Second-Line Cancer Therapy Extends Lives

Esophageal and gastric cancer patients live longer taking docetaxel after first chemotherapy fails

(RxWiki News) Cancers of the esophagus and stomach often require treatment with more than one type of chemotherapy agent. Researchers now know which medication is best if initial, or first-line, therapy fails.

A phase III trial showed that using docetaxel (brand name Taxotere) as a second-line therapy for advanced esophageal-gastric (esophagus and stomach) cancers extended patient lives.

The study compared docetaxel treatment to active symptom control, which includes radiation, steroids and/or other medications, in patients whose late-stage cancer had progressed after receiving first-line chemotherapy.

"Ask your oncologist about second-line therapies."

Hugo Ford, MD was the study lead author. He is director of cancer services at Addenbrooke’s Hospital in Cambridge, UK.

About 39,000 Americans are diagnosed with esophagogastric cancers every year. These malignancies appear in the esophagus (the tube that connects the throat to the stomach), the stomach or the point at which the esophagus and stomach meet (esophagogastric juncture).

These cancers are tough to treat. All advanced esophagogastric cancers which have spread (metastasized) beyond the original site, return after first-line therapy, as do about 65 percent of tumors that have not yet metastasized. Without second-line therapy, patients with advanced cancers live only about three months.

This trial, which was conducted in the UK, involved 168 patients with large tumors or metastatic esophagogastric adenocarcinoma, the most common form of this cancer. Their cancers had all gotten worse within six months of initial chemotherapy treatment.

The participants were randomly assigned to receive either docetaxel or active symptom control. Study members treated with docetaxel lived just over five months compared to 3.6 months for those whose symptoms were controlled. 

In addition to improved survival, patients receiving docetaxel also reported better pain management, and the second-line therapy did not negatively impact quality of life, according to the researchers.

Dr. Ford said in a statement, “Current practice in the United States and a lot of Europe is to give second-line chemotherapy to patients with esophagogastric cancers, even though the evidence isn’t as strong as we would like. This is the first trial to show second-line chemotherapy extends survival, without causing deterioration in quality of life.”

Docetaxel is used to treat a number of other cancers, including those of the breast, ovarian, prostate and head and neck, as well as non-small cell lung cancer (NSCLC).

The trial findings were presented at the 2013 Gastrointestinal Cancers Symposium. Several of the authors disclosed financial relationships with Sanofi, the manufacturer of docetaxel.

All research is considered preliminary before it’s published in a peer-reviewed journal.

Review Date: 
January 25, 2013