Journal of Clinical Oncology, Vol 10, 536-540, Copyright © 1992 by American Society of Clinical Oncology
Etoposide, doxorubicin, and cisplatin chemotherapy for advanced gastric adenocarcinoma: results of a phase II trial
A Lerner, R Gonin, GD Steele Jr and RJ Mayer
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115.
PURPOSE: A phase II study of etoposide, doxorubicin, and cisplatin (EAP)
therapy in patients with advanced gastric carcinoma was performed in an
attempt to confirm encouraging results reported by German investigators
using an identical EAP regimen. PATIENTS AND METHODS: Thirty-six
consecutive, previously untreated patients with surgically unresectable,
measurable gastric carcinoma were treated every 28 days with etoposide (120
mg/m2, days 4, 5, and 6), doxorubicin (20 mg/m2, days 1 and 7), and
cisplatin (40 mg/m2, days 2 and 8). A total of 108 courses of treatment was
given. RESULTS: Therapy was associated with myelosuppression (median
granulocyte nadir, 239/microL; median platelet nadir, 81,000/microL), which
reached its maximum 14 days after the start of therapy and necessitated
hospitalization after 24 of 108 (22%) treatment courses. Four of 36 (11%)
patients died of treatment-related toxicity: three from sepsis and one from
hemorrhage. Objective responses were observed in 12 of 36 (33%) patients;
three (8%) patients experienced a clinical complete response. The median
time to progression was 4 months for all 36 patients and 8 months for the
12 responding patients. Of the 13 patients with localized but unresectable
disease, five subsequently underwent surgical resection; only one of these
five was rendered disease-free. CONCLUSION: The EAP regimen is highly toxic
and results in response rates and survival times no better than those of
more easily tolerated treatment programs.
