Adjuvant Chemotherapy for Gastric Cancer

Abstract

We here briefly review the most important clinical trials on adjuvant chemotherapy for gastric cancer published since the 60s and present the results of study No. 40813 of the European Organization for Research and Treatment of Cancer (EORTC) on adjuvant FAM₂ chemotherapy. By comparing the efficacy of FAM₂ chemotherapy with that of surgery alone, we found that adjuvant FAM₂ delayed the time of recurrence, but did not influence overall survival. Therefore, even in the light of its hematological and nonhematological toxicity, this regimen cannot be recommended as standard treatment following radical resection of stomach neoplasms. It is, moreover, stressed that disease stage and adequacy of surgery are the most important prognostic factors, and it is suggested that the combination of advanced disease stage and inadequate surgery may influence the final results of a medium size study like this one. Future trends for new therapeutic combinations tested in phase II and III clinical trials are here discussed and the ongoing EORTC clinical trial No. 40905 on adjuvant chemotherapy with FAMTX is presented.