Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 24 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Optimal combination treatments for esophagogastric cancer

The British Journal of Cancer this month confirms that capecitabine 625 mg m-2/bid is the optimal dose showing similar toxicity as 5-fluorouracil, whereas cisplatin replaced by oxaliplatin and 5-fluorouracil by capecitabine does not impair efficacy.

News image

fiogf49gjkf04

Professor Cunningham and colleagues from England established the optimal dose of capecitabine to be used within a multicenter.

The researchers designed a randomized study evaluating the potential roles of oxaliplatin and capecitabine in chemonaive patients with advanced oesophagogastric cancer.

The research team randomized patients to 4 combination treatment regimens and stratified for extent of disease, performance status and center.

The treatments included epirubicin, cisplatin, 5-fluorouracil as Group 1, and epirubicin, oxaliplatin, 5-fluorouracil as Group 2.

Response rate was 48% for the epirubicin, oxaliplatin, capecitabine combination group
British Journal of Cancer

Treatment regimes in Group 3 included epirubicin, cisplatin, capecitabine and Group 4 was given epirubicin, oxaliplatin, capecitabine.

The team gave weekly doses of 50 mg/m2 of epirubicin, 60 mg/m 2 capecitabine, and 130 mg/m of oxaliplatin.

The researchers gave 5-fluorouracil intranvenously at a dose of 200 mg/m2 per day and capecitabine at 500 mg/m2 escalating to 625 mg/m2/bid after the first interim analysis results.

The researchers performed the first interim analysis when 80 patients had been randomized.

The team reported that dose-limiting fluoropyrimidine toxicities were stomatitis, palmar plantar erythema and diarrhoea.

The research team noted that 5% of capecitabine treated patients experienced grade 3 to 4 toxicity.

The protocol planned dose escalation of capecitabine to 625 mg/m2/bid was instituted and a second interim analysis was performed by the researchers.

The team reported that a total of 204 patient were randomized at the time of the protocol planned second interim analysis.

The researchers observed grade 3 to 4 fluoropyrimidine-related toxicity in 14% receiving 5-fluorouracil, 8% receiving capecitabine of 500 mg/m2/bid and 15% receiving capecitabine 625 mg/m2/bid.

Combined complete and partial response rates were 31% with epirubicin, cisplatin, 5-fluorouracil and 39% with epirubicin, oxaliplatin, 5-fluorouracil.

The team also found that response rates for the epirubicin, cisplatin, capecitabine group was 35% and 48% for epirubicin, oxaliplatin, capecitabine group.

Professor Cunningham's team concluded, “Grade 3 to 4 fluoropyrimidine toxicity affected 15% of patients treated with capecitabine 625 mg m-2/bid, which is similar to that observed with 5-fluorouracil, confirming this to be the optimal dose."

“The replacement of cisplatin by oxaliplatin and 5-fluorouracil by capecitabine does not appear to impair efficacy.”

“The trial will continue to total accrual of 1000 patients.”

Br J Canc 2005: 92: 1976-83
03 June 2005

Go to top of page Email this page Email this page to a colleague

 24 May 2018 
Precision medicine for tumors
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 23 May 2018 
High body mass index is and ulcerative colitis
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Fecal incontinence and quality of life in IBD
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Depressive symptoms in IBD youth
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
New therapies for CDI
 15 May 2018 
Hep B in the Grey Zone
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Post‐operative complications in elderly IBD
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Esophageal dilatation in clinical practice 
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's
 24 April 2018 
Microbiome in athletes vs sedentary subjects
 23 April 2018 
Genome-wide study on HBV-related acute-on-chronic liver failure

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us