ETOPOSIDE, DOXORUBICIN AND CISPLATIN (EAP) TREATMENT IN ADVANCED GASTRIC-CARCINOMA - A MULTICENTER STUDY OF THE ITALIAN TRIALS IN MEDICAL ONCOLOGY (ITMO) GROUP

Various reports have documented the efficacy of the combination of eto poside, doxorubicin and cisplatin (EAP) in the treatment of advanced g astric cancer, although other studies have not confirmed such results. This multicentre phase II study was designed to try to define the eff icacy and tolerability of the original EAP regimen. From January 1990 to May 1992, 96 patients with locally advanced or metastatic gastric c ancer were treated every 3 weeks with etoposide (120 mg/m(2)) on days 4, 5 and 6, doxorubicin (20 mg/m(2)) on days 1 and 7, and cisplatin (4 0 mg/m(2)) on days 2 and 8. All of the patients had measurable lesions , and were to receive a maximum of six cycles. A total of 416 courses was given (median four/patient), 27% with a delay of greater than or e qual to 2 weeks. Objective responses were achieved in 34 of the 91 eva luable patients (37%: confidence interval 27-47%), with complete respo nse (CR) in 11 (12%) and partial response (PR) in 23 (25%). The median duration of response was 6 months (range 1-19), and the median surviv al of the 96 eligible patients was 9 months. Side-effects (WHO grade 3 -4) were leucopenia (30%), thrombocytopenia (9%) and mucositis (10%). We conclude that the EAP regimen is active in inducing major objective responses (12% of CR), and that treatment is feasible in patients wit h good performance status.