Eloxatin (Oxaliplatin), Xeloda (Capecitabine) and Epirubicin (EXE) as First Line Treatment in Metastatic Gastric Carcinoma

Introduction & The combination of oxaliplatin and capecitabine has demonstrated its effect against various gastrointestinal cancers. On the other hand, Epirubicin, Cisplatin plus continuous infusion of 5-FU is widely used as a palliative regimen in patients with gastric cancer. If cisplatin is substituted by oxaliplatin and 5-FU by capecitabine, this regimen can be administered in the out patient setting, therefore we conducted this study to evaluate the effect of this first line combination in patients with metastatic gastric cancer. Twenty three patients with histologic confirmation of gastric cancer were enrolled. All patients had adequate major organ function and their PS was in the range o-2. The Patients received 100mg/m2 Oxaliplatin intravenously on the first day and 850mg/m2 capecitabine in the first days and 60mg/m2 Epirubicin on the first day of every third week, for maximum of 8 cycles. The meximum number of given courses were 6(1-8). The response rate was 60.8% [95% confidence intervals (CI) 38.5 – 80.3%] medium PFS was 7 months and median survival was 10.6 months. The most important toxicities were as follows: anemia 45%, nausea and vomiting 10%, diarrhea 2%. Neurotoxicity grade I was seen in 10%. We concluded that EXE regimen every third week is a convenient and effective regimen that can easily be administrated in the outpatient setting, but this regimen needs further evaluation in large trials.