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Case study 2: 45-year-old female patient treated with DXP

Case study 2: 45-year-old female patient treated with DXP. Yoon-Koo Kang University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea. Initial presentation. Presented with epigastric pain in Nov 2002 Gastroscopy

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Case study 2: 45-year-old female patient treated with DXP

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  1. Case study 2:45-year-old female patienttreated with DXP Yoon-Koo Kang University of Ulsan College of MedicineAsan Medical Center, Seoul, Korea

  2. Initial presentation • Presented with epigastric pain in Nov 2002 • Gastroscopy • ulceroinfiltrativemass on cardia with extension to distal esophagus • Biopsy • adenocarcinoma • poorly differentiated

  3. Investigations • Physical examination • 2cm left supraclavicular lymph node • adenocarcinoma confirmed by fine needle biopsy • Abdomen & pelvis CT scan • gastric mass extending posteriorly to spleen • conglomerated retropancreatic lymphadenopathy

  4. DXP regimen • Docetaxel: 60 mg/m2 i.v. (D1) • Xeloda: 937.5 mg/m2 p.o. bid (D1–14) • Cisplatin: 60 mg/m2 i.v. (D1) • Repeated every 3 weeks

  5. PR after 9 cycles of DXP 19 Nov 2002 20 May 2003

  6. Complete response? 21 Nov 2002 20 Jun 2003

  7. What do you recommend? A. Stop treatment and observe B. Further chemotherapy with different regimen C. Surgery: gastrectomy D. Radiation therapy

  8. Treatment outcome • Extended total gastrectomy • no residual tumors (pCR) • Follow up without further treatment • No evidence of relapse 2.5 years later in March 2006

  9. Questions • What would your recommendations be for first-line treatment of advanced gastric cancer?

  10. Questions • What would your recommendations be for first-line treatment of advanced gastric cancer? • How do you envisage integrating Xeloda into your practice for the treatment of gastric cancer?

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