Treatment was delayed or the dose was reduced during under 34 cycles. Treatment was delayed during 5 cycles (2.0%) and in 5 patients (11.6%), due to neutropaenia (2 cycles), elevated transaminase (2 cycles), and hand�Cfoot syndrome (1 cycle). Paclitaxel dose was reduced during 14 cycles (5.6%) in 4 patients (9.3%), due to myalgia (8 cycles), arthralgia (4 cycles), neutropaenia (1 cycle) and neuropathy (1 cycle). The dose of capecitabine was reduced during 25 cycles (10.1%) in 6 patients (14%), due to hand�Cfoot syndrome (17 cycles), and myalgia (8 cycles). Ten patients (22.2%) withdrew from study treatment because of financial problems or paclitaxel-induced neurotoxicity. These 10 patients received a median 3.5 cycles (range=1�C9 cycles) of capecitabine monotherapy.

Over all treatment cycles, the mean dose intensity of paclitaxel was 57.2mgm?2 per week (range=23.3�C58.3mgm?2 per week) and that of capecitabine was 7277mgm?2 per week (range=3080�C7700mgm?2 per week), corresponding to 98.0 and 94.5%, respectively of the planned dose intensities. The actual dose intensity of both drugs was maintained at over 95% during the first 5 chemotherapy cycles (Figure 3). There was 97.5% compliance with capecitabine treatment during the first 6 cycles. Figure 3 Dose intensity of paclitaxel and capecitabine during cycles 1�C6. DISCUSSION The results presented here suggest that the combination of paclitaxel and capecitabine is effective and well tolerated as a first-line regimen in patients with AGC. This combination regimen demonstrated promising efficacy, with a tumour response rate of 48.

9%, a median TTP of 5.6 months, and a median OS of 11.3 months. These results are comparable to other paclitaxel-based combination regimens in patients with previously untreated AGC. For example, in 29 evaluable patients treated with paclitaxel 175mgm?2 on day 1 followed by 5-fluorouracil 1500mgm?2 on day 2 every 3 weeks, the response rate 65.5% and the median Carfilzomib OS was 12 months (Murad et al, 1999), and the combination of paclitaxel with a 24-h continuous infusion of high-dose 5-FU/folinic acid and cisplatin in 45 evaluable patients resulted in a 51% response rate, a median TTP of 9 months, and a median OS of 14 months (Kollmannsberger et al, 2000). The results of this combination of paclitaxel and capecitabine (TX) seem to be also comparable in efficacy and even better in safety as compared to the current standard platinum-containing first-line regimens. In comparison with capecitabine plus cisplatin (XP) or 5-FU plus cisplatin (FP) combination reported in a recent phase III trial (Kang et al, 2006), this TX regimen was comparable in terms of RR (48.9 vs 46/32%), TTP (5.6 months vs 5.6/5.0 months), and OS (11.3 months vs 10.5/9.