Comparative Analysis of the Efficacy and Safety of Oxaliplatin Plus 5-Fluorouracil/Leucovorin (Modified FOLFOX6) with Advanced Gastric Cancer Patients having a Good or Poor Performance Status

Background: Combination chemotherapy of 5 fluorouracil (5-FU) and leucovorin (LV) with oxaliplatin,mainly FOLFOX regimens, has shown considerable antitumor activity and a tolerable toxicity profile in gastriccancer. The goal of this study was to retrospectively compare the efficacy and toxicity of modified FOLFOX-6(mFOLFOX6) regimen in advanced gastric cancer (AGC) patients with good and poor performance status (PS).Materials and
Methods: AGC patients receiving the mFOLFOX6 regimen including oxaliplatin 85 mg/m2, bolusof 5-FU 400 mg/m2 and LV 400 mg/m2 on the first day, followed by 2400mg/m2 of 5- FU as a continious infusionover 46 hour for first-line treatment were eligible for the study.
Results: A total 58 patients with a median age of59.5 (32-81) were included. The median follow up of the study was 9.2 months. Thirty patients (51.7%) with anECOG PS 0-1 were assigned to the good PS arm, while 28 patients (48.3%) with ECOG PS 2 were in the poor PSarm. Overall response rates were 36.6 and 28.8%, respectively (p=0.91). Median PFS was 6.7 and 6.3 months ingood PS and poor PS arms (p=0.50) and median OS was 9.6 and 10.4 months (p=0.55). As compared with goodPS arm, poor PS arm was associated with more grade 3-4 neutropenia and anemia. Dose reduction and dosedelays were also significantly higher.
Conclusions: In this study, mFOLFOX6 was similarly effective in botharms. Although hematologic toxicity was significantly higher in patients with poor PS, it remained manageable.Our results suggest that this regimen may be an effective treatment option for AGC patients with poor PS.