Phase II Study of the Modified Regimen of Etoposide, Leucovorin and 5-Fluorouracil for Patients with Advanced Gastric Cancer

Tzeon Jye Chiou, Shiao Lin Tung, Ruey Kuen Hsieh, Wei Shu Wang, Chueh Chuan Yen, Frank S. Fan, Jin Hwang Liu, Po Min Chen

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background: The efficacy of the treatment of advanced gastric cancer is not very good. The response rate to the original etoposide-leucovorin-5-fluorouracil (ELF) treatment is 53% with tolerable side effects. Whether increasing the dose intensity by prolonging the duration of infusion with 5-fluorouracil (5-FU) and leucovorin (LV) from 3 to 5 days for advanced or metastatic gastric cancer patients would enhance the efficacy but not increase side effects is still unknown. Methods: Thirty-six advanced or metastatic gastric cancer and chemotherapy-naïve patients with measurable or evaluable diseases were scheduled to receive intravenous etoposide 100 mg/m2/day on days 2-4, LV 300 mg/m2/day intravenously and 5-FU 500 mg/m2/day intravenously on days 1-5, every 4 weeks. All patients who received at least two courses of chemotherapy were evaluated for tumor response, survival and response duration and toxicity according to the WHO criteria. Results: Thirteen patients showed a response, including five with complete response (CR). The overall response rate was 36% (95% confidence interval, CI, 20-52%) in the whole group and 46% (95% CI 28-66%) in the 28 patients with measurable disease. The median progression-free interval and overall median survival time were 5 and 7 months, respectively. The most frequent toxicity was alopecia (grade I/II 56.3%). The incidence of grade III or greater myelosuppression was 5.9%. No treatment-related death occurred. Conclusions: The efficacy of the modified ELF by increasing the dosages of 5-FU and LV is not superior to the results of the original regimen, yet it is a relatively safe and tolerable combination regimen for advanced gastric cancer.

Original languageEnglish
Pages (from-to)318-322
Number of pages5
JournalJapanese Journal of Clinical Oncology
Issue number5
Publication statusPublished - 1998
Externally publishedYes


  • Advanced gastric cancer
  • Modified ELF
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


Dive into the research topics of 'Phase II Study of the Modified Regimen of Etoposide, Leucovorin and 5-Fluorouracil for Patients with Advanced Gastric Cancer'. Together they form a unique fingerprint.

Cite this