15615 Background: Several different combination chemotherapies for advanced gastric cancer(AGC) have been studied, but there is no great difference in survival benefit compared to previous studies. We designed this phase I/II study of docetaxel(D)-oxaliplatin(O) combination chemotherapy to determine its dose-limiting toxicity, maximum tolerated dose (MTD) and efficacy as a first line treatment in patients with AGC. Methods: Patients aged 18∼70 years, histologically documented gastric adenocarcinoma with measurable disease and adequate organ functions were enrolled.In phase I study, enrolled patients were divided into three groups by doses, and Level I, II, III received D-O 60mg/m2-100mg/m2, 75mg/m2-100mg/m2, 75mg/m2- 130mg/m2 respectively on day 1 every 3 weeks. In phase II study, subjects treated to maximum of 9 cycles of D and O unless there was documented disease progression, unacceptable adverse event or withdrawal of consent. Results: In phase I, there was no dose limiting toxicity (DLT) at all drug levels, so we determined recommended dose of D-O as 75mg/m2-130mg/m2 on level III. In phase II, additional 47 patients were entered into the study. In total, all 50 patients were evaluable. Median follow up duration was 6.5 months (range 0.7–17.3). Overall response rate was 26% (95% CI, 13.8–38.2%) with only 13 partial responders and median duration of response was 3.9 months (range, 0.2–8.8). The time to progression was 2.3 months (range, 1.4–6.6) and 6 months progression free survival rate was 25% (95% CI, 13.0–37.0%). Median overall survival was not reached, and 1 year survival rate was 77.2% (95% CI, 65.6–88.8%). The main toxicities (more than grade 3 or 4) were febrile neutropenia (14%), diarrhea (10%), neutropenia (8%) and neurotoxicity (8%). Neutropenia occurred in first 4 cycles, especially 1st cycle. On the other hand, neurotoxicity occurred after 6th cycles. Treatment related mortality occurred in one patient due to peritonitis-related sepsis (2%). Conclusions: It should be further investigated to know whether D and O combination chemotherapy might be another feasible option as a first line treatment in patients with AGC. No significant financial relationships to disclose.
Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses. Data of 34 patients with HFRS hospitalized at Chosun University Hospital, South Korea, between 2010 and 2021 were retrospectively analyzed. Nested reverse transcription polymerase chain reaction (RT-nPCR) targeting the L segment of hantavirus and sequencing were used for diagnosis. Most cases occurred in men and during the months of October through December. Common symptoms were fever, chills, gastrointestinal symptoms, and myalgia. The common laboratory abnormalities were thrombocytopenia, proteinuria, and elevated levels of serum creatinine, aspartate transaminase, alanine transaminase, and lactate dehydrogenase. Approximately 91.2% of patients had the Hantaan virus with a new genotype cluster, whereas 8.8% had the Seoul virus. Seropositivity based on IgM titer >1:32 on admission was noted in 20.6%, and a 4-fold increase in IgG titer of 1:512 was observed in 11.8%. This study demonstrated that RT-nPCR targeting the L segment of hantaviruses is a more reliable diagnostic method compared to serological testing.
4551 Background: S-1 is a fourth-generation oral fluoropyrimidine that was developed to mimic protracted continuous infusion of 5-fluorouracil (5-FU). In previous study, S-1 demonstrated promising activity which is comparable to combination chemotherapy in advanced gastric cancer. This phase II study evaluated the efficacy and safety of S-1 salvage chemotherapy, in patients with taxane and cisplatin refractory gastric cancer. The primary end point was progression free survival and secondary end points were overall survival, safety and clinical benefit. Methods: Patients were eligible if they had histologically documented gastric adenocarcinoma previously treated with taxane (docetaxel or paclitaxel) and cisplatin; age≥18; Eastern Clinical Oncology Group (ECOG) performance status of 2 or less; adequate organ function; no evidence of gastrointestinal obstruction or passage disturbance. S-1 treatment was performed according to BSA as followed; < BSA 1.25, 80 mg/day, 1.25 ≤ BSA < 1.5, 100 mg/day; BSA ≥ 1.5, 120 mg/day. Every dosage was delivered divided two times and administered for 4 weeks followed by 2 weeks of resting period. Treatment continued until progression of disease or life-threatening adverse events were occurred. Results: Fifty-four patients were enrolled in this study and of the patients, forty-eight patients were evaluable. A total 194 chemotherapy cycles were administered and median number of cycles was three. Four (8.3%) patients had a partial response and 18 (37.5%) patients had stable disease. The median progression free survival and overall survival were 3.8 and 10.2 months, respectively. Grade III/IV hematologic toxicities included neutropenia in 6 patients (12.5%) and there was no febrile neutropenia. Most of nonhematologic toxicities were diarrhea, asthenia, and mucositis, and there was no grade 3 or grade 4 except two patients, who developed grade 3 anorexia and diarrhea, respectively. The clinical benefit response was observed in 16 patients (33.3%). Conclusions: This results showed that S-1 monotherapy was active and safe salvage chemotherapy in patients with advanced gastric cancer previously treated with taxane and cisplatin. No significant financial relationships to disclose.
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