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The Role of Chemotherapy

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Abstract

Gastric cancer is a heterogeneous disease, and, despite the most modern molecular classification, that proposed by Lauren remains applicable in clinical practice. The objective of this chapter is to explore the aspects related to curative and palliative systemic treatment, focusing on the aspects related to the diffuse subtype.

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References

  1. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–30.

    Article  CAS  PubMed  Google Scholar 

  2. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for Resectable gastroesophageal Cancer. N Engl J Med. 2006;355:11–20.

    Article  CAS  PubMed  Google Scholar 

  3. Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, et al. Adjuvant chemotherapy for gastric Cancer with S-1, an oral Fluoropyrimidine. N Engl J Med. 2007;357:1810–20.

    Article  CAS  PubMed  Google Scholar 

  4. Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379:315–21.

    Article  CAS  PubMed  Google Scholar 

  5. Park SH, Sohn TS, Lee J, Lim DH, Hong ME, Kim KM, et al. Phase III trial to compare adjuvant chemotherapy with Capecitabine and cisplatin versus concurrent Chemoradiotherapy in gastric Cancer: final report of the adjuvant Chemoradiotherapy in stomach tumors trial, including survival and subset analyses. J Clin Oncol. 2015;33(28):3130–6.

    Article  CAS  PubMed  Google Scholar 

  6. GASTRIC Group, Paoletti X, Oba K, Burzykowski T, Michiels S, Ohashi Y, et al. Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA. 2010;303(17):1729–37.

    Article  Google Scholar 

  7. Smalley SR, Benedetti JK, Haller DG, Hundahl SA, Estes NC, Ajani JA, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant Radiochemotherapy versus observation after curative gastric Cancer resection. J Clin Oncol. 2012;19:2327–33.

    Article  CAS  Google Scholar 

  8. Ychou M, Boige V, Pignon JP, Conroy T, Bouché O, Lebreton G, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011;29(13):1715–21.

    Article  CAS  PubMed  Google Scholar 

  9. Messager M, Lefevre JH, Pichot-Delahaye V, Souadka A, Piessen G, Mariette C, et al. The impact of perioperative chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: a multicenter comparative study. Ann Surg. 2011;254(5):684–93.

    Article  PubMed  Google Scholar 

  10. Pyrhönen S, Kuitunen T, Nyandoto P, Kouri M. Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer. 1995;71(3):587–91.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Glimelius B, Ekström K, Hoffman K, Graf W, Sjödén PO, et al. Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol. 1997;8(2):163–8.

    Article  CAS  PubMed  Google Scholar 

  12. Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric Cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006;24:2903–9.

    Article  CAS  PubMed  Google Scholar 

  13. Pernot S, Dubreuil O, Tougeron D, Soudan D, Bachet JB, Lepère C, et al. Docetaxel, 5FU, oxaliplatin (TEFOX) in 1st line treatment of signet ring cell and/or poorly differentiated gastric adenocarcinoma: a retrospective study of AGEO. J Clin Oncol. 2015;33(15_suppl):e15048.

    Google Scholar 

  14. Sedef AM, Köse F, Sümbül AT, Doğan Ö, Beşen AA, Tatlı AM, et al. Patients with distal intestinal gastric cancer have superior outcome with addition of taxanes to combination chemotherapy, while proximal intestinal and diffuse gastric cancers do not: does biology and location predict chemotherapy benefit? Med Oncol. 2015;32:18.

    Article  CAS  Google Scholar 

  15. Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomized controlled trial. Lancet. 2010;376:687–97.

    Article  CAS  PubMed  Google Scholar 

  16. Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric Cancer: a report of the V325 study group. J Clin Oncol. 2006;24:4991–7.

    Article  CAS  PubMed  Google Scholar 

  17. Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and Oxaliplatin for advanced Esophagogastric Cancer. N Engl J Med. 2008;358:36–46.

    Article  CAS  PubMed  Google Scholar 

  18. Guimbaud R, Louvet C, Ries P, Ychou M, Maillard E, André T, et al. Prospective, randomized, multicenter, phase III study of Fluorouracil, Leucovorin, and irinotecan versus Epirubicin, cisplatin, and Capecitabine in advanced gastric adenocarcinoma: a French intergroup (Fédération francophone de Cancérologie digestive, Fédération Nationale des Centres de Lutte Contre le Cancer, and Groupe Coopérateur Multidisciplinaire en Oncologie) study. J Clin Oncol. 2014;32:3520–6.

