Advancements and challenges in treating advanced gastric cancer in the West

Table 2 Chemotherapy trials

Trial name	Country	Status	Years	Groups	Chemotherapy regimens	Outcome
MAGIC	UK	Complete	1994-2002	Surgery alone	-	Smaller tumors in chemo group (3 cm vs 5 cm)
				Surgery with perioperative chemo	Epirubicin, cisplatin, 5-FU (ECF)	Better PFS and OS in chemo group (5-yr OS 36% vs 23%)
ACCORD 07	France	Complete	1995-2003	Surgery alone	-	Improved curative resection rates with chemo (84% vs 73%)
				Surgery with perioperative chemo	Cisplatin and 5-FU	Better DFS and OS in chemo group (5-yr OS 38% vs 24%)
AIO-FLOT4 (Phase II)	Germany	Complete	2010-2012	Neoadjuvant ECF/ECX	Epirubicin and cisplatin with either 5-FU (ECF) or capecitabine (ECX)	Improved pathological complete regression in FLOT vs ECF/ECX
				Neoadjuvant FLOT	Docetaxel, oxaliplatin, 5-FU with leucovorin
AIO-FLOT4 (Phase III)	Germany	Complete	2010-2015	Neoadjuvant ECF/ECX	Epirubicin and cisplatin with either 5-FU (ECF) or capecitabine (ECX)	Improved OS in FLOT group with no increase in toxicities
				Neoadjuvant FLOT	Docetaxel, oxaliplatin, 5-FU with leucovorin

MAGIC: Medical Research Council Adjuvant Gastric Infusional Chemotherapy; UK: United Kingdom; 5-FU: 5-fluorouracil; PFS: Progression-free survival; OS: Overall survival; DFS: Disease-free survival; ECF: Epirubicin, cisplatin, and 5-fluorouracil; ECX: Epirubicin, cisplatin, and capecitabine; FLOT: 5-fluorouracil, leuocovorin, oxaliplatin, and docetaxel.