Weekly docetaxel, cisplatin, and irinotecan (TPC): results of a multicenter phase II trial in patients with metastatic esophagogastric cancer

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BackgroundRecent studies have examined the addition of docetaxel to fluorouracil and cisplatin in advanced esophagogastric cancer.Patients and methodsWe carried out a phase I dose-escalation study of weekly docetaxel, cisplatin, and irinotecan (TPC), given on days 1 and 8 every 3 weeks, in patients with chemonaive solid tumors. Subsequently, we completed a multiinstitutional phase II study of TPC in patients with previously untreated, metastatic esophagogastric cancer.ResultsThirty-nine patients were enrolled in the phase I trial; a weekly schedule of TPC was well tolerated. On that basis, docetaxel 30 mg/m2, cisplatin 25 mg/m2, and irinotecan 65 mg/m2 were selected for the phase II trial, where in the first 18 patients irinotecan 65 mg/m2 caused too much diarrhea and was reduced to 50 mg/m2. Among 56 eligible patients with previously untreated, metastatic esophagogastric cancer enrolled in the phase II trial, three complete and 27 partial responses were observed (overall response rate=54%), and 15 patients (30%) had stable disease. Median progression-free survival was 7.1 months, and median survival was 11.9 months. At the final irinotecan dose of 50 mg/m2, grade 3 or higher toxicity included diarrhea (26%), neutropenia (21%), nausea (18%), fatigue (16%), anorexia (13%), and thrombosis/embolism (13%).ConclusionsWeekly TPC is an active and well-tolerated regimen for patients with esophagogastric cancer.

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