UFT and oral calcium folinate as first-line chemotherapy for metastatic gastric cancer

Locally advanced or metastatic adenocarcinoma of the stomach still carries a poor prognosis, with 5-year survival rates of < 15%. Palliative chemother apeutic regimens for this disease are largely 5-FU-based. We have investiga ted the clinical activity of an oral combination of uracil and tegafur (UFT ) with calcium folinate (Orzel), in patients with measurable metastatic dis ease. Thirty-six patients received a total of 94 courses of daily UFT 300 m g/m(2) plus calcium folinate 90 mg for 28 consecutive days followed by a 7- day rest. Planned treatment doses were maintained in 83% of all evaluable c ourses. Main toxicities included diarrhea (21 patients) and nausea and vomi ting (20 patients). Other side effects were asthenia, malaise, stomatitis, and myelosuppression. At present, 26 patients are evaluable for response. O f these, one achieved a complete response and three achieved partial remiss ions. In addition, six patients reached stable disease, yielding an overall response rate of 27%. We conclude that the combination of UFT and calcium folinate is a feasible outpatient regimen that warrants further clinical ev aluation.