A Phase I/II Study of NAC with Docetaxel, Cisplatin, and S-1 for Stage III Gastric Cancer

Anticancer Res. 2018 Oct;38(10):6015-6021. doi: 10.21873/anticanres.12951.

Abstract

Background/aim: The aim of this phase I/II study was to determine the safety, and efficacy of combination of neoadjuvant chemotherapy (NAC) with biweekly docetaxel, cisplatin, and S-1 (DCS) in stage III gastric cancer patients.

Patients and methods: In the phase I study, S1 was administered at doses of 80 mg/day to 120 mg/day depending on the body surface area and docetaxel was administered at 20 mg/m2, whereas cisplatin was initially administered at 25 mg/m2 and was escalated by 5 mg/m2 up to 50 mg/m2 In the phase II study, safety and therapeutic efficacy of DCS were evaluated using the recommended dose of cisplatin.

Results: In phase I, 21 patients were enrolled. In level II, perforation of gastric cancer occurred in one case although no dose limiting toxicities (DLTs) were noted in level III-VI. Recommended dose for cisplatin was 50 mg/m2/day. In phase II, among 47 patients, 14 experienced grade 3/4 adverse events. Clinically, response rate was 66.7% and disease control rate was 97.9%. The curative (R0) resection rate was 95.7%. Pathological response rate was 53.3%. Three-year overall survival and relapse-free survival rates were 78.5% and 65.3%, respectively.

Conclusion: Biweekly DCS as NAC was efficient, safe, and acceptable; however, long-term survival should be evaluated to confirm the efficacy of biweekly DCS for stage III gastric cancer patients.

Keywords: Docetaxel; S-1; cisplatin; gastric cancer; neoadjuvant chemotherapy.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / secondary
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Docetaxel
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Oxonic Acid / administration & dosage
  • Prognosis
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Survival Rate
  • Taxoids / administration & dosage
  • Tegafur / administration & dosage

Substances

  • Drug Combinations
  • Taxoids
  • S 1 (combination)
  • Tegafur
  • Docetaxel
  • Oxonic Acid
  • Cisplatin