Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2017; 23(6): 1090-1097
Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1090
Modified docetaxel, cisplatin and capecitabine for stage IV gastric cancer in Japanese patients: A feasibility study
Osamu Maeda, Ayumu Matsuoka, Ryoji Miyahara, Kohei Funasaka, Yoshiki Hirooka, Masahide Fukaya, Masato Nagino, Yasuhiro Kodera, Hidemi Goto, Yuichi Ando
Osamu Maeda, Ayumu Matsuoka, Yuichi Ando, Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya 466-8560, Japan
Ryoji Miyahara, Kohei Funasaka, Hidemi Goto, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
Yoshiki Hirooka, Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Japan
Masahide Fukaya, Masato Nagino, Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 466-8550 Nagoya, Japan
Yasuhiro Kodera, Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 466-8550 Nagoya, Japan
Author contributions: Maeda O and Ando Y designed the research, performed the protocol treatment and wrote the manuscript; Matsuoka A, Miyahra R, Funasaka K and Fukaya M contributed to performing the protocol treatment; Hirooka Y, Nagino M, Kodera Y and Goto H were involved in patient recruitment and data analysis.
Institutional review board statement: This study was approved by the review boards of Nagoya University Hospital.
Clinical trial registration statement: This study was registered at, registration identification number is UMIN000006009.
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: Kodera Y has received research funding from Chugai Pharmaceutical Co., Ltd., Sanofi, Yakult Honsha Co., Ltd., Takeda Pharmaceutical Co., Ltd., Pfizer Inc., and Bristol-Myers Squib. Goto H has received research funding from Bristol-Myers Squibb, and Takeda Pharmaceutical Co., Ltd. Ando Y has received research funding from Sanofi, Chugai Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co. Ltd., Yakult Honsya Co., Ltd., and Mochida Pharmaceutical Co., Ltd.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Osamu Maeda, MD, PhD, Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Aichi, Japan.
Telephone: +81-52-7441903 Fax: +81-52-7441903
Received: October 20, 2016
Peer-review started: October 24, 2016
First decision: October 28, 2016
Revised: December 19, 2016
Accepted: January 17, 2017
Article in press: January 17, 2017
Published online: February 14, 2017


To evaluate the feasibility of chemotherapy including fluoropyrimidine, platinum and taxane with modified dosages for unresectable gastric cancer in Japanese patients.


We performed a feasibility study of a modified docetaxel, cisplatin and capecitabine (DCX) regimen for stage IV gastric cancer. In particular, 30 or 40 mg/m2 of docetaxel on day 1, 60 mg/m2 of cisplatin on day 1, and 2000 mg/m2 of capecitabine for 2 wk were administered every three weeks.


Three patients were treated with modified DCX (mDCX) with 30 mg/m2 docetaxel, and five patients were treated with this regimen with 40 mg/m2 docetaxel. Grade 3 or 4 neutropenia was observed in six of the eight patients; no patients exhibited febrile neutropenia. Partial response was achieved in four of the eight patients. Three patients underwent gastrectomy, which achieved R0 resection without residual tumors in dissected lymph nodes. In one of these three patients, resected specimens revealed pathological complete response in the primary lesion and in lymph nodes.


mDCX was well tolerated by Japanese patients with stage IV gastric cancer. This regimen might be useful for allowing gastric cancer patients with distant lymph node metastasis to undergo conversion surgery.

Keywords: Docetaxel, Cisplatin, Capecitabine, Gastric cancer

Core tip: A combination of fluoropyrimidine and platinum is a standard treatment for unresectable gastric cancer. Although the addition of a taxane to this doublet is expected to improve effectiveness, research has demonstrated that such triplet regimens often cause adverse effects, including neutropenia. To reduce adverse events but maintain therapeutic effectiveness, we devised a triplet regimen with modified dosages. Modified docetaxel, cisplatin and capecitabine treatment was safe and effective for stage IV gastric cancer. Three of the eight treated patients underwent conversion surgery and achieved long-term survival without recurrence.