared capecitabine and 5-FU in mGC. In this retrospective study, we compared the efficacy and safety of modified DCF (mDCF) (docetaxel, cisplatin, and 5-FU) and modified DCX (mDCX) (docetaxel, cisplatin, and capecitabine) regimens for first-line treatment in patients with mGC. The study included 112 mGC patients treated with either mDCF (n = 69) or mDCX (n = 43) between 2010 and 2021. Demographic data, response rate, progression-free survival (PFS), overall survival (OS), and adverse events were evaluated. The complete response rate in the mDCF group was 10.1%, whereas the complete response rate in the mDCX group was 2.3%. The partial response rate for mDCF and mDCX were 29% and 37%, respectively. The 2 treatment arms of the study had the same objective rate of response and disease control rate (DCR). PFS and OS rates were comparable between the 2 groups. The median PFS in the mDCF and mDCX arms were 6.0 months (95% CI, 4.87–7.14) and 5.0 months (95% CI, 4.10–5.90) respectively (P = .08). The median OS in the mDCF and mDCX arms were 9.0 months (95% CI, 7.53–10.47) and 9.0 months (95% CI, 6.87–11.11) respectively (P = .07). Neutropenia, asthenia, stomatitis, and nausea/vomiting were the most frequently reported grade 3 to 4 adverse events (AEs). The rates of grade 3/4 AEs and dose reduction were comparable between the 2 groups. There was no treatment discontinuation due to grade 3 to 4 AE. As a first-line treatment for patients with mGC, mDCX and mDCF regimens have comparable efficacy and tolerability profiles.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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