Phase II Trial of XELOX as First-Line Treatment for Patients with Advanced Gastric Cancer.

Background: The prognosis of patients with advanced gastric cancer (AGC) remains poor, and no single chemotherapy regimen is recognized as a global standard. A phase II trial was conducted to determine the efficacy and tolerability of capecitabine and oxaliplatin (XELOX) given every 3 weeks in combination in patients with AGC. Methods: Patients with previously untreated AGC received intravenous oxaliplatin 130 mg/m2 over 2 h on day 1 plus oral capecitabine 1,000 mg/m2 twice daily on days 1–14, every 3 weeks. Treatment was continued for 8 cycles or until disease progression or intolerable toxicity. Results: Fifty patients were enrolled. In total, 210 cycles of XELOX were delivered. The OVERALL response rate was 42% (95% CI 28.6–56.7), with 2 complete and 19 partial responses. At 15.2 months of median follow-up, median time to progression and overall survival were 5.8 (95% CI 3.4–8.2) and 11.1 (95% CI 5.6–16.5) months, respectively. The most common hematological adverse event was neutropenia (56% of patients); grade 3–4 neutropenia was observed in 6 patients, with neutropenic fever in only 2 patients. The most common non-hematological toxicities were vomiting (34%), hand-foot syndrome (26%), diarrhea (24%) and neurosensory toxicity (22%). There were no treatment-related deaths. Conclusions: XELOX is active for the first-line treatment of AGC with a manageable tolerability profile. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]