***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE For patients with advanced gastric or gastroesophageal cancer ( AGGEC ) providing clinical benefit with improved palliation is highly desirable . However , a prospect i ve evaluation of clinical benefit in AGGEC patients has never before been reported in a phase III setting . PATIENTS AND METHODS In a multinational trial ( V325 ) , 445 patients were r and omly assigned and treated with either docetaxel plus cisplatin and fluorouracil ( DCF ) or cisplatin and fluorouracil ( CF ) . Clinical benefit was prospect ively evaluated in this trial as a secondary end point . The primary measure for clinical benefit analysis was time to definitive worsening by one or more categories of Karnofsky performance status ( KPS ) . Secondary clinical benefit end points included time to 5 % definitive weight loss , time to definitive worsening of appetite by one grade , pain-free survival ( defined as time to first appearance of pain ) , and time to first cancer pain-related opioid intake . Clinical benefit assessment s were recorded at each clinic visit . RESULTS Clinical benefit assessment s were performed in more than 75 % of patients throughout V325 . DCF significantly prolonged time to definitive worsening of KPS compared with CF ( median , 6.1 v 4.8 months ; hazard ratio , 1.38 ; 95 % CI , 1.08 to 1.76 ; log-rank P = .009 ) . Although time to definitive weight loss and time to definitive worsening of appetite favored DCF , the results were not statistically significant . Pain-free survival and time to first cancer pain-related opioid intake were comparable . CONCLUSION To our knowledge , V325 is the first phase III trial to report clinical benefit in AGGEC patients . Clinical benefit was assessed beyond protocol -specific chemotherapy . The addition of D to CF not only significantly improved clinical benefit but also improved quality of life , time to progression , and overall survival compared with CF Purpose The aim of this retrospective study ( from January 2007 to December 2011 ) was to investigate the efficacy and tolerability of mDCF schedule for chemotherapy-naïve AGC patients . Patients Patients ( n = 54 ) with locally inoperable or distant metastasis and performance status of 0–2 were eligible . The triplet combination chemotherapy consisting of docetaxel 60 mg/m2 on day 1 , cisplatin 60 mg/m2 on day 1 , and 5-fluorouracil 600 mg/m2 for 5 days of continuous infusion were administered every 21 days , up to nine cycles . Prophylactic G-CSF was not allowed . Results In all , 36 ( 67 % ) patients were male and 18 ( 33 % ) were female ; median age was 59 years . The majority of patients ( n = 46 , 85 % ) had metastatic disease and 8 ( 15 % ) of them had locally advanced disease . Liver metastasis and peritonitis carcinomatosa were found in 20 ( 43 % ) and 18 ( 39 % ) of the 46 cases , respectively . The median cycle of chemotherapy was 6 . In assessing 50 patients for response evaluation , one had complete response . Partial response was achieved in 27 ( 54 % ) patients . Seventeen patients ( 34 % ) had stable disease and 5 ( 10 % ) had progressive disease , while 4 % ( n = 2 ) and 11 % ( n = 6 ) of the patients developed severe ( grade 3–4 ) neutropenia and anemia , respectively . During the median follow-up time ( 6.9 months , range 0.4–24 ) , 28 ( 52 % ) patients died . The overall and progression-free survival were 10.7 [ 95 % CI 8.9–12.4 ] and 6.8 [ 95 % CI 5.8–7.8 ] months , respectively . Conclusions Although this was not a prospect i ve comparative study , the mDCF regimen seems to be as effective as the original DCF in AGC with acceptable and manageable side effects Gastric cancer is the second most common among cancer-related deaths in the world . Systemic chemotherapy for patients with gastric cancer has limited impact on overall survival . We