Treatment of advanced gastric cancer with 5-fluorouracil and cisplatin in combination with dipyridamole

We investigated the efficacy of combination chemotherapy using 5-fluorourac il (5-FU), cisplatin (CDDP), and dipyridamole (DP), which is based on the c oncept of double biochemical modulation. Twenty-eight patients with advance d gastric cancer were treated with the simultaneous continuous intravenous (i.v.) infusion of 5-FU (800 mg/m(2)/day) and DP (4 mg/kg/day), and i.v. in fusion of CDDP (20 mg/m(2)/day) for 5 days. The cycles were repeated every 4 weeks. Twelve patients (43%) had a partial response (PR), while stable di sease (NC) occurred in 13 patients (46%), and progression (PD) in 3 patient s (11%). An improved performance status was observed in 20 patients (71%). The carcinoembryonic antigen (CEA) level was markedly decreased in 75% of t he CEA-positive patients. Toxicity was acceptable. The mean steady state pl asma concentration of total DP was 6.4+/-0.5 mu M, which thus seemed adequa te to potentiate the cytotoxicity of 5-FU. The treatment regimen described herein thus appears to be effective, safe and well tolerated by patients wi th advanced gastric cancer.