Docetaxel Plus Capecitabine Doublet as a 1st Line Regimen in Patients with Advanced Gastric and Gastroesophageal Junction Adenocarcinoma

Purpose: Gastric cancer is associated with high mortality figures due to late stage at presentation and high relapse rates. This study was conducted to evaluate the combination of docetaxel and capecitabine as a 1st line clinical trial on outpatient basis for patients with advanced gastric / gastroesophageal junction (GEJ) carcinoma as regard efficacy, tolerability, response rate and survival benefit.Patients and Methods: From January 2008 to December 2010, prospectively recruited 25 patients with previously untreated advanced metastatic gastric/GEJ carcinoma were subjected to a median of 6 cycles of docetaxel 75 mg/m² IV on day 1 plus capecitabine 2000 mg/m² PO d1-14 q3w.Results: Twenty five patients were enrolled and evaluable. Age: 19-75 yr (median: 48 yr), M/F: 18/7, ECOG PS 0: 4, 1: 17, 2:4 patients. Fifteen patients (60%) had 2 metastatic sites. Most of the reported non-hematological events were mild to moderate, grade 3/4 febrile neutropenia occurred in 3 patients (12%), grade 3 hand foot syndrome experienced by 5 patients (20%), while grade 3/4 leucopenia and neutropenia reported in 11 (44%) 12 (48%) patients, respectively. Subjective improvement of disease related symptoms was reported in 20 out of 25 patients (80%). Regarding clinical response, CR: 1 patient (4%), PR: 12 patients (48%), SD: 9 patients (36%) PD: 2 patients (8%). Median TTP: 8 months (95% confidence intervals 4.6-9.4). Median OS was 11.1 months (95% CI: 7.2-14.8).Conclusion: Docetaxel/capecitabine combination has a promising efficacy as a first line regimen against advanced gastric/GEJ carcinoma patients, and can be given on an outpatient basis and merits further study.