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Articles on Chemotherapy & Chemoradiotherapy in Gastric Cancer
This section of the Advances in Gastrointestinal Cancer Resource Centre focuses on the latest clinically relevant findings in chemotherapy and chemoradiotherapy for gastrointestinal cancers. The peer-reviewed articles available here have been independently selected, and several commented upon, by members of the Editorial Board. Many of the articles are freely available for downloading.
Focusing initially on gastric cancer, these pages will provide new content each month to help you stay abreast of recent scientific developments in this area.
The use of chemotherapy or chemoradiotherapy (or both) is currently recommended for the treatment of gastric cancer in guidelines from both the USA (NCCN) and Europe (ESMO-ESSO-ESTRO).1 Depending on tumour stage and resectability, patients may be given chemotherapy or chemoradiotherapy preoperatively, postoperatively, or as an adjuvant therapy. Recommended second-line chemotherapy options include irinotecan and docetaxel or paclitaxel. Palliative therapy for inoperable or metastatic gastric cancer may include fluoropyrimidine- or taxane-based chemoradiotherapy or chemotherapy.
Other chemotherapeutic options depend on the patient's HER-2 status. Combination regimens based on a platinum–fluoropyrimidine doublet are generally used for HER-2 negative disease, possibly also with an anthracycline (e.g. epirubicin). Trastuzumab plus cisplatin and either 5-fluorouracil or capecitabine are recommended for HER-2 positive disease.
Treatment options are continually expanding, through use of new combinations of existing or novel therapies, new drugs or treatment approaches, and different ways of administering therapy.
To stay abreast of the most recent developments and clinical trial findings in the use of chemotherapy and chemoradiotherapy for the treatment of gastrointestinal cancers, please subscribe to our eAlert to ensure you are informed of all new content as it is published on this platform.
ESMO-ESSO-ESTRO: European Society for Medical Oncology, European Society of Surgical Oncology, and European Society for Therapeutic Radiology and Oncology; HER-2, human epidermal growth factor receptor 2; NCCN: (US) National Comprehensive Cancer Network.
1. Cabebe EC. Gastric cancer treatment & management. Approach considerations. In Medscape: Drugs & Diseases. Available from: http://emedicine.medscape.com/article/278744-treatment. Last updated 11 Nov 2015; accessed 7 Apr 2016.
S-1 plus leucovorin versus S-1 plus leucovorin and oxaliplatin versus S-1 plus cisplatin in patients with advanced gastric cancer: a randomised, multicentre, open-label, phase 2 trial
Hironaka S, Sugimoto N, Yamaguchi K, Moriwaki T, Komatsu Y, Nishina T, et al.Lancet Oncol. 2016 Jan;17(1):99-108.
A Randomised Clinical Trial of Neoadjuvant Chemotherapy vs. Neoadjuvant Chemoradiotherapy for Cancer of the Oesophagus or Gastro-Oesophageal Junction
Klevebro F, Alexandersson von Döbeln G, Wang N, Johnsen G, Jacobsen AB, Friesland S, et alAnn Oncol 2016 Jan 17 [Epub ahead of print]
Impact of age on the feasibility and efficacy of neoadjuvant chemotherapy in patients with locally advanced oesophagogastric cancer
Lorenzen Sylvie, Spoerl Silvia, Al-Batran Salah-Eddin, Feith Markus, Lordick Florian, Thuss-Patience Peter, Haller Bernhard, Angele Martin, Novotny Alexander
European Journal of Cancer, Volume 51, Issue 14, September 2015, Pages 1918 - 1926
Comparison of two different S-1 plus cisplatin dosing schedules as first-line chemotherapy for metastatic and/or recurrent gastric cancer: a multicenter, randomized phase III trial (SOS)
Ryu MH, Baba E, Lee KH, Park YI, Boku N, Hyodo I,et al.Ann Oncol. 2015 Oct;26(10):2097-101
NeoFLOT: Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma-Very good response predominantly in patients with intestinal type tumors
Schulz C, Kullmann F, Kunzmann V, Fuchs M, Geissler M, Vehling-Kaiser U, et al.Int J Cancer. 2015 Aug 1;137(3):678-85.
Randomized Multicenter Phase II Study of Modified Docetaxel, Cisplatin, and Fluorouracil (DCF) Versus DCF Plus Growth Factor Support in Patients With Metastatic Gastric Adenocarcinoma: A Study of the US Gastric Cancer Consortium
Shah MA, Janjigian YY, Stoller R, Shibata S, Kemeny M, Krishnamurthi S, et al.J Clin Oncol. 2015 Oct 5. [Epub ahead of print]
Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial
Shapiro J, van Lanschot JJ, Hulshof MC, van Hagen P, van Berge Henegouwen MI, Wijnhoven BP, et al.Lancet Oncol. 2015 Sep;16(9):1090-8.
Biweekly irinotecan plus cisplatin versus irinotecan alone as second-line treatment for advanced gastric cancer: A randomised phase III trial (TCOG GI-0801/BIRIP trial)
Katsuhiko Higuchi, Satoshi Tanabe, Ken Shimada, Hisashi Hosaka, Eisaku Sasaki, Norisuke Nakayama, Yuiti Takeda, Toshikazu Moriwaki, Kenji Amagai, Takashi Sekikawa, Toshikazu Sakuyama, Tatsuo Kanda, Tohru Sasaki, Mizutomo Azuma, Fumiaki Takahashi, Masahiro Takeuchi, Wasaburo Koizumi, The Tokyo Cooperative Oncology Group, Tokyo, Japan.
European Journal of Cancer, Volume 50, Issue 8, May 2014, Pages 1437 - 1445
Role of chemotherapy for advanced/recurrent gastric cancer: An individual-patient-data meta-analysis
European Journal of Cancer, Volume 49, Issue 7, May 2013, Pages 1565 - 1577
The feasibility of triple-drug chemotherapy combination in older adult patients with oesophagogastric cancer: A randomised trial of the Arbeitsgemeinschaft Internistische Onkologie (FLOT65+)
Salah-Eddin Al-Batran, Claudia Pauligk, Nils Homann, Jörg T. Hartmann, Markus Moehler, Stephan Probst, Volker Rethwisch, Jan Stoehlmacher-Williams, Nicole Prasnikar, Stephan Hollerbach, Carsten Bokemeyer, Rolf Mahlberg, Ralf D. Hofheinz, Kim Luley, Frank Kullmann, Elke Jäger
European Journal of Cancer, Volume 49, Issue 4, March 2013, Pages 835 - 842