Controlled evaluation of three drug combination regimens versus fluorouracil alone for the therapy of advanced gastric cancer. North Central Cancer Treatment Group.

Abstract

FAMe, FAP, or FAMe alternating with TZT cannot be recommended for the therapy of advanced gastric carcinoma. Therapy of this disease should remain an experimental endeavor. It would seem reasonable to prove the value of any new treatment approach by a randomized comparison to simple therapy with 5-FU alone.

Combination chemotherapy of irinotecan plus cisplatin for advanced gastric cancer: efficacy and feasibility in clinical practice

“…These results recapitulated the favorable antitumor effects and survival outcomes reported in the previous phase II study (response rate, 17/29 [59%]; MST, 322 days). 13 Considering that MSTs in other clinical trials of chemotherapy for advanced gastric cancer have ranged from 7 to 10 months, 8,[20][21][22] it appears that this regimen may yield favorable survival rates, even in clinical practice.…”

“…[2][3][4][5] However, none of the combination regimens have yet demonstrated a prolongation of survival as compared with 5-fluorouracil alone; [6][7][8] accordingly new active chemotherapy regimens are needed. Irinotecan hydrochloride (CPT-11) is a water-soluble, semisynthetic derivative of camptothecin (CPT) that retains the original antitumor activity of CPT, but has lower toxicity.…”

Optimal chemotherapy for advanced gastric cancer: is there a global consensus?

“…Cisplatin and capecitabine has become the standard backbone chemotherapy in trials investigating monoclonal antibodies in GC [10,35,36]. In the treatment of elderly or frail patients, or in cases where platinum agents are contraindicated, singleagent fluoropyrimidine, although not as effective as doublet regimens, should also be considered an option [37,38]. Doublets or triplets-the rationale for adding a third cytotoxic drug Triplet combination chemotherapy comprising an anthracycline or a taxane in addition to a platinum compound and a fluoropyrimidine has resulted in higher response rates and a modest improvement in overall survival compared with doublet combinations, but it also exposes patients to more serious side effects [12,19].…”

Safety and efficacy of S-1 monotherapy in elderly patients with advanced gastric cancer

“…The prognosis of unresectable or recurrent tumors is very poor: the median survival time is about 4 months with best supportive care [4][5][6]. Although several randomized trials of treatments for advanced gastric cancer were conducted during the 1990s, with anthracyclines, mitomycin C, 5-fl uorouracil (5-FU), methotrexate, and cisplatin [7][8][9][10][11][12][13][14][15], no standard treatment for advanced gastric cancer was established.S-1 is an oral fl uoropyrimidine, consisting of tegafur (a prodrug of fl uorouracil), 5-chloro-2, 4-dihydropyrimidine (CDHP), and potassium oxonate. CDHP is an inhibitor of dihydropyrimidine dehydrogenase (DPD), which is the rate-limiting enzyme for the degradation of fl uorouracil [16].…”