P-168 Retrospective comparison of efficacy and safety of docetaxel and weekly-paclitaxel as 2nd-line chemotherapy for patients with unresectable or recurrent esophageal cancer

Abstract

Introduction: Efficacy and safety of docetaxel (DTX) or weekly‐paclitaxel (wPTX) had been reported in single‐arm phase II studies, and DTX or wPTX is widely used in clinical practice as second‐line chemotherapy for patients with unresectable or recurrent esophageal cancer. However, there was no randomized controlled trial comparing DTX and wPTX.We investigated retrospectively the efficacy and safety of DTX and wPTX as second‐line chemotherapy for patients with esophageal cancer in our institution. Methods: Unresectable or recurrent esophageal cancer patients who started second‐line chemotherapy in Hokkaido University Hospital from July 2005 to July 2015 were included in this analysis. Patients who had been treated with taxane‐containing chemotherapy as first‐line setting were excluded. Patients' characteristics were compared using Fisher's exact test or student t‐test. Treatment response was evaluated according to RECIST v1.1, and adverse events were evaluated according to CTCAE v4.0. Survival curves were estimated using Kaplan‐Meier method, and differences were evaluated using log‐rank test. Results: There were 39 eligible patients (25 patients in DTX group and 14 patients in wPTX group). Median age (range) was 63 years (26‐78) in DTX group and 65 years (55‐74) in wPTX group. Sex (male/female) was 20/5 in DTX group and 12/2 in wPTX group. ECOG PS (0/1/2/3) was 8/13/4/0 in DTX group and 4/9/0/1 in wPTX group. Prior esophagectomy had been performed in 44% in DTX group and 57% in wPTX group. Prior radiation therapy had been performed in 60% in DTX group and 71% in wPTX group. First‐line chemotherapy was 5‐FU + cisplatin (80% in DTX and 86% in wPTX) or 5‐FU + nedaplatin (20% in DTX and 14% in wPTX). The median relative dose intensity was 82.1% in DTX vs 87.1% in wPTX (p = 0.223). Response rate was 12% in DTX vs 28.6% in wPTX (p = 0.225), and disease control rate was 28% in DTX vs 64.3% in wPTX (p = 0.043). The median progression‐free survival was 1.84 months in DTX vs 3.71 months in wPTX (HR = 0.41; 95% CI 0.19‐0.91; p = 0.023), and the median survival time was 5.29 months in DTX vs 8.61 months in wPTX (HR = 0.62; 95% CI 0.29‐1.32; p = 0.209). Grade 3 or higher adverse events included leukopenia (58.3% in DTX vs 28.6% in PTX; p = 0.101), neutropenia (69.6% in DTX vs 35.7% in PTX; p = 0.086), febrile neutropenia (33.3% in DTX vs 7.1% in PTX; p = 0.115). Conclusion: Our retrospective analysis suggested that wPTX was safer and more effective than DTX as second‐line chemotherapy for esophageal cancer.