Study of Docetaxel, Capecitabine and Oxaliplatin in Advanced Stomach Cancer

Phase 1

Completed

Brief Summary: Considering synergism between docetaxel (D), capecitabine (X), and oxaliplatin (O) and favourable toxicity profile of oxaliplatin over cisplatin, it is to be expected that combination of docetaxel, capecitabine, and oxaliplatin (DXO) will be more effective than other regimens and feasible in advanced gastric cancer. DXO regimen can be also easily administered on out-patient setting. However, so far, DXO combination has not been tried in advanced gastric cancer. The investigators will determine maximum tolerated dose of DXO regimen in this phase I study.

Recruitment & Eligibility

Inclusion Criteria

Histologically confirmed unresectable or metastatic advanced gastric adenocarcinoma
Completion of adjuvant chemotherapy 6 months before the study, or no previous chemotherapy (But, patients who received docetaxel, capecitabine, or oxaliplatin as adjuvant chemotherapy should be excluded.)
Age 18 to 70 years old
Eastern Cooperative Oncology Group performance status 0~2
Adequate bone marrow function: white blood cell counts >4,000/µL, absolute neutrophil count >2,000/µL, and platelets>100,000/µL
Adequate renal function: creatinine < 1 x upper normal limit (UNL) or creatinine clearance 60ml/min
Adequate hepatic function: bilirubin < 1.5 x UNL, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels < 2.5 x UNL, and alkaline phosphatase < 5 x UNL (except in case of bone metastasis without any liver disease)
Given written informed consent prior to study-specific screening procedures, with the understanding that the patient has the right to withdraw from the study at any time, without prejudice

Exclusion Criteria

Contraindication to any drug contained in the chemotherapy regimen
Other tumor type than adenocarcinoma
Presence or history of central nervous system (CNS) metastasis
Gastric outlet or bowel obstruction
Evidence of serious gastrointestinal bleeding
Peripheral neuropathy > grade 1
History of significant neurologic or psychiatric disorders
History of another malignancy within the last five years except cured basal cell carcinoma of skin and cured carcinoma in-situ of uterine cervix
Pregnant or lactating women, women of childbearing potential not employing adequate contraception. Postmenopausal women must have been amenorrheic for at least 12 months to be considered of non-childbearing potential
Sexually active males and females (of childbearing potential) unwilling to practice conception during the study
Clinically significant cardiac disease (e.g. severe non-compensated hypertension, non-compensated heart failure, dilated cardiomyopathy, and coronary heart disease with ST segment depression in electrocardiogram) or myocardial infarction within the last 6 months
Serious pulmonary conditions/illness (e.g. chronic lung disease with hypoxemia)
Serious metabolic disease such as severe non-compensated diabetes mellitus
Serious uncontrolled intercurrent infections, or other serious uncontrolled concomitant disease
Positive serology for the human immunodeficiency virus (HIV)

Arm && Interventions

Group	Intervention	Description
Docetaxel, Capecitabine and Oxaliplatin	Docetaxel, Capecitabine and Oxaliplatin	-

Primary Outcome Measures

Name	Time	Method
Number of Participants With DLTs	2 years	Dose limiting toxicity (DLTs) was determined during the Wrst two cycles of treat- ment. The definitions of DLTs were as follows: (1) grade 4 neutropenia lasting for more than 5 days, or grade 3/4 neu- tropenia with fever; (2) grade 4 thrombocytopenia; (3) any other grade 3 non-hematological toxicity (excluding alope- cia); or (4) treatment delay of more than 2 weeks following the time of planned treatment. Maximal tolerated dose was defined as that the DLTs were observed in two or more patients from a cohort of two to six patients

Secondary Outcome Measures