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World J Gastroenterol. May 14, 2014; 20(18): 5396-5402
Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5396
Non-platinum-based chemotherapy for treatment of advanced gastric cancer: 5-fluorouracil, taxanes, and irinotecan
Byung Woog Kang, Jong Gwang Kim, Oh-Kyoung Kwon, Ho Young Chung, Wansik Yu
Byung Woog Kang, Jong Gwang Kim, Department of Hematology/Oncology, Kyungpook National University Medical Center, Daegu 702-210, South Korea
Oh-Kyoung Kwon, Ho Young Chung, Wansik Yu, Department of Surgery, Kyungpook National University Medical Center, Daegu 702-210, South Korea
Author contributions: Kang BW and Kim JG performed the majority of the study and wrote the manuscript; Kwon OK, Chung HY and Yu W conceived the study and finalized the revision; all authors read and approved the final manuscript.
Supported by Kyungpook National University Research Fund, 2012
Correspondence to: Jong Gwang Kim, MD, PhD, Department of Hematology/Oncology, Kyungpook National University Medical Center, 807 Hogukno, Buk-gu, Daegu 700-712, South Korea. jkk21c@knu.ac.kr
Telephone: +82-53-2003521 Fax: +82-53-2002029
Received: August 6, 2013
Revised: September 4, 2013
Accepted: January 6, 2014
Published online: May 14, 2014
Abstract

Despite numerous advances in treatment options, advanced gastric cancer (AGC) remains a major public health issue and the leading cause of cancer-related deaths. Cisplatin is one of the most effective broad-spectrum anticancer drugs for AGC and a doublet combination regimen of either cisplatin-based or 5-fluorouracil (5FU)-based chemotherapy is generally used for treatment of patients with AGC. However, there is still no consensus on the best regimen for treating AGC. Recently, various new chemotherapeutic agents, including oral 5FU, taxanes, and irinotecan, have been identified as improving the outcomes for AGC when used as a single agent or in combination with non-platinum chemotherapy. Nonetheless, it is still unclear whether non-platinum-based chemotherapy is a viable treatment option for patients with AGC. Accordingly, this review focuses on the efficacy and tolerability of non-platinum-based chemotherapy for patients with AGC.

Keywords: Gastric cancer, Cisplatin, 5-fluorouracil, Taxane, Irinotecan

Core tip: Although platinum-based chemotherapy is adopted widely nowadays in spite of numerous side effects, there is still no standard treatment for palliative chemotherapy of advanced gastric cancer. The current review assessed the efficacy and tolerability of non-platinum-based chemotherapy as first-line palliative treatment in patients with inoperable advanced gastric cancer. The results showed that non-platinum-based chemotherapy including 5-fluorouracil, taxanes, and irinotecan, would seem to be as effective and tolerable as traditional platinum-based chemotherapy.