The efficacy of modified docetaxel-cisplatin-5-fluorouracil regimen as first-line treatment in patients with alpha-fetoprotein producing gastric carcinoma

Bozkaya Y., Dogan M., Yazici O., Erdem G. U., Demirci N. S., Zengin N.

BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES, vol.17, no.2, pp.138-143, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 17 Issue: 2
  • Publication Date: 2017
  • Doi Number: 10.17305/bjbms.2017.1684
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.138-143
  • Keywords: Alpha-fetoprotein, alpha-fetoprotein producing gastric carcinoma, gastric carcinoma, modified docetaxel, cisplatin-5-fluorouracil, chemotherapy, CLINICOPATHOLOGICAL FEATURES, HEPATOCELLULAR-CARCINOMA, HEPATOID ADENOCARCINOMA, PROGNOSTIC-FACTORS, CA 72-4, CANCER, DOCETAXEL, CISPLATIN, STOMACH, 5-FLUOROURACIL
  • Gazi University Affiliated: No


Alpha-fetoprotein producing gastric carcinoma (AFP-PGC) is a rare cancer for which limited data on the clinicopathological features and treatment modalities exist. The aim of this study was to compare the efficacy of modified docetaxel-cisplatin-5-fluorouracil (mDCF) as the first-line chemotherapy regimen in metastatic AFP-PGC and non-AFP-PGC. The patients diagnosed with metastatic gastric cancer who were given mDCF as first-line therapy were retrospectively reviewed. The patients with a basal serum AFP level over 9 ng/ml were defined as AFP-PGC patients. In total, 169 patients (34 with AFP-PGC and 135 with non-AFP-PGC) were included in this study. AFP-PGC patients had more liver metastases than non-AFP-PGC patients (p < 0.001). A decrease in basal AFP levels after three cycles of chemotherapy was significantly different in AFP-PGC group (p = 0.001). Overall disease control rate was 79.4% (partial response [PR] -44.1%, stable disease [SD] -35.3%), and 82.2% (complete response -3%, PR-36.2%, SD -43%) in AFP-PGC and non-AFP-PGC patients, respectively. There was no difference between AFP-PGC and non-AFP-PGC groups in overall and progression-free survival rates (11.3 versus 11.4 months and 7.7 versus 7.1 months, respectively). Rates of grade 3-4 hematologic toxicity were 8.8% and 6.7% for neutropenia in AFP-PGC and non-AFP-PGC group, respectively and 5.9% and 7.4% for anemia. In conclusion, mDCF regimen is well-tolerated with acceptable toxicity outcomes in both AFP-PGC and non-AFP-PGC patients. A statistically significant decrease in AFP levels after mDCF regimen indicate that AFP might be considered as a supplemental marker of response to mDCF chemotherapy in AFP-PGC patients. However, further prospective clinical trials are required in this area.