Multimodality Therapy in Gastric Cancer

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Abstract

Gastric cancer remains a significant cause of morbidity and mortality worldwide. Surgical resection has been the mainstay of curative therapy for localized and locoregional disease, but high local and distant recurrence rates have led to evaluation of additional therapies. A number of trials have evaluated chemotherapy and/or radiation both in the neoadjuvant and adjuvant settings as additional modalities to improve outcome after surgical resection. Though there is consensus that additional modalities play a role in improving overall survival after curative intent surgery, preference for certain regimens and modalities varies markedly across different regions of the world.

Keywords

Gastric Cancer Febrile Neutropenia Metastatic Gastric Cancer Concurrent Chemoradiation Proximal Gastric Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. 1.
    Jemal A, et al. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.PubMedCrossRefGoogle Scholar
  2. 2.
    National Cancer Institute: PDQ® Gastric Cancer Treatment. Bethesda: National Cancer Institute. Date last modified 15 Feb 2013. Available at. http://cancer.gov/cancertopics/pdq/treatment/gastric/HealthProfessional. Accessed 20 Nov 2013.
  3. 3.
    Cunningham D, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11–20.PubMedCrossRefGoogle Scholar
  4. 4.
    du Bois A, et al. Addition of epirubicin as a third drug to carboplatin-paclitaxel in first-line treatment of advanced ovarian cancer: a prospectively randomized gynecologic cancer intergroup trial by the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group and the Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens. J Clin Oncol. 2006;24(7):1127–35.PubMedCrossRefGoogle Scholar
  5. 5.
    Ychou M, 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.PubMedCrossRefGoogle Scholar
  6. 6.
    Adjuvant treatments following curative resection for gastric cancer. The Italian Gastrointestinal Tumor Study Group. Br J Surg. 1988;75(11):1100–4.Google Scholar
  7. 7.
    Schuhmacher C, et al. Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. J Clin Oncol. 2010;28(35):5210–8.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Engstrom PF, et al. Postoperative adjuvant 5-fluorouracil plus methyl-CCNU therapy for gastric cancer patients. Eastern Cooperative Oncology Group study (EST 3275). Cancer. 1985;55(9):1868–73.PubMedCrossRefGoogle Scholar
  9. 9.
    Hallissey MT, et al. The second British Stomach Cancer Group trial of adjuvant radiotherapy or chemotherapy in resectable gastric cancer: five-year follow-up. Lancet. 1994;343(8909):1309–12.PubMedCrossRefGoogle Scholar
  10. 10.
    Coombes RC, et al. A randomized trial comparing adjuvant fluorouracil, doxorubicin, and mitomycin with no treatment in operable gastric cancer. International Collaborative Cancer Group. J Clin Oncol. 1990;8(8):1362–9.PubMedGoogle Scholar
  11. 11.
    Nitti D, et al. Randomized phase III trials of adjuvant FAMTX or FEMTX compared with surgery alone in resected gastric cancer. A combined analysis of the EORTC GI Group and the ICCG. Ann Oncol. 2006;17(2):262–9.PubMedCrossRefGoogle Scholar
  12. 12.
    De Vita F, et al. Adjuvant chemotherapy with epirubicin, leucovorin, 5-fluorouracil and etoposide regimen in resected gastric cancer patients: a randomized phase III trial by the Gruppo Oncologico Italia Meridionale (GOIM 9602 Study). Ann Oncol. 2007;18(8):1354–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Bang YJ, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379(9813):315–21.PubMedCrossRefGoogle Scholar
  14. 14.
    Noh SH, et al. O-0007 adjuvant Capecitabine and Oxaliplatin (XELOX) for gastric cancer after D2 gastrectomy: final results from the classic trial. Ann Oncol. 2013;24(suppl 4):iv14.Google Scholar
  15. 15.
    Diaz-Nieto R, Orti-Rodriguez R, Winslet M. Post-surgical chemotherapy versus surgery alone for resectable gastric cancer. Cochrane Database Syst Rev. 2013;9, CD008415.PubMedGoogle Scholar
  16. 16.
    Boku N, et al. Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study. Lancet Oncol. 2009;10(11):1063–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Bleiberg H, et al. Adjuvant radiotherapy and chemotherapy in resectable gastric cancer. A randomized trial of the gastro-intestinal tract cancer cooperative group of the EORTC. Eur J Surg Oncol. 1989;15(6):535–43.PubMedGoogle Scholar
  18. 18.
    Macdonald JS, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725–30.PubMedCrossRefGoogle Scholar
  19. 19.
    Smalley SR, 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;30(19):2327–33.PubMedCrossRefGoogle Scholar
  20. 20.
    Fuchs CS, et al. Postoperative adjuvant chemoradiation for gastric or gastroesophageal junction (GEJ) adenocarcinoma using epirubicin, cisplatin, and infusional (CI) 5-FU (ECF) before and after CI 5-FU and radiotherapy (CRT) compared with bolus 5-FU/LV before and after CRT: Intergroup trial CALGB 80101. ASCO Meet Abstr. 2011;29(15_suppl):4003.Google Scholar
  21. 21.
    Ajani JA, et al. Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome. J Clin Oncol. 2005;23(6):1237–44.PubMedCrossRefGoogle Scholar
  22. 22.
    Schwartz GK, et al. Randomized Phase II Trial Evaluating Two Paclitaxel and Cisplatin‚ ÄìContaining Chemoradiation Regimens As Adjuvant Therapy in Resected Gastric Cancer (RTOG-0114). J Clin Oncol. 2009;27(12):1956–62.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Lee J, et al. Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clin Oncol. 2012;30(3):268–73.PubMedCrossRefGoogle Scholar
  24. 24.
    Wagner AD, et al. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006;24(18):2903–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Shah MA, Kelsen DP. Gastric cancer: a primer on the epidemiology and biology of the disease and an overview of the medical management of advanced disease. J Natl Compr Canc Netw. 2010;8(4):437–47.PubMedGoogle Scholar
  26. 26.
    Vanhoefer U, et al. Final results of a randomized phase III trial of sequential high-dose methotrexate, fluorouracil, and doxorubicin versus etoposide, leucovorin, and fluorouracil versus infusional fluorouracil and cisplatin in advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group. J Clin Oncol. 2000;18(14):2648–57.PubMedGoogle Scholar
  27. 27.
    Dank M, et al. Randomized phase III study comparing irinotecan combined with 5-fluorouracil and folinic acid to cisplatin combined with 5-fluorouracil in chemotherapy naive patients with advanced adenocarcinoma of the stomach or esophagogastric junction. Ann Oncol. 2008;19(8):1450–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Van Cutsem E, 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(31):4991–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Ajani JA, et al. Quality of life with docetaxel plus cisplatin and fluorouracil compared with cisplatin and fluorouracil from a phase III trial for advanced gastric or gastroesophageal adenocarcinoma: the V-325 Study Group. J Clin Oncol. 2007;25(22):3210–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Shah MA, et al. Random assignment multicenter phase II study of modified docetaxel, cisplatin, fluorouracil (mDCF) versus DCF with growth factor support (GCSF) in metastatic gastroesophageal adenocarcinoma (GE). ASCO Meet Abstr. 2010;28(15_suppl):4014.Google Scholar
  31. 31.
    Mathe G, et al. Oxalato-platinum or 1-OHP, a third-generation platinum complex: an experimental and clinical appraisal and preliminary comparison with cis-platinum and carboplatinum. Biomed Pharmacother. 1989;43(4):237–50.PubMedCrossRefGoogle Scholar
  32. 32.
    Rixe O, et al. Oxaliplatin, tetraplatin, cisplatin, and carboplatin: spectrum of activity in drug-resistant cell lines and in the cell lines of the National Cancer Institute’s Anticancer Drug Screen panel. Biochem Pharmacol. 1996;52(12):1855–65.PubMedCrossRefGoogle Scholar
  33. 33.
    Cunningham D, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358(1):36–46.PubMedCrossRefGoogle Scholar
  34. 34.
    Shah MA, Schwartz GK. Treatment of metastatic esophagus and gastric cancer. Semin Oncol. 2004;31(4):574–87.PubMedCrossRefGoogle Scholar
  35. 35.
    Shah MA, et al. Multicenter phase II study of irinotecan, cisplatin, and bevacizumab in patients with metastatic gastric or gastroesophageal junction adenocarcinoma. J Clin Oncol. 2006;24(33):5201–6.PubMedCrossRefGoogle Scholar
  36. 36.
    Shah MA, et al. Phase II study of modified docetaxel, cisplatin, and fluorouracil with bevacizumab in patients with metastatic gastroesophageal adenocarcinoma. J Clin Oncol. 2011;29(7):868–74.PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Bang YJ, 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, randomised controlled trial. Lancet. 2010;376(9742):687–97.PubMedCrossRefGoogle Scholar
  38. 38.
    Kang JH, et al. Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol. 2012;30(13):1513–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Spratlin JL, et al. Phase I pharmacologic and biologic study of ramucirumab (IMC-1121B), a fully human immunoglobulin G1 monoclonal antibody targeting the vascular endothelial growth factor receptor-2. J Clin Oncol. 2010;28(5):780–7.PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Fuchs CS, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2014 Jan 4;383(9911):31–9.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of MedicineRoswell Park Cancer InstituteBuffaloUSA
  2. 2.Department of PharmacyRoswell Park Cancer InstituteBuffaloUSA

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