Top

Journal of Cancer Research and Clinical Oncology

Published in:

01-01-2009 | Review

Current strategies in systemic treatment of gastric cancer and cancer of the gastroesophageal junction

Authors: Markus Menges, Thomas Hoehler

Published in: Journal of Cancer Research and Clinical Oncology | Issue 1/2009

Abstract

Gastric cancer is a major health issue and a leading cause of death worldwide. The results of standard therapy remain unsatisfactory mainly because of diagnosis at the late stage of disease. Innovative strategies such as neoadjuvant chemotherapy in locally advanced cancer have improved the outcome even in operable cases. Whether an adjuvant radiochemotherapy is of benefit after curative resection including systematic lymphadenectomy remains yet unclear. Some progress has been made in the palliative setting by introducing new substances. This review examines recent advances in the systemic treatment of gastric and gastroesophageal junction cancer.

Al-Batran S, Hartmann J, Probst S et al (2008) 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 26:1435. doi:10.1200/JCO.2007.13.9378 PubMedCrossRef

Ajani JA, Baker J, Pisters PW et al (2002) CPT-11 plus cisplatin in patients with advanced, untreated gastric or gastroesophageal junction carcinoma: results of a phase II study. Cancer 94(3):641–646. doi:10.1002/cncr.10279 PubMedCrossRef

Ajani JA, Lee FC, Singh DA et al (2006) Multicenter phase II trial of S-1 plus cisplatin in patients with untreated advanced gastric or gastroesophageal junction adenocarcinoma. J Clin Oncol 24:663–667. doi:10.1200/JCO.2005.04.2994 PubMedCrossRef

Boigé V, Pignon J, Saint-Aubert B, et al 2007 Final results of a randomized trial comparing preoperative 5-fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE). J Clin Oncol, 25; 18s #4510

Boku N, Yamamoto S, Shirao K et al (2007) Randomized phase III study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG9912). J Clin Oncol 25:965S. doi:10.1200/JCO.2006.10.0131 CrossRef

Bonenkamp JJ, Songun I, Hermans J et al (1995) Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 345:745–748. doi:10.1016/S0140-6736(95)90637-1 PubMedCrossRef

Bouche O, Raoul JL, Giovanini M et al (2003) Randomized phase II trial of LV5FU2, LV5FU2-cisplatinum or LV5FU2-irinotecan in patients (pts) with metastatic gastric or cardial adenocarcinoma (MGA): final results of study FFCD 9803. Proc Am Soc Clin Oncol 22:A1033

Bouché O, Ychou M, Burtin P, Bedenne L, Ducreux M, Lebreton G et al (2005) Adjuvant chemotherapy with 5-fluorouracil and cisplatin compared with surgery alone for gastric cancer: 7-year results of the FFCD randomized phase III trial (8801). Ann Oncol 16(9):1488–1497. doi:10.1093/annonc/mdi270 PubMedCrossRef

Cascinu S, Labianca R, Graziano F et al (1998) Intensive weekly chemotherapy for locally advanced gastric cancer using 5-fluorouracil, cisplatin, epidoxorubicin, 6S-leucovorin, glutathione and filgrastim: a report from the Italian Group for the Study of Digestive Tract Cancer (GISCAD). Br J Cancer 78:390–393PubMed

Cascinu S, Scartozzi M, Labianca R et al (2004) High curative resection rate with weekly cisplatin, 5-fluorouracil, epidoxorubicin, 6S-leucovorin, glutathione, and filgastrim in patients with locally advanced, unresectable gastric cancer: a report from the Italian Group for the Study of Digestive Tract Cancer (GISCAD). Br J