FAMTX versus etoposide, doxorubicin, and cisplatin: a random assignment trial in gastric cancer.

Abstract

FAMTX is at least as active as EAP and is significantly less toxic. Although both regimens remain investigational, the toxicities of FAMTX are more manageable. Further studies involving FAMTX in both the adjuvant and advanced disease setting are underway.

A phase II study of paclitaxel, weekly, 24-hour continuous infusion 5-fluorouracil, folinic acid and cisplatin in patients with advanced gastric cancer

“…In phase II trials, response rates up to 60% have been reported for regimens such as FAMTX, ELF, EAP, Cisplatin/5-FU or ECF (Klein et al, 1986;Preusser et al, 1989;Wilke et al, 1990;Findley and Cunningham, 1993;Wils, 1996). However, in randomised phase III trials, this high level of activity has only been confirmed for the ECF-regimen (Webb et al, 1997;Waters et al, 1999), whereas for the FAMTX, ELF or cisplatin/5-FU-regimen response rates of 20-25% have been reported (Kelsen et al, 1992;Wilke et al, 1995). In addition, particularly the FAMTX and EAP regimens were associated with severe toxicity.…”

Combination chemotherapy of irinotecan plus cisplatin for advanced gastric cancer: efficacy and feasibility in clinical practice

“…These results recapitulated the favorable antitumor effects and survival outcomes reported in the previous phase II study (response rate, 17/29 [59%]; MST, 322 days). 13 Considering that MSTs in other clinical trials of chemotherapy for advanced gastric cancer have ranged from 7 to 10 months, 8,[20][21][22] it appears that this regimen may yield favorable survival rates, even in clinical practice.…”

Docetaxel and oxaliplatin combination in second-line treatment of patients with advanced gastric cancer

“…In phase III studies the median survival does not exceed 10 months, even with combination therapies including new drugs such as docetaxel (DTX) [11][12][13]15,16,25]. These poor results are often obtained at the cost of a high incidence of hematological toxicity and diarrhea [25].…”

“…The combination of 5-fl uorouracil (5-FU), doxorubicin, and mitomycin-C (FAM) was considered the standard regimen until the FAMTX schedule (including 5-FU, doxorubicin, high-dose methotrexate, and leucovorin) was shown to be superior in terms of both response rates (41% vs 9%) and overall survival (42 vs 29 weeks) [8]. On the other hand, cisplatin (CDDP)-based regimens demonstrated response rates of between 37% and 72% in phase II studies [9,10], although these results were not confi rmed in phase III studies [11][12][13]. More recently, the ECF combination regimen of CDDP, epirubicin (EPI), and infusional 5-FU proved very effective in phase II studies [14,15], and it was superior to FAMTX in terms of response rates (46% vs 21%; P = 0.0002) and overall survival (8.7 vs 6.1 months; P = 0.0005) in a randomized phase III comparison, with mild toxicity (16).…”