Oral etoposide for patients with metastatic gastric adenocarcinoma

PURPOSE Oral administration of etoposide represents a pharmacokinetic advantage ove r the traditional intermittent intravenous usage of this drug. This phase I I trial was undertaken to determine its activity against gastric adenocarci noma in chemotherapy-naive patients. PATIENTS AND METHODS Patients with measurable, unresectable, metastatic gastric carcinoma with p erformance status less than or equal to 2 by Zubrod scale were eligible. Pa tients had to have normal liver, renal, and bone marrow functions, Written informed consent was obtained from all patients. The starting dose of etopo side was 50 mg/m(2)/day, given orally daily for 21 days, followed by a 7-da y rest period. Oral etoposide was repeated every 28 days. Response was eval uated after two courses. RESULTS Twenty-eight patients were registered. The median number of courses was two (range, 1 to 12; total, 63 courses). Twenty-six patients were evaluable fo r response and toxicity. Five patients (13%; 35% confidence interval, 3% to 35%) achieved a partial response. The median duration of response was 3.5 months. There was no treatment-related death. Toxic effects were mild to mo derate. CONCLUSIONS Oral etoposide is modestly active against gastric carcinoma. It is well tol erated by patients. Further studies in combination with other active agents against gastric carcinoma may be warranted.