Abstract
Purpose
Capecitabine in combination with docetaxel given every 3 weeks has shown a high degree of activity in a number of tumor types, but at the expense of significant toxicity. To improve the therapeutic index, we evaluated a weekly regimen of docetaxel in combination with capecitabine, and determined the maximum tolerated dose, toxicities and pharmacokinetics of this combination.
Patients and methods
Patients with advanced solid malignancies were treated with docetaxel on days 1 and 8, and capecitabine, twice daily on days 1–14, of an every-21-day cycle. Pharmacokinetics of docetaxel were assessed on days 1 and 8 of the first cycle of chemotherapy.
Results
Enrolled in the study were 25 patients. The most frequent toxicities were asthenia, hand-foot syndrome and mucositis. Inability to deliver at least 75% of the planned doses of both drugs during the first two cycles of chemotherapy was noted at dose levels 2, 3 and 4. Dose level 1 (docetaxel 30 mg/m2 and capecitabine 825 mg/m2 twice daily) is the recommended dose for phase II studies. Five patients experienced a partial response, and eight patients had stabilization of disease. Coadministration of capecitabine did not alter the pharmacokinetics of docetaxel.
Conclusion
The regimen consisting of docetaxel 30 mg/m2 (days 1, 8) and capecitabine 825 mg/m2 twice daily (days 1–14) was well tolerated. Capecitabine did not alter pharmacokinetics of docetaxel. Further testing of this regimen in tumor-specific trials, especially gastric, lung and breast cancer, is warranted.
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References
Miwa M, Ura M, Nishida M, et al (1998) Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumors by enzymes concentrated in human liver and cancer tissue. Eur J Cancer 34:1274–1281
Arima J, Imazono Y, Takebayashi Y, et al (2000) Expression of thymidine phosphorylase as an indicator of poor prognosis for patients with transitional cell carcinoma of the bladder. Cancer 88:1131–1138
Moghaddam A, Zhang HT, Fan TP, et al (1995) Thymidine phosphorylase is angiogenic and promotes tumor growth. Proc Natl Acad Sci U S A 92:998–1002
Imazano Y, Takebayashi Y, Nishiyama K, et al (1997) Correlation between thymidine phosphorylase expression and prognosis in human renal cell carcinoma. J Clin Oncol 15:2570–2578
Takebyashi Y, Yamada K, Miyadera K, et al (1996) The activity and expression of thymidine phosphorylase in human solid tumors. Eur J Cancer 32A:1227–1232
Schuller J, Cassidy J, Dumont E, et al (2000) Preferential activation of capecitabine in tumor following oral administration to colorectal cancer patients. Cancer Chemother Pharmacol 45:291–297
Wagstaff AJ, Ibbotson T, Goa KL (2003) Capecitabine: a review of its pharmacology and therapeutic efficacy in the management of advanced breast cancer. Drugs 63:217–236
Fujimoto-Ouchi K, Tanaka Y, Tominaga T (2001) Schedule dependency of antitumor activity in combination therapy with capecitabine/5′-deoxy-5-fluorouridine and docetaxel in breast cancer models. Clin Cancer Res 7:1079–1086
Sawada N, Ishikawa T, Fukase Y, et al (1998) Induction of thymidine phosphorylase activity and enhancement of capecitabine efficacy by taxol/taxotere in human cancer xenografts. Clin Cancer Res 4:1013–1019
Takeda Y, Yoshizaki I, Nonaka Y, et al (2001) Docetaxel alone or orally combined with 5-fluorouracil and its derivatives: effects on mouse mammary tumor cell line MM2 in vitro and in vivo. Anticancer Drugs 12:691–698
Kurosumi M, Tabei T, Suemasu K, et al (2000) Enhancement of immunohistochemical reactivity for thymidine phosphorylase in breast carcinoma cells after administration of docetaxel as neoadjuvant chemotherapy in advanced breast cancer patients. Oncol Rep 7:945–948
Pronk LC, Vasey P, Sparreboom A, et al (2000) A phase I and pharmacokinetic study of the combination of capecitabine and docetaxel in patients with advanced solid tumors. Br J Cancer 83:22–29
O’Shaughnessy J, Miles D, Vukeja S, et al (2002) Superior survival with capecitabine plus docetaxel combination therapy in anthracycline-pretreated patients with advanced breast cancer: phase III trial results. J Clin Oncol 20:2812–2823
Park YH, Ryoo BY, Choi SJ (2004) A phase II study of capecitabine and docetaxel combination chemotherapy in patients with advanced gastric cancer. Br J Cancer 90:1329–1333
Ramalingam S, Belani CP (2002) Taxanes for advanced non-small cell lung cancer. Expert Opin Pharmacother 3:1693–1709
Gervais R, Ducolone AM, Breton JL, et al (2002) Multicenter, randomized, phase II trial of docetaxel 75 mg/m2 q e 2 versus 40 mg/m2 weekly in patients with pretreated non-small cell lung cancer. Proc Am Soc Clin Oncol 21:310a
Schutte W, Nagel S, Lautenschlager B, et al (2002) Randomised phase III study of weekly versus three-weekly docetaxel as second-line chemotherapy for advanced non-small cell lung cancer. Proc Am Soc Clin Oncol 21:308a
Theresse P, Arbuck SG, Eisenhauer EA, et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216
Parise RA, Ramanathan RK, Zamboni WC, et al (2003) Sensitive liquid chromatography-mass spectrometry assay for quantitation of docetaxel and paclitaxel in human plasma. J Chromatogr B Anal Technol Biomed Life Sci 783:231–236
Nadella P, Shapiro C, Otterson GA, et al (2002) Pharmacobiologically based scheduling of capecitabine and docetaxel results in antitumor activity in resistant human malignancies. J Clin Oncol 20:2616–2623
Toi M, Bando H, Horiguchi S, Takada M, et al (2004) Modulation of thymidine phosphorylase by neoadjuvant chemotherapy in primary breast cancer. Br J Cancer 90:2338–2343
Han JY, Lee DH, Kim H, et al (2003) A phase II study of weekly docetaxel plus capecitabine for patients with advanced nonsmall cell lung carcinoma. Cancer 98:1918–1924
Clarke SJ, Rivory LP (1999) Clinical pharmacokinetics of docetaxel. Clin Pharmacokinet 36:99–114
Acknowledgements
Supported in part by a grant from Aventis Pharmaceuticals, and by grants NCI 2P30 CA47904 and NIH/NCRR/GCRC/#5M01RR00056.
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Ramanathan, R.K., Ramalingam, S., Egorin, M.J. et al. Phase I study of weekly (day 1 and 8) docetaxel in combination with capecitabine in patients with advanced solid malignancies. Cancer Chemother Pharmacol 55, 354–360 (2005). https://doi.org/10.1007/s00280-004-0909-8
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DOI: https://doi.org/10.1007/s00280-004-0909-8