Comparative Study between Anthracycline Based Regimen and Taxane Based Regimen in Metastatic Gastric Cancer

Introduction: Taxanes and anthracyclin containing regimes are the most successful regimens in advanced gastric cancer with comparable results but with different toxicity profiles.

Objective: To compare efficacy and toxicity of 2 regimens one containing anthrathycline (ECSF regimen) and other contain taxane (PCF regimen) as a first line therapy in advanced gastric cancer.

Methods: Between May 2011 and Dec 2015, a total of 120 patients with locally advanced and metastatic gastric adenocarcinoma were included in the study, 60 patients received ECSF (Epirubicin 50 mg/m2 iv d1, Cisplatin 60 mg/m2 iv d1, 5-FU 1750 mg/m2/d “1 and 8” CIVI over 24 h, Folinic acid 200 mg /m2 day 1, 8 repeated every 3 weeks), while, another 60 patients received PCF (Paclitaxel 150 mg/m2 IV on day 1; Cisplatin 15 mg/m2 IV on days 1-5 and 5-FU 600mg/m2/day CIVI d1-5 every 3 weeks) until disease progression or unacceptable toxicities.

Results: ORR of ECSF was superior to PCF arm, 47% vs. 34% respectively p = 0.001. The toxicity profiles were less in ECSF arm than PCF arm especially in neutropenia and mucositis. Median PFS and OS were significantly higher in ECSF arm than PCF (6.9 vs. 4.9 months p= 0.022) and (11.1 vs.8.9 months p = 0.028) respectively.

Conclusion: The use of anthracycline based regimen as first line therapy in advanced gastric cancer showed better outcome and acceptable toxicity when it compared with paclitaxel containing regimen.