Comparative Study between Anthracycline Based Regimen and Taxane Based Regimen in Metastatic Gastric Cancer: General Perspectives

Introduction: Taxanes and anthracyclin containing regimes are the most successful regimens in
advanced gastric cancer with comparable results but with different toxicity profiles.
Objective: To compare efficacy and toxicity of 2 regimens one containing anthrathycline (ECSF
regimen) and other contain taxane (PCF regimen) as a first line therapy in advanced gastric cancer.
Methods: Between May 2011 and Dec 2015, a total of 120 patients with locally advanced and
metastatic gastric adenocarcinoma were included in the study, 60 patients received ECSF (Epirubicin
50 mg/m2 iv d1, Cisplatin 60 mg/m2 iv d1, 5-FU 1750 mg/m2/d “1 and 8” CIVI over 24 h, Folinic acid
200 mg /m2 day 1, 8 repeated every 3 weeks), while, another 60 patients received PCF (Paclitaxel
150 mg/m2 IV on day 1; Cisplatin 15 mg/m2 IV on days 1-5 and 5-FU 600mg/m2/day CIVI d1-5 every
3 weeks) until disease progression or unacceptable toxicities.
Results: ORR of ECSF was superior to PCF arm, 47% vs. 34% respectively p = 0.001. The toxicity
profiles were less in ECSF arm than PCF arm especially in neutropenia and mucositis. Median PFS
and OS were significantly higher in ECSF arm than PCF (6.9 vs. 4.9 months p= 0.022) and (11.1
vs.8.9 months p = 0.028) respectively.
Conclusion: The use of anthracycline based regimen as first line therapy in advanced gastric cancer
showed better outcome and acceptable toxicity when it compared with paclitaxel containing regimen.