AI Article Synopsis
- Oxaliplatin, part of the XELOX regimen, has a better toxicity profile than cisplatin for treating advanced gastric cancer but can cause sensory neuropathy; this study explores whether capecitabine maintenance helps reduce neurotoxicity while improving patient outcomes.
- In a randomized trial involving 63 patients who received XELOX, those on capecitabine maintenance showed significantly prolonged progression-free survival (PFS) compared to those under observation (6.3 vs. 4.1 months).
- Although overall survival rates were similar between both groups, the study concluded that capecitabine maintenance is a significant factor for improving PFS and that associated toxicities were manageable.
Article Abstract
Purpose: Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy.
Materials And Methods: Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level.
Results: Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250-0.890; P=0.020).
Conclusions: After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.
Trial Registration: ClinicalTrials.gov Identifier: NCT02289547.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154142 | PMC |
| http://dx.doi.org/10.5230/jgc.2023.23.e16 | DOI Listing |
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