P-0061 Docetaxel Monotherapy as a Second-Line Salvage Treatment in Advanced Gastric Cancer: Experience of 40 Patients with Prognostic Factor Analysis

Abstract Introduction Fluoropyrimidine (F) and platinum (P) combination chemotherapy has been widely used as a first-line treatment of advanced gastric cancer (AGC). Docetaxel has been considerable promise against this disease. We want to investigate the efficacy and safety of docetaxel monotherapy as salvage chemotherapy for AGC in clinical practice and determine the prognostic factors in these patients. Methods We retrospectively reviewed the medical records of patients with AGC for whom fluoropyrimidine and platinum had previously failed and who had received docetaxel salvage monotherapy between March 2005 and December 2011. Docetaxel was administered at a dose of 75 mg/m(2) intravenously every 3 weeks with dexamethasone prophylaxis. Results A total of 40 patients received 133 cycles of docetaxel with a median of three cycles per patient (range 1-6). The median age was 63 years (range 38-78 years). The objective response rate was 10%, with 4 partial responses, with response duration of 1.1, 2.2, 2.6 and 7.1 months respectively. An additional 4 patients achieved stable disease. The median time to progression (TTP) for all patients was 1.9 months [95% confidence interval (CI), 1.2-2.7] and the median overall survival (OS) from the start of docetaxel chemotherapy was 4.1 months (95% CI, 3.6-4.6). Grade 3/4 neutropenia and febrile neutropenia occurred in 15% of patients and anemia occurred in 12.5%. The incidence of non-hematologic toxicities of grade 3 or worse was asthenia 25%, anorexia 12.5%, diarrhea 2.5% and stomatitis 2.5%. Multivariate analysis showed that the Eastern Cooperative Oncology Group (ECOG) performance status (0 or 1 versus 2) was an independent prognostic factor for both TTP and OS. Number of metastatic sites was a predictor for better TTP. Conclusion Docetaxel 75 mg/m(2) is relatively active against AGC as a second-line salvage treatment after failure of fluoropyrimidine and platinum combination chemotherapy in general clinical practice. The toxicity profile is moderate. Further investigation in salvage therapy is needed, in order to improve survival and provide palliation of symptoms.