Second-Line Docetaxel Improves Survival in Esophageal and Gastric Cancer

Second-line treatment with docetaxel improves overall survival of patients with advanced esophageal and gastric cancer, according to the results of a study presented at the 2013 Gastrointestinal Cancers Symposium in San Francisco.

The esophagus is a muscular tube that food and liquids pass through on their on their way to the stomach. Each year in the United States, more than 17,000 people are diagnosed with cancer of the esophagus and more than 15,000 die of the disease. Gastric cancer refers to cancer of the stomach. Patients with advanced esophagogastric cancer who relapse after first-line chemotherapy have a median overall survival of only three months; however, recent studies have suggested that second-line treatment may extend survival.

The COUGAR-02 study was a multicenter open-label, randomized controlled phase III trial for patients with locally advanced or metastatic esophagogastric adenocarcinoma with disease progression within six months of first-line treatment. The study involved 168 patients who were randomly assigned to receive docetaxel every three weeks for up to six cycles or active symptom control, which included radiotherapy, steroids, and/or supportive care.

The results indicated that docetaxel significantly improved overall survival over active symptom control. Median overall survival in the docetaxel group was 5.2 months compared to 3.6 months in the control group. Partial responses to chemotherapy were observed in 7 percent of patients in the docetaxel group, and disease was stabilized in 46 percent. Treatment with docetaxel significantly reduced mortality by 33 percent.

The researchers concluded that second-line docetaxel significantly improved overall survival in this patient population and can be considered a standard of care in this setting.


Ford H, Marshall A, Wadsley J, et al: COUGAR-02: A randomized phase III study of docetaxel versus active symptom control in patients with relapsed esophagogastric adenocarcinoma. Journal of Clinical Oncology. 2012; 30(suppl 34): Abstract LBA4.

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