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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0044-1786680
Original Article

Docetaxel, Oxaliplatin with Capecitabine (TEX Regimen) in Metastatic Gastric and Gastroesophageal Adenocarcinoma: A Prospective Single-Arm Observational Study from a Tertiary Cancer Center in Kashmir

Sanudev Sadanandan Vadakke Puthiyottil 
1   Department of Medical Oncology, Government Medical College, Kozhikode, Medical College PO, Kozhikode, Kerala, India
,
Faisal R. Guru
2   Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
,
Syed Nisar Ahmad
2   Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
,
Mir Ab Wahid
3   Department of Surgical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
,
Choh Naseer Ahmad
4   Department of Radiodiagnosis, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
,
Lone Mohammad Maqbool
5   Department of Radiation Oncology, Government Medical College, Baramulla, Kant Bagh, Baramulla, Jammu & Kashmir, India
,
Mohammad Hussain Mir
2   Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
,
Banday Saquib Zaffar
2   Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
,
Hashim Ismail Kunju
6   Department of Medical Oncology, Travancore Medical College, Thattamala PO, Kollam, Kerala, India
,
Bhat Gul Muhammed
2   Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
› Author Affiliations Funding This work had no specific funding.
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Abstract

Background Metastatic gastric and gastroesophageal adenocarcinoma (MGGEAC) is a challenging disease with limited treatment options. The Taxotere, Eloxatin, and Xeloda (TEX) regimen has shown promising results in several clinical trials. There exists a dearth of data pertaining to the efficacy and tolerance of the treatment approach in the populace of Kashmir.

Methods This study was performed at the Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir. Patients with MGGEAC received treatment with biweekly TEX regimen that included docetaxel 50 mg/m2-D1, oxaliplatin 85 mg/m2-D1, and capecitabine 1250 mg/m2/day, twice daily orally, for 14 days. The effectiveness of the regimen was assessed based on the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), along with the prognostic factors, safety, and tolerability of the regimen.

Results The ORR was 63.5% after four cycles. The median PFS and OS were 9.1 and 13 months, respectively. Univariate and multivariate analysis showed that a higher number of sites of metastases is associated with poor PFS. The TEX regimen was well tolerated. The most observed grade 3 to 4 toxicities were neutropenia (36.7%), anemia (20%), fatigue (20%), and febrile neutropenia (16.7%).

Conclusion Using the TEX regimen in MGGEAC showed better response rates and a slightly longer PFS. A higher number of sites of metastases is a poor prognostic factor in MGGEAC, as seen in our study. The toxicity profile shows that the regimen is tolerable. We recommend a randomized controlled study comparing CapeOx with TEX to test this regimen further.

Keywords

gastric cancer - TEX regimen - docetaxel - oxaliplatin - capecitabine - prognostic score

Ethics

The Ethical Standards by the Institutions and National Research Committee, Helsinki Declaration of 1964, and subsequent amendments or equivalent standards have been complied with for all procedures undertaken in this study. The study was approved by the Institutional Ethics Committee of SKIMS, Soura, Jammu & Kashmir (Protocol number 65/2018 dated 07.07.2018), and conducted in compliance with protocol after written informed consent to participate in the study was taken from all patients before enrolment.




Publication History

Article published online:
24 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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