Combination of trastuzumab and triple FLOT chemotherapy (5-fluorouracil/leucovorin, oxaliplatin, and docetaxel) in patients with HER2-positive metastatic gastric cancer: report of 3 cases

Onkologie. 2012;35(9):505-8. doi: 10.1159/000341841. Epub 2012 Aug 17.

Abstract

Background: Trastuzumab in combination with doublet chemotherapy (cisplatin and fluoropyrimidine) is a standard treatment for patients with HER2-positive advanced gastric cancer. There have been no studies evaluating trastuzumab with more intensive triplet chemotherapy regimens in this setting. We report the treatment outcome in 3 patients with HER2-positive metastatic gastric cancer who were treated with trastuzumab plus the triplet FLOT regimen (5-fluorouracil/leucovorin, oxaliplatin, and docetaxel).

Patients and methods: 3 patients with HER2-positive metastatic gastric cancer received trastuzumab plus FLOT. Trastuzumab 4 mg/kg was given with the 2nd chemotherapy cycle and was continued at 2 mg/kg every week with subsequent cycles.

Results: All 3 patients had a dismal prognosis because of their heavy disease burden, most notably extensive hepatic metastatic involvement. Patients tolerated the triple-drug plus trastuzumab combination well. All patients exhibited a dramatic clinical response.

Conclusion: This report provides the first evidence that the addition of trastuzumab to a docetaxel-based, triple-drug chemotherapy combination is feasible and highly active in patients with HER2-positive metastatic gastric cancer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Docetaxel
  • Fluorouracil / administration & dosage
  • Humans
  • Leucovorin / administration & dosage
  • Male
  • Middle Aged
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Receptor, ErbB-2 / metabolism*
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / secondary*
  • Taxoids / administration & dosage
  • Trastuzumab
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Organoplatinum Compounds
  • Taxoids
  • Oxaliplatin
  • Docetaxel
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab
  • Leucovorin
  • Fluorouracil