A modified epirubicin and oxaliplatin plus capecitabine (EOX) regimen as a second- line therapy in patients with advanced gastric cancer

Bozkaya Y., Özdemir N. Y., Yazici O., DEMİRCİ N. S., Kurtipek A., Erdem G. U., ...More

Asian Pacific Journal of Cancer Prevention, vol.19, no.1, pp.283-290, 2018 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 19 Issue: 1
  • Publication Date: 2018
  • Doi Number: 10.22034/apjcp.2018.19.1.283
  • Journal Name: Asian Pacific Journal of Cancer Prevention
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.283-290
  • Keywords: Gastric cancer, Modified DCF, Modified EOX, Second-line therapy
  • Lokman Hekim University Affiliated: No


Objective: We aimed to evaluate the effectiveness of an mEOX (modified epirubicin, oxaliplatin plus capecitabine) regimen as second line therapy after failure of mDCF (modified docetaxel, cisplatin plus fluorouracil). Methods: Gastic cancer patients for whom first-line therapy was unsuccessful and who subsequently received mEOX (epirubicin 50 mg/m2 on day 1, oxaliplatin 85 mg/m2 day 1 and capecitabine twice-daily dose of 625 mg/m2, p.o. for 2 weeks) every 3 weeks until disease progression or unacceptable toxicity, were retrospectively analyzed. Results: The study population comprised 129 cases with a median age of 55 years (range= 27-78), the majority being male (76 %). Most (75.2%) had ≥ 2 sites of metastasis. The median number of chemotherapy courses was five (range= 2-9). Forty-nine achieved a partial response and 33 showed stable disease, resulting in a ORR (overall response rate) of 38% and a DCR (disease control rate) of 63.6%. The most frequent features of grade 3-4 hematological and non-hematological toxicity were neutropenia (8.5%) and nausea/vomiting (5.4%). None of the patients suffered death due to toxicity. The median PFS was 4.7 months (95% CI, 4.1-5.3) and the OS was 7.4 months (95% CI, 6.3-8.5). On multivariate analysis, age ≥ 60 years and ECOG performance status (0-1) were independent prognostic factors affecting PFS and OS. Conslusions: In advanced gastric cancer patients, who progress after first line chemotherapy and have an ECOG performance status of 0-1, mEOX is a well tolerated triple regimen associated with a promising OS and PFS.