performed a retrospective analysis of the efficacy and side effects of Docetaxel and Cisplatin Plus Fluorouracil ( DCF ) versus Modified-Dose Docetaxel , Cisplatin , and 5-Fluorouracil ( mDCF ) in the metastatic gastric cancer with first-line chemotherapy treated patients . Retrospectively were review ed 107 locally advanced or metastatic gastric cancer patients who were treated DCF or mDCF as first-line treatment from June 2007 to August 2011 in Dicle University Hospital , Department of Medical Oncology . The DCF protocol included 75 mg/m2 docetaxel and cisplatin on day 1 and 750 mg/m2/day 5-FU infusion for 5 days , repeated every 3 weeks . The mDCF protocol included 60 mg/m² docetaxel and cisplatin on day 1 and 600 mg/m² 5-Fluorouracil continuous infusion per day on days 1 - 5 , every 3 weeks . Patients were treated using DCF arm 85 ( M : 56 , F : 29 ) , the mDCF arm 22 ( M : 13 , F : 9 ) After treatment toxicities were : Grade III-IV neutropenia ( 48.2 % vs 13.6 % p=0.003 ) , anemia ( 21.2 % vs 4.5 % p=0.06 ) , nausea ( 44.7 % vs 13.6 % p=0.008 ) and vomiting ( 31.8 % vs 4.5 % , p=0.01 ) was higher in the DCF  arm . Other toxicities profile was similar in both groups ( p>0.05 ) . The rate of response was similar in both arm . Among patients with the DCF and mDCF  arm rate complete response ( 10.3 % vs 6.7 % , p>0.05 ) , partial response ( 35.3 % vs 40.0 % , p>0.05 ) , stable disease ( 32.4 % vs 33.3 % , p>0.05 ) , progressive disease ( 22.1 % vs 20.0 % , p>0.05 ) and overall response ( 45.6 % vs 46.7 % , p>0.05 ) did not have a statistically difference ( p>0.05 ) . Progression-free survival ( PFS ) and overall survival ( OS ) were more favorable in the DCF arm than mDCF arm , but the difference was not significant statistically ( 9.9 vs 8.6 , 7.4 vs 6.5 p>0.05)In conclusion , the response rate , median PFS and median OS are similar in both arms , while the mDCF regimen are more favorable than the DCF for toxicity profile regimen in advanced gastric cancer patients who were undergoing first-line palliative treatment . Therefore , a prospect i ve and larger clinical trials are needed Background This study was conducted to determine the optimal dosage of the docetaxel-capecitabine-cisplatin ( DXP ) regimen and to evaluate its efficacy and safety in patients with advanced gastric cancer . Methods Patients with advanced gastric or esophagogastric junctional adenocarcinoma received capecitabine ( days 1–14 ) and intravenous docetaxel and cisplatin ( day 1 ) every 3 weeks . Results In the phase I study , 15 patients were treated with 4 different dose levels . Asthenia and neutropenic fever were the dose-limiting toxicities . For the phase II study , 1,125 mg/m2 of capecitabine was initially recommended with 60 mg/m2 docetaxel and 60 mg/m2 cisplatin . However , frequent dose modifications at this dose level result ed in a final optimal dose of 937.5 mg/m2 capecitabine . Among the 40 patients enrolled in the phase II study , 4 complete and 23 partial responses were observed , presenting objective response rate of 68 % . Ten patients achieving good response with complete disappearance of distant metastases underwent surgery , and 4 pathologic complete responses were identified . After the median follow-up of 83.7 months ( range , 20.2–86.5 ) in surviving patients , the median overall survival was 14.4 months and median progression-free survival was 7.6 months . The most frequent grade 3/4 adverse events were neutropenia ( 62.5 % ) and asthenia ( 37.5 % ) . Ten per cent of the patients experienced neutropenic fever , with one case of sepsis-induced death . Conclusion DXP displays considerable antitumor activity , and may thus present effective first-line treatment for advanced gastric cancer . Further investigation of the efficacy and safety of this regimen in both first-line and neoadjuvant setting s is warranted