Treatment of gastric cancer

Table 2 Milestone phase III trials in metastatic gastric cancer

Ref.	Regimen	n	Response rate	Overall survival	DSF/PFS/TTP	G3-G4 toxicity
Cullinan et al[122], 1985	FAM	350	-	-	-	-
	5-FU
Wils et al[100], 1991	FAMTX	213	41%	42 wk		4%
	FAM		9%	29 wk		3%
					Median TTP: 12
Kim et al[123], 1993	FAM	117	51%	No difference	21.8	-
	PF		26%		9.1
	5-FU
					PFS
Webb et al[108], 1997	FAMTX	256	21%	5.7	3.4	-
	ECF		45%	8.9	7.4
Vanhoefer[124], 2000	ELF		9%	7.2		No toxicity G 3- 4
	PF		20%	7.2
	FAMTX		12%	6.7
					TTP:
Van Cutsem et al[106]	CF	224	37%	9.2	3.9	69%
V325 trial, 2006	DCF	221	25%	8.6	5.6	59%
Cunnigham et al[104]	ECX	250	42.4%	11.2	ECF: 40.7 and similar in all groups	Neutropenia most frequent in ECX and ECF regimen 51.5% and 41.7% vs 29.9% and 27.6%
REAL II, 2008	EOX	244	47.9%
	ECF	263	40.7%	9.9
	EOF	245	46.4%
					PFS:
Koizumi et al[101]	S-1	150		11	4.0	Neutropenia:
Spirit trial, 2008	CDDP + S-1	149		13	6.0	59% vs 16%
						Anemia: 38% vs 6%
						Anorexia 45% vs 9%
					TTP
Ajani et al[102]	CDDP+	508	32%	7.9	5.5
FLAGS, 2010	5-FU	521	29%	8.6	4.8
	CDDP + S-1
Bang et al[110]	CDDP + 5-FU/Cap	290		11.1
ToGA, 2010	CDDP + 5-FU/Cap + Trastuzumab					Neutropenia
		294		13.8		88%
						79%

FAM: 5-fluorouracil, adriamycin, mitomycin; 5-FU: 5-fluorouracil; FAMTX: 5-fluorouracil, adriamycin, metrotexate; PF: Cisplatin, 5-fluorouracil; ECF: Epirubicin, cisplatin, 5-fluorouracil; ELF: Etoposide, leucovorin, 5-fluorouracil; CF: Cisplatin, 5-fluorouracil; DCF: Docetaxel, cisplatin, 5-fluorouracil; ECX: Epirubicin, cisplatin, capecitabine; EOX: Epirubicin, oxaliplatin, capecitabine; EOF: Epirubicin, oxaliplatin, 5-fluorouracil.