Chemotherapy with Epirubicin, Cisplatin, and Continuous 5-Fluorouracil for Advanced Gastric Adenocarcinoma

Sofia Man, K. Lavrenkov, J. Dudnik, D. B. Geffen, Y. Cohen

    Research output: Contribution to journalArticlepeer-review


    Objective: There is no widely accepted standard chemotherapy regimen for advanced adenocarcinoma of the stomach. An impressive 77% response rate with epirubicin, cisplatin, and 5-fluorouracil chemotherapy was obtained in a phase II trial and subsequently confirmed in a phase III trial. This regimen has been adopted for the treatment of patients with advanced gastric cancer in Israel and a study was performed to document the experience with this regimen. Patients and Methods: From January 1998 to December 2001, thirty patients with pathologically confirmed advanced adenocarcinoma of the stomach were treated with epirubicin 50 mg/m2 and cisplatin 60 mg/m2 given intravenously every 3 weeks, and 5-fluorouracil 200 mg/m2/day given by continuous intravenous infusion. The median age was 57 years. Twenty three patients (77%) presented with stage IV disease, and 7 patients (23%) had relapsed after initial surgery. The treatment was continued until unacceptable toxicity or disease progression. Results: All patients were eligible for evaluation of response and toxicity. The total number of cycles given was 129 (mean, 4 cycles). The average given relative-dose intensity was 0.82. Therapy was well-tolerated. Five patients (17%) developed grade 3 to 4 vomiting in 7 cycles. Grade 3 to 4 haematological toxicities were neutropenia in 15 patients (50%) in 33 cycles (26%), and anaemia in 1 patient. Three episodes of febrile neutropenia in 3 patients (10%) were registered. Five patients required admission to hospital for toxicity. No treatment related deaths were reported. One patient (3%) with liver metastases achieved complete response and remained disease-free for 7.5 months. Partial response was registered in 5 patients (17%). Disease remained stable in 9 patients (30%). The median progression-free survival was 4.5 months, median survival was 7.5 months, and 1-year survival was 23%. Conclusion: Epirubicin, cisplatin, and 5-fluorouracil chemotherapy for advanced gastric adenocarcinoma is well tolerated with acceptable toxicity, but the response and survival rates in community practice are lower than reported in clinical trials.

    Original languageEnglish
    Pages (from-to)7-9
    Number of pages3
    JournalOncology Forum
    Issue number3
    StatePublished - 20 Apr 2004


    • Combination chemotherapy
    • Gastrointestinal cancer

    ASJC Scopus subject areas

    • Cancer Research


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