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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastric cancer is the second most common cause of cancer death worldwide. In operable patients, standard care includes surgery with or without adjuvant chemotherapy and radiotherapy; standard care for inoperable disease includes chemotherapy with or without radiotherapy. Docetaxel has shown in vitro and in vivo antitumor effects on human gastric cell lines and gastric cancer xenografts. Phase I through III trials of docetaxel alone and in combination with other chemotherapy agents have subsequently been conducted. This review provides an overview of these studies and suggestions for future directions in the treatment of gastric cancer.
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PMID:Experience with docetaxel in the treatment of gastric cancer. 1601 52

Esophageal cancer is the ninth most common malignancy in the world and the seventh leading cause of death in American men. Because symptoms are often intermittent and vague, patients typically present at an advanced stage, with limited survival. In operable patients, standard care includes surgery with or without adjuvant chemotherapy and radiotherapy; chemotherapy and radiotherapy is the standard care for inoperable disease. Docetaxel, a taxane that promotes polymerization of tubules and inhibits depolymerization of microtubules, has shown in vitro and in vivo antitumor effects on human gastric cell lines and gastric cancer xenografts. These antitumor effects have led to the evaluation of docetaxel as a single agent and in combination with other agents and modalities in patients with esophageal cancer. Results of relevant trials are reviewed herein.
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PMID:Docetaxel in the treatment of esophageal cancer. 1601 53

Docetaxel, one of the most effective anticancer drugs for gastric cancer, targets beta-tubulin, the major protein in mitotic spindles. Eight isotypes of beta-tubulin, with tissue and organ-specific expression, have been identified in mammalian cells. We examined class III beta-tubulin expression in gastric cancer and assessed its relationship with sensitivity to docetaxel-based chemotherapy. A total of 115 paraffin-embedded gastric tumors were analyzed by immunohistochemistry for class III beta-tubulin expression. Twenty patients with advanced gastric cancer received preoperative docetaxel-based chemotherapy. Their biopsied specimens, obtained by endoscopy before chemotherapy were examined for class III beta-tubulin expression. The relationship between expression and chemosensitivity was assessed. Forty-two (36.4%) of 115 cases were confirmed to be positive for class III beta-tubulin expression. There was no association between clinicopathological status and prognosis. Among the patients positive for class III beta-tubulin expression, only 16.7% showed no response to chemotherapy, while 64.3% responded to the chemotherapy in the negative group. Our results suggest that class III beta-tubulin is a simple and useful predictive marker for the clinical response to docetaxel-based chemotherapy in gastric cancer.
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PMID:Clinical significance of class III beta-tubulin expression and its predictive value for resistance to docetaxel-based chemotherapy in gastric cancer. 1639 92

Docetaxel is a semisynthetic taxane that acts by binding to the beta-tubulin subunit of the microtubules, resulting in cell-cycle arrest and apoptosis. It is approved for the management of early and advanced breast cancer, locally advanced and metastatic lung cancer and hormone refractory prostate cancer. Docetaxel has also shown significant antitumor activity in ovarian and gastric tumors and has very recently been approved for the treatment of advanced gastric cancer. Severe neutropenia is the major dose-limiting toxicity with the approved three-weekly regimens, although alternate weekly schedules with less myelotoxicity have been developed for patients with poor bone marrow reserve. This article will review the pharmacology and trials leading to the clinical approval of this agent.
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PMID:Docetaxel: a tubulin-stabilizing agent approved for the management of several solid tumors. 1670 23

Despite continuing decline in its incidence, gastric cancer remains the fourth most commonly diagnosed malignancy and is the second leading cause of cancer death around the world. There are > 50% of patients who develop metastatic cancer, which in the majority is beyond cure and, despite many advances that have been achieved in the management of gastric cancer over the past 15 years, patient prognosis remains very poor. The need for the development of more effective therapies that are likely to further improve survival time cannot be overemphasised. A number of new active classes of agents have been identified and these include camptothecins, taxanes, platinols and oral fluoropyrimidines. This review explicitly focuses on the development of docetaxel in the treatment of advanced gastric or gastroesophageal cancer. Docetaxel, a potent taxane, is active as a single agent and in combination with other active agents. Most importantly, the final results of a pivotal randomised Phase III trial have demonstrated a higher overall response rate, longer time to progression and longer overall survival when docetaxal was added to cisplatin plus 5-fluorouracil and compared with cisplatin plus 5-fluorouracil (a reference regimen). This regimen with docetaxel, cisplatin and 5-fluorouracil is intense and proper patient selection and monitoring of the patients is recommended. Future developments will lead to the incorporation of docetaxel in regimens with improved safety profile.
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PMID:Chemotherapy for advanced gastric or gastroesophageal cancer: defining the contributions of docetaxel. 1687 65

Docetaxel is part of the standard chemotherapy in breast, non-small cell lung cancer and androgen-independent metastatic prostate cancer and has recently been approved for advanced gastric cancer. It demonstrated promising single-agent efficacy in gastric cancer and was therefore investigated in different combination regimens. The combination of docetaxel with 5-fluorouracil (5-FU), capecitabine, irinotecan or cisplatin demonstrated high efficacy. The triple combination of docetaxel/cisplatin and 5-FU (DCF) was investigated in randomized Phase II trials and a randomized Phase III study (TAX325). In TAX325, DCF demonstrated superiority in terms of time to tumor progression, response rate and survival against a cisplatin/5-FU combination. Docetaxel was therefore approved for advanced gastric cancer by the US FDA and the European Agency for the Evaluation of Medicinal Products and will evolve as an integral part of routine combination regimens against gastric cancer. This review will discuss and interpret the different Phase II and III trials of docetaxel in gastric cancer.
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PMID:Docetaxel in the treatment of gastric cancer. 1702 52

Nail changes are common side effects of taxane chemotherapeutic agents. Docetaxel (Taxotere) is known to cause a great incidence of nail change. Various types of nail changes have previously been reported as a result of treatment with taxanes. We describe 2 cases of severe nail changes induced by docetaxel. The patients had previously been diagnosed with breast cancer and advanced gastric cancer, respectively. During the course of treatment with docetaxel, nail changes became apparent in both patients. Initially, they complained of nail bed purpura. Subungual hematomas with hemopurulent discharge were later observed in several fingers. Drainage of the hemopurulent material occurred spontaneously in our cases, leading to onycholysis. Following drainage, the pain in the nail with subungual hemoprulent material was relieved immediately and spontaneous healing of the patients' nails was noticed after few months. Subungual hemorrhage and suppuration therefore are considered causes of onycholysis and the pain in these patients. Although systemic or topical antibiotics were not used to treat these patients, antibiotics may be also worthwhile to hasten the drainage of the subungual hematomas and suppuration in patients for quick relief of pain.
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PMID:Docetaxel-induced onycholysis: the role of subungual hemorrhage and suppuration. 1732 55

Gastric cancer is the second most frequent cancer in the world. Approximately 84% of patients with gastric cancer will have advanced disease and median survival of these patients without chemotherapy is only 3-4 months. "Classical" chemotherapy regimens, mainly CF (cisplatin plus infusional 5FU) and ECF (cisplatin plus infusional 5FU plus Epirubicin) obtain responses in 20-40% of the patients and improve quality of life. Nevertheless, duration of these responses is short with very few complete responses. Median time to tumor progression (TTP) with these regimens is only about 4-5 months and median survival does not exceed 7-10 months. Moreover, benefit seems to be limited to patients with good performance status and treatment toxicity and discomfort are not negligible, specially that of regimens with cisplatin or infusional 5FU. Trying to improve these results, the incorporation of new drugs has been explored. Among the new combinations, the more developed ones are those with Docetaxel (DCF), oxaliplatin (EOX, FLO), Capecitabine (EOX, cisplatin-Xeloda) and irinotecan (ILF). We have final results from Phase III trials that suggest that all these regimens could have a role in the treatment of these patients but survival is still very poor and toxicity remains important. It would be interesting to investigate other new combinations and the incorporation of drugs directed against new therapeutic targets in this setting. It would be of utmost interest that these clinical trials would also explore clinical and molecular prognostic and predictive factors.
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PMID:Chemotherapy of advanced gastric cancer. 1737 98

Docetaxel is a taxane analogue that inhibits microtubule disassembly and, in cultured gastric cancer cells, induces apoptosis-associated binding activity of the transcription factor activating protein-1, and activates the proapoptotic genes BCL2L1 and BAX. In patients with metastatic or locally advanced/recurrent gastric or gastro-oesophageal junction adenocarcinoma, the median time to tumour progression was significantly prolonged with 3-week cycles of intravenous (IV) docetaxel plus cisplatin and fluorouracil (5-fluorouracil) compared with 4-week cycles of IV cisplatin plus IV fluorouracil (5.6 vs 3.7 months) in a large (n = 445), randomised, multicentre, phase III trial. Furthermore, recipients of this triple regimen experienced a significantly longer median overall survival time, a higher overall response rate and delayed deterioration in health-related quality of life than those receiving cisplatin plus fluorouracil. These data are supported by two large (n > 100), randomised, phase II studies in patients with metastatic or locally advanced/recurrent gastric or gastro-oesophageal junction cancer. In general, combination therapy with docetaxel, cisplatin and fluorouracil was relatively well tolerated given the nature of chemotherapy in patients with metastatic or locally advanced/recurrent gastric or gastro-oesophageal adenocarcinoma
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PMID:Docetaxel: in gastric cancer. 1772 57

A 75-year-old male patient had advanced gastric cancer with severe lymph node metastasis. He was treated with docetaxel 60 mg/body (day 1) and S-1 120 mg/body (2 weeks administration and 1 week rest) as neoadjuvant chemotherapy. After two courses of this neoadjuvant chemotherapy, the primary lesion and lymph node swelling were remarkably improved. The patient underwent total gastrectomy and D2 lymph node dissection. The histological effect was judged to be Grade 3, and no viable cancer cell was detected in the primary lesion and lymph node (pCR). Docetaxel and S-1 combination therapy were thought to be an effective method as neoadjuvant chemotherapy for advanced gastric cancer with severe lymph node metastasis.
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PMID:[A case of gastric cancer with severe lymph node metastasis effectively treated with docetaxel / S-1 as neoadjuvant chemotherapy]. 1794 Mar 81


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