Effects of weekly paclitaxel as a second-line anticancer chemotherapy for patients with advanced and recurrent gastric carcinoma

Efficacy and toxicity of paclitaxel administered on weekly schedule for 3 weeks per month were examined for patients with advanced and recurrent gastric carcinoma who had received prior fluoropyrimidine-based chemotherapy. Twenty-eight patients with advanced and recurrent gastric carcinoma received weekly paclitaxel therapy at a dose of 80 mg/m2 for 3 weeks per months until disease progression after the resistance against prior fluoropyrimidine-based therapy. The patients had received at most one prior chemotherapy regimen regardless of cycle performed. Prior first-line chemotherapy included UFT (n=4), SI alone (n=6), and S-1 plus cisplatin (n=18) and the mean period of prior chemotherapy was 8.5 +/- 11.7 months. The mean cycles of weekly paclitaxel performed on these patients was 4.3 +/- 4.4 months. Overall response rate was 45.4% and the median survival time after the start of paclitaxel and after the first-line chemotherapy was 296 days and 446 days, respectively. Toxic effects appeared were leucopenia, neutropenia and alopecia and other toxic effects were minimal. Kaplan-Meier's survival analysis indicated that there was no difference of cumulative survival rate between differentiated and poorly differentiated adenocarcinoma, suggesting that weekly paclitaxel had an impact on survival more on poorly differentiated carcinoma. These results suggest that weekly paclitaxel therapy is active and well tolerated in patients with advanced and recurrent gastric carcinoma who had a prior chemotherapy regimen. Weekly paclitaxel appears to be reliable second line anticancer chemotherapy in patients with advanced and recurrent gastric carcinoma who had resistance against prior fluoropyrimidine-based chemotherapy.