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Multicenter phase II study of capecitabine plus cisplatin as first-line therapy for human epidermal growth factor receptor 2-negative advanced gastric cancer: Yokohama Clinical Oncology Group Study YCOG1107

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Abstract

Purpose

S-1 plus cisplatin therapy is the recommended standard first-line regimen for human epidermal growth factor receptor 2 (HER-2)-negative advanced unresectable or recurrent gastric cancer (AGC) in the Japanese Gastric Cancer Treatment Guidelines. By contrast, capecitabine plus cisplatin (XP) therapy has been second-line therapy for these patients. This prospective study aimed to evaluate the efficacy and safety of XP as a first-line regimen for HER2-negative patients with AGC.

Methods

In this multicenter, open-label, phase II study, patients received cisplatin (80 mg/m2 i.v. day 1) plus capecitabine (1000 mg/m2 orally, twice daily, days 1–14) at 3 week intervals until disease progression or non-continuation for various reasons. The primary endpoint was overall response rate; secondary endpoints included progression-free survival (PFS), overall survival (OS), and toxicity profiles.

Results

Thirty-six patients with HER2-negative AGC were enrolled in this study. Of these, 16 patients with evaluable lesions were assessable for efficacy and 36 were assessable for toxicity. One patient achieved a complete response and five partial responses. The overall response rate was 37.5% [95% confidence interval (CI) 13.7–61.2%] calculated on an intention-to-treat basis. The median PFS and median OS were 5.2 months (95% CI 4.2–6.2 months) and 16.9 months (95% CI 5.8–27.9 months), respectively. Treatment-related adverse events were generally mild; the most common grade 3/4 adverse event was neutropenia (27.8%), followed by anorexia (19.4%), leucopenia (16.7%), anemia (16.7%), and nausea (13.9%).

Conclusion

XP as first-line therapy is effective and well tolerated by patients with HER2-negative AGC.

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Acknowledgements

We gratefully thank the staff members in the YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT).

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Authors and Affiliations

  1. Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Kei Sato, Chikara Kunisaki, Hiroshi Miyamoto, Sho Sato & Yusaku Tanaka

  2. Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan

    Kei Sato, Takashi Kosaka, Naotaka Yamaguchi, Jun Kimura, Hidetaka A. Ono, Hirochika Makino, Hirotoshi Akiyama & Itaru Endo

  3. Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan

    Ryo Takagawa

  4. Department of Surgery, Yokohama City Hospital, Yokohama, Japan

    Masazumi Takahashi

  5. Department of Surgery, Fujisawa City Hospital, Fujisawa, Japan

    Yusuke Izumisawa

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  1. Kei Sato
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  2. Chikara Kunisaki
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Correspondence to Chikara Kunisaki.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sato, K., Kunisaki, C., Kosaka, T. et al. Multicenter phase II study of capecitabine plus cisplatin as first-line therapy for human epidermal growth factor receptor 2-negative advanced gastric cancer: Yokohama Clinical Oncology Group Study YCOG1107. Cancer Chemother Pharmacol 80, 939–943 (2017). https://doi.org/10.1007/s00280-017-3430-6

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