B-DOC Regimen Plus Maintenance Feasible for Advanced Gastric Cancer

Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine (B-DOC) plus maintenance therapy was feasible and active.
Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine (B-DOC) plus maintenance therapy was feasible and active.

Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine (B-DOC) plus maintenance therapy was feasible and active as first-line therapy in patients with advanced gastric or gastroesophageal adenocarcinoma, a study published in the journal Cancer has shown.1

For the study, researchers enrolled 60 patients with advanced human epidermal growth factor receptor 2 (HER2)-negative, previously untreated, gastric or gastroesophageal adenocarcinoma. Participants received bevacizumab 7.5 mg/kg IV, docetaxel 50 mg/m2 IV, and oxaliplatin 100 mg/m2 on day 1 plus capecitabine 850 mg/m2 orally twice daily on days 1 to 14 every 3 weeks for 6 cycles. Patients with disease control then received maintenance therapy with capecitabine and bevacizumab.

Results showed that median progression-free survival was 8.3 months (95% CI: 7.2-10.9) with the B-DOC regimen. The objective response rate and disease control rate was 70% (95% CI: 55-83) and 96% (95% CI: 85-99), respectively.

Researchers found that the median overall survival was 12.0 months (95% CI: 10.2-16.1).

In terms of safety, the most common treatment-emergent grade 3 or worse adverse events were neutropenia (20%), leukopenia (18%), diarrhea (15%), and nausea/vomiting (15%).

The study also demonstrated that the presence of circulating tumor cells at baseline and methylenetetrahydrofolate reductase (MTHFR) 677C>T genotype were strongly associated with progression-free and overall survival.

“Docetaxel-based triplet chemotherapy as a backbone for targeted therapies is feasible and deserves further study,” the authors conclude.

REFERENCE

1. Meulendijks D, de Groot JWB, Los M, et al. Bevacizumab combined with docetaxel, oxaliplatin, and capecitabine, followed by maintenance with capecitabine and bevacizumab, as first-line treatment of patients with advanced HER2-negative gastric cancer: A multicenter phase 2 study [published online ahead of print March 11, 2016]. Cancer. doi:10.1002/cncr.29864.

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