Oxaliplatin, 5-fluorouracil and leucovorin (modified FOLFOX-6) as first-line chemotherapy for advanced gastric cancer patients with poor performance status

This study was designed to retrospectively evaluate the efficacy and safety of modified FOLFOX-6 regimen in advanced gastric cancer (AGC) patients with poor performance status (PS). From January 2005 to August 2010, 23 AGC patients with poor PS who received mFOLFOX-6 as first-line chemotherapy were reviewed. Patients received 100 mg/m2 oxaliplatin and 100 mg/m2 leucovorin (LV) as a 2-h intravenous infusion on day 1, followed by 5-fluorouracil (5-FU) at 2000 mg/m2 as a 46-h continuous infusion. A total of 22 patients received more than 3 cycles of chemotherapy and were evaluable for tumor response. Seven patients achieved partial response, giving an overall response rate of 31.8%. The median time to progression and overall survival were 3.5 and 9.2 months, respectively. Grade 3–4 hematological toxicities were noted: neutropenia in four patients (17.4%), anemia in two (8.7%) and thrombocytopenia in one (4.3%). Two patients developed febrile neutropenia and one of these patients succumbed to sepsis. Grade 3–4 gastrointestinal toxicities, such as nausea, vomiting and diarrhea were observed in less than 10% of patients. Peripheral neuropathy was observed in 9 patients (39.1%). In conclusion, the mFOLFOX-6 regimen for AGC patients with poor PS was effective with acceptable toxicity. Our results suggest that this regimen may be an effective option for these patients.