BACKGROUND Phase II and III trials of docetaxel , cisplatin and fluorouracil ( DCF ) have shown superior efficacy versus cisplatin and fluorouracil alone but high rates of hematologic toxicity in advanced gastric cancer . To reduce toxicity while maintaining the efficacy of DCF , we investigated split doses of docetaxel ( T ) , cisplatin ( P ) , leucovorin ( L ) and fluorouracil ( F ) . PATIENTS AND METHODS Chemotherapy-naive patients with advanced gastric-/esophageal adenocarcinomas received T 50 mg/m(2 ) and P 50 mg/m(2 ) on days 1 , 15 and 29 and L 500 mg/m(2 ) plus F 2000 mg/m(2 ) weekly , every 8 weeks . Because significant dose reductions to < 80 % became necessary in 80 % of patients , the regimen was amended after the first 15 patients to T 40 mg/m(2 ) , P 40 mg/m(2 ) , L 200 mg/m(2 ) and F 2000 mg/m(2 ) . The primary endpoint was response rate .  RESULTS Sixty patients were enrolled : 24 had locally advanced ( LA ) tumors and 36 had metastatic disease .  Grade 3/4 toxicities included neutropenia ( 22 % ) , febrile neutropenia ( 5 % ) , diarrhea ( 20 % ) and lethargy ( 18 % ) . The overall response rate was 47 % . Twenty-three LA patients underwent secondary surgical resection ( 96 % ) ; complete resection was achieved in 87 % . Overall , median time to progression and overall survival were 9.4 and 17.9 months , respectively ( 8.1 and 15.1 months , respectively , for patients with metastatic disease ) . CONCLUSION T-PLF regimen is highly active and has a favorable toxicity profile Background The V325 study showed that docetaxel , cisplatin , and fluorouracil ( DCF ) prolonged overall survival ( OS ) of patients with advanced gastric cancer , but with a high incidence of dose-limiting toxicities . We investigated the efficacy and safety of a modified DCF ( mDCF ) regimen for Chinese patients with advanced gastric cancer . Methods Untreated advanced gastric cancer patients r and omly received docetaxel and cisplatin at 60 mg/m2 ( day 1 ) followed by fluorouracil at 600 mg/m2/day ( days 1–5 ; mDCF regimen ) or cisplatin at 75 mg/m2 ( day 1 ) followed by fluorouracil at 600 mg/m2/day ( days 1–5 ; CF ) every 3 weeks . The primary end point was progression-free survival ( PFS ) . The secondary end points were OS , overall response rate ( ORR ) , time-to-treatment failure ( TTF ) , and safety . Results In total , 243 patients were r and omized to treatment ( mDCF regimen 121 ; CF 122 ) . Compared with CF , the mDCF regimen significantly improved PFS and OS : the median PFS was 7.2 and 4.9 months , respectively [ hazard ratio ( HR ) 0.58 , log-rank P = 0.0008 ] , and the median OS was 10.2 and 8.5 months , respectively ( HR = 0.71 , P = 0.0319 ) . Additionally , the mDCF regimen improved the parameters used as secondary objectives : the ORR was 48.7 % with the mDCF regimen versus 33.9 % with CF ( P = 0.0244 ) ; the median TTF was 3.4 months with the mDCF regimen and 2.4 months with CF ( HR = 0.67 , P = 0.0027 ) . Grade 3 and grade 4 treatment-related adverse events occurred in 77.3 % of patients who received the mDCF regimen versus 46.1 % of patients who received CF ( P < 0.001 ) . Conclusions The mDCF regimen , compared with CF , significantly prolonged PFS and OS and enhanced ORR of Chinese patients with advanced gastric cancer .  The mDCF regimen achieved efficacy comparable to that of DCF but with fewer toxicities , which is appropriate for the Chinese population Purpose This phase II trial aim ed to evaluate the efficacy and safety of docetaxel , cis 
    Output:
    
mDCF chemotherapy with splitted weekly or biweekly schedules , or reduced 3-weekly doses , is a very effective and well-tolerated regimen in metastatic GC .
By providing a 50 % ORR , such regimens may be particularly indicated for younger and fit patients for cytoreductive purpose s ( conversion therapy ) or in case of symptomatic tumor burden