    Article  CAS  PubMed  Google Scholar 

  19. Al-Batran SE, Hartmann JT, Probst S, Schmalenberg H, Hollerbach S, Hofheinz R, et al. Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, Leucovorin plus either Oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkologie. J Clin Oncol. 2016;26:1435–42.

    Article  CAS  Google Scholar 

  20. Higuchi K, Tanabe S, Shimada K, Hosaka H, Sasaki E, Nakayama N, et al. 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). Eur J Cancer. 2014;50(8):1437–45.

    Article  CAS  PubMed  Google Scholar 

  21. Sym SJ, Hong J, Park J, Cho EK, Lee JH, Park YH, et al. A randomized phase II study of biweekly irinotecan monotherapy or a combination of irinotecan plus 5-fluorouracil/leucovorin (mFOLFIRI) in patients with metastatic gastric adenocarcinoma refractory to or progressive after first-line chemotherapy. Cancer Chemother Pharmacol. 2013;71(2):481–8.

    Article  CAS  PubMed  Google Scholar 

  22. Hironaka S, Ueda S, Yasui H, Nishina T, Tsuda M, Tsumura T, et al. Randomized, open-label, phase III study comparing irinotecan with paclitaxel in patients with advanced gastric Cancer without severe peritoneal metastasis after failure of prior combination chemotherapy using Fluoropyrimidine plus platinum: WJOG 4007 trial. J Clin Oncol. 2013;31:4438–44.

    Article  CAS  PubMed  Google Scholar 

  23. Kang JH, Lee SI, Lim DH, Park KW, Oh SY, Kwon HC, et al. Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best Sspportive care alone. J Clin Oncol. 2012;30:1513–8.

    Article  CAS  PubMed  Google Scholar 

  24. Fuchs CS, Tomasek J, Yong CJ, Dumitru F, Passalacqua R, Goswami C, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): a double-blind, randomized phase 3 trial. Lancet. 2014;383:31–9.

    Article  CAS  PubMed  Google Scholar 

  25. Wilke H, Muro K, Van Cutsem E, Oh SC, Bodoky G, Shimada Y, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial. Lancet Oncol. 2014;15(11):1224–35.

    Article  CAS  PubMed  Google Scholar 

  26. Wu CW, Hsieh MC, Lo SS, Tsay SH, Li AF, Lui WY, et al. Prognostic indicators for survival after curative resection for patients with carcinoma of the stomach. Dig Dis Sci. 1997;42:1265–9.

    Article  CAS  PubMed  Google Scholar 

  27. Liu L, Wang ZW, Ji J, Zhang JN, Yan M, Zhang J, et al. A cohort study and meta-analysis between histopathological classification and prognosis of gastric carcinoma. Anti Cancer Agents Med Chem. 2013;13(2):227–34.

    Article  Google Scholar 

  28. Bittoni A, Scartozzi M, Giampieri R, Faloppi L, Bianconi M, Mandolesi A, et al. Clinical evidence for three distinct gastric cancer subtypes:time for a new approach. PLoS One. 2013;8:e78544.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Tan IB, Ivanova T, Lim KH, Ong CW, Deng N, Lee J, et al. Intrinsic subtypes of Gastric Cancer, based on gene expression pattern, predict survival and respond differently to chemotherapy. Gastroenterology. 2011;141(2):476–85.

    Article  PubMed  Google Scholar 

  30. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513(7517):202–9.

    Article  CAS  Google Scholar 

  31. Choi AH, Kim J, Chao J. Perioperative chemotherapy for resectable gastric cancer: MAGIC and beyond. World J Gastroenterol. 2015;21(24):7343–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Muro K, Chung HC, Shankaran V, Geva R, Catenacci D, Gupta S, et al. Pembrolizumab for patients with PD-L1-positive advanced gastric cancer (KEYNOTE-012): a multicentre, open-label, phase 1b trial. The Lancet Oncol. 2016;17(60):717–6.

    Article  CAS  PubMed  Google Scholar 

  33. Le DT, Bendell JC, Calvo E, Kim JW, Ascierto PA, Sharma P, et al. Safety and activity of nivolumab monotherapy in advanced and metastatic (A/M) gastric or gastroesophageal junction cancer (GC/GEC): Results from the CheckMate-032 study. J Clin Oncol. 2016;34(4_suppl):6.

    Article  Google Scholar 

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Pereira, G.L.S., Neto, E.S. (2018). The Role of Chemotherapy. In: de Castria, T., Guindalini, R. (eds) Diffuse Gastric Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-95234-5_8

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  • DOI: https://doi.org/10.1007/978-3-319-95234-5_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95233-8

  • Online ISBN: 978-3-319-95234-5

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