Efficacy and Safety of mDCF as First-Line Therapy for HER2-Negative Advanced Gastric Cancer in Vietnam: A Real-World Retrospective Study

Introduction For patients with advanced gastric cancer (AGC) who are HER2-negative and ineligible for targeted therapies, chemotherapy remains the cornerstone of treatment. The modified docetaxel, cisplatin, and fluorouracil (mDCF) regimen has been proposed as an effective and tolerable triplet regimen in this setting. This study aimed to evaluate the efficacy and safety of first-line mDCF in Vietnamese patients with HER2-negative AGC. Methods We conducted a retrospective study of 64 patients with histologically confirmed HER2-negative advanced or recurrent gastric adenocarcinoma treated with mDCF at K Hospital, Vietnam, between January 2017 and January 2022. The regimen was administered every 14 days, consisting of docetaxel 40 mg/m 2 , cisplatin 40 mg/m 2 , leucovorin 400 mg/m 2 , 5-FU 400 mg/m 2 IV bolus, and 5-FU 2000 mg/m 2 as a 48-hour continuous infusion. The primary endpoints were disease control rate (DCR) and progression-free survival (PFS). Safety was assessed as a secondary endpoint. Results The overall DCR was 87.5%, including complete response in 9.4%, partial response in 59.4%, and stable disease in 18.7%. Median PFS was 8.7 months. Grade 3-4 hematologic toxicities occurred in 21.9% of patients, including neutropenia (15.6%) and thrombocytopenia (3.1%). No grade 3-4 non-hematologic toxicities were observed. Primary prophylactic G-CSF use was associated with a significantly lower incidence of grade 3-4 neutropenia ( P < .05). In multivariate analysis, poor ECOG performance status (≥2) and poor histological differentiation were independently associated with shorter PFS ( P < .05). Conclusions mDCF is an effective and tolerable first-line chemotherapy regimen for HER2-negative AGC patients in Vietnam. These findings support mDCF as a practical first-line option for HER2-negative AGC in real-world settings with limited access to targeted therapies.