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Triweekly Oxaliplatin Plus Oral Capecitabine as First-Line Chemotherapy in Elderly Patients With Advanced Gastric Cancer

Dong, Ningning MD*; Jiang, Wanrong MD; Li, Huiqing PhD; Liu, Zhifang MD*; Xu, Xiaoqing MD; Wang, Mingyu PhD*

American Journal of Clinical Oncology: December 2009 - Volume 32 - Issue 6 - p 559-563
doi: 10.1097/COC.0b013e3181967db3
Original Article: Gastointestinal

Objectives: To investigate the efficacy and safety of oxaliplatin plus oral capecitabine (XELOX) as first-line chemotherapy in elderly patients with advanced gastric cancer (AGC).

Patients and Methods: Forty-four previously untreated patients with AGC aged 70 or older participated in the study. They received oxaliplatin 130 mg/m2 as 2-hour intravenous infusion on day 1 and oral capecitabine 1000 mg/m2 twice daily on days 1 to 14 every 3 weeks XELOX.

Results: All patients were assessable for toxicity and 41 patients for response. Median age was 75 years (range, 70–83). In total, 215 cycles of XELOX were delivered. The response rate according to Response Evaluation Criteria in Solid Tumors was 51.2% (95% confidence interval [CI]: 35.9%–66.5%), with 2 complete responses, 19 partial responses, 11 stable diseases, and 9 progressions. At 9.5 months median follow-up, median time to progression and overall survival were 5.6 (95% CI: 4.6–6.6) and 9.8 months (95% CI: 7.4–12.2), respectively. Toxicities were generally mild. Grades 3 to 4 adverse events included: neutropenia (6 patients, 13.6%), diarrhea (6 patients, 13.6%), thrombocytopenia (5 patients, 11.4%), hand-foot syndrome (4 patients, 9.1%), nausea and vomiting (2 patients, 4.5%), and anemia (1 patient, 2.3%). Neutropenic fever occurred in 2 patients. There was no treatment-related death.

Conclusions: XELOX is active and well tolerated as first-line chemotherapy for elderly patients with AGC. Given its ease of administration, it represents a good therapeutic option in the elderly.

From the Departments of *Chemotherapy and †Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan, China; and ‡Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China.

Reprints: Mingyu Wang, PhD, Chemotherapy Department, Shandong Tumor Hospital and Institute, Jiyan Rd 440, Jinan 250117, Shandong Province, China. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.