Treatment of patients with advanced gastric carcinoma with a 5-fluorouracil-based or a cisplatin-based regimen

Abstract

The efficacy of 5-FU, modulated with 6S-LV, is moderate in patients with advanced gastric carcinoma, similar to cisplatin-containing regimens. PS and other prognostic factors could influence the response rate, which does not appear to be a reliable parameter for evaluating the outcome of chemotherapy trials.

Phase 2 Study of Capecitabine and Irinotecan Combination Chemotherapy (Modified XELIRI Regimen) in Patients With Advanced Gastric Cancer

“…24,36 The decreased rate of HFS observed in our study might be due to the lower dose of capecitabine (850 mg/m 2 twice daily on days). [2][3][4][5][6][7][8][9][10][11][12][13][14][15] In summary, this study shows that mXELIRI is a safe and effective therapy for patients with AGC, with a manageable tolerability profile. XELIRI offers a simplified regimen that is less inconvenient for patients and avoids the discomfort and complications of the central venous access required with continuous infusion of 5-FU.…”

“…Current response rates to chemotherapy among advanced gastric cancer (AGC) patients are about 10% to 20% for a single agent and 30% to 50% for combination regimens. [3][4][5][6][7] New chemotherapeutic agents, including taxane, irinotecan, oxaliplatin, and S-1, have been introduced for the treatment of gastric cancer, and these drugs have shown promising response rates without sacrificing acceptable toxicity. [8][9][10] However, no regimen has been regarded as definitely superior to any other at present.…”

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

“…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). Since then the combination of CDDP and infusional 5-FU, with or without EPI, has become the most widely used regimen in front-line chemotherapy for advanced gastric cancer, even though some authors have reported no signifi cant differences between CDDP and non-CDDP-containing regimens [17,18]. However, front-line chemotherapy for advanced gastric cancer has remained unsatisfactory, because overall survival does not generally exceed 10 months.…”

Treatment of advanced oesophagogastric cancer with FOLFOX-4 regimen followed by leucovorin/bolus and continuous infusion 5-FU as maintenance chemotherapy in patients aged ≥75years with impaired performance status

“…Fluoropyrimidines may be considered a reference treatment for elderly patients with advanced gastric cancer, and most studies investigating these agents as monochemotherapy suggest that approximately 20% of patients are progression-free 6 months after treatment onset. [25][26][27][28] The hypothesis for the current study was that, using FOLFOX-4 as induction chemotherapy and LV/bolus and continuous infusion 5-FU as maintenance chemotherapy, at least 40% of patients would be progression-free 6 months after the start of chemotherapy. It was calculated that 33 patients should be recruited with a 0.05 level of significance and 80% power for correct selection of treatment (absolute difference in 6-month DCR of 20%), based on Simon's mimax design.…”