Trastuzumab in combination with docetaxel/cisplatin/S-1 (DCS) for patients with HER2-positive metastatic gastric cancer: feasibility and preliminary efficacy

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• 作者：Yasuhiro Mitsui ; Yasushi Sato ; Hiroshi Miyamoto…
• 关键词：Gastric cancer ; HER2 ; Trastuzumab ; Feasibility
• 刊名：Cancer Chemotherapy and Pharmacology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：76
• 期：2
• 页码：375-382
• 全文大小：488 KB
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  15.Sato Y, Takayama T, Sagawa T et al (2010) Phase II study of S-1, docetaxel and cisplatin combination chemotherapy in patients with unresectable metastatic gastric cancer. Cancer Chemother Pharmacol 66:721-28PubMed View Article
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• 作者单位：Yasuhiro Mitsui (1)
  Yasushi Sato (2)
  Hiroshi Miyamoto (1)
  Yasuteru Fujino (1)
  Toshi Takaoka (1)
  Jinsei Miyoshi (1)
  Miwako Kagawa (1)
  Hiroyuki Ohnuma (2)
  Masahiro Hirakawa (2)
  Tomohiro Kubo (2)
  Takahiro Osuga (2)
  Tamotsu Sagawa (3)
  Yasuhiro Sato (3)
  Yasuo Takahashi (3)
  Shinich Katsuki (4)
  Toshinori Okuda (5)
  Rishu Takimoto (2)
  Masayoshi Kobune (2)
  Takayuki Nobuoka (6)
  Koichi Hirata (6)
  Junji Kato (2)
  Tetsuji Takayama (1)
  
  1. Department of Gastroenterology and Oncology, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15, Kuramoto-cho, Tokushima City, 770-8503, Japan
  2. Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
  3. Division of Gastroenterology, Hokkaido Cancer Center, 4-2-3-54, Kikusui, Shiroishi-ku, Sapporo, 003-0804, Japan
  4. Division of Gastroenterology, Otaru Ekisaikai Hospital, 1-10-17, Shikinai, Otaru, 047-0031, Japan
  5. Department of Gastroenterology, Oji General Hospital, 3-4-8, Wakakusa-cho, Tomakomai, 053-0021, Japan
  6. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
  
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine
  Cancer Research
  Pharmacology and Toxicology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0843

文摘

Purpose We previously reported that a triplet combination of docetaxel, cisplatin, and S-1 (DCS) is active against metastatic gastric cancer with a very high response rate of 87.1?% in a phase II study. Recently, the efficacy of trastuzumab (T-mab) for the treatment of HER2-positive gastric cancer has been reported. Therefore, we investigated the feasibility and preliminary efficacy of DCS?+?T-mab (DCS-T) for unresectable HER2-positive metastatic gastric cancer. Methods Patients received oral S-1 (40?mg/m2?b.i.d.) on days 1-4, intravenous cisplatin (60?mg/m2), docetaxel (50?mg/m2), and T-mab (8?mg/kg in the first cycle and 6?mg/kg in the second cycle and thereafter) on day 8 every 3?weeks. Results The study included 16 patients: median age, 60 (34-6) years; males/females, 11:5; intestinal-type/diffuse-type histology, 11:5; and HER2 3+/2+(FISH+), 13:3. The completion rate until the third cycle was 87.5?% (14/16) (95?%CI 71.3-03.7?%). Adverse events of grade 3/4 severity during the first 3 cycles were: leukopenia/neutropenia, 50.0:75.0?%; febrile neutropenia, 12.5?%; diarrhea, 12.5?%; and stomatitis, 12.5?%. All of these side effects were manageable and well controlled. There were no treatment-related deaths. The overall response rate was 93.8?% (15/16), and the response rate in patients with measurable lesions was 100?% (15/15). The median cycle to response was only 1 (1- cycles). Non-curative factors disappeared in 56.3?% (9/16) of patients, and conversion surgery (R0 resection) was performed in all these cases. Pathological response rates in primary and metastatic lesions were 88.9?% (8/9) and 100?% (9/9), respectively. The median PFS and OS were not reached during the median follow-up time of 18.3?months ranged from 11.0 to 34.3?months. Conclusions DCS-T was feasible in patients with unresectable HER2-positive metastatic gastric cancer. The observed response was very promising and warrants further investigation. Clinical trial registration number UMIN000005603.