Chemotherapy for gastric cancer

Table 1 Single agent activity in advanced gastric cancer

Agents	Response rate (%)
Mitomycin C	30
Doxorubicin	17
Epirubicin	19
Cisplatin	19
BCNU	18
5-Fluorouracil	21
Etoposide (oral)	21
Hydroxurea	19
UFT	27
Capecitabina	19
S-1	45
Paclitaxel	17-23
Docetaxel	17-29
CPT-11	18

Table 2 Combination therapy for advanced gastric cancer

	Response rat (%)	Median survival (mo)
FU-based combinations
FAM	30-42	6-9
FAMTX	33-63	6
ELF	53	11
Modified-ELF	16-42	6-9.5
Cisplatin-5-FU CI synergism
PF	40	9-10
ECF	59-71	8.7
P-5-FU 48-h CI	50	9.3
P-5FU 24-h CI	58	11
Cisplatin-based combinations
EAP	33-64	9
FLEP	35	8
FLEP-type	39	11
LV5FU2-P	27	13.3
Combinations including new drugs
P-CPT11	41-58	9-12
LOHP-CPT11	50	8.5
CPT11-bolus 5-FU	22	7.6
CPT11- 5-FU CI	20	7
P-Xeloda	54.8	10.1
ECC	59	9.6
P-S-1	73-74	12
TPFU/LV	50	11-14
DP	37-56	9-11
DPF	51	9.3

CI: Continuous infusion.

Table 3 Meta-analysis of randomized trials of adjuvant cytotoxic chemotherapy in gastric cancer

Author.Year	Number of patients/number of trials included	Mortalityrisk ratio	95% confidence interval	P value
Hermans.1993	2 096/11	0.88	0.78-1.08	NS
Earle. 1999	1 190/13	0.80	0.66-0.97	0.024
Mari. 2000	3 658/20	0.82	0.75-0.89	<0.001
Panzini.2002	2 913/17	0.72	0.62-0.84	NA
Janunger.2002	3 962/21	0.84	0.74-0.96	NA

Table 4 Phase II studies of preoperative chemotherapy in localized gastric cancer

Author.Year	Number of patients	Neoadjuvant chemotherapy regimen	Adjuvant chemotherapy regimen	R0 rate	PCR	Median survival (mo)	2-yr survival rate (%)
Wilke.1989	34	EAP × 2	EAP × 2	29	5	18	26
Leichman.1992	38	CF ×2	Intraperitoneal	76	3	17	NR
Ajani.1993	48	EAP × 3	EAP × 2	77	0	16	42
Kang.1996	53	EFP ×2-3	EFP × 3-6	71	4	43	NR
	54	Surgery	None	61		30	NR
Crookes.1997	59	CF ×2	Intraperitoneal	71	5	48	64
Songun.1999	27	FAMtx × 4	None	56	0	36	62
	29	Surgery	None	62		13.1	NR

EAP: etoposide, doxorubicin and cisplatin; CF: cisplatin and 5-fluoruracil; EFP: etoposide, 5-fluouracil and cisplatin; FAMtx: 5-fluoruracil, doxorubicin and methotrexate; pCR: pathological complete remission; NR: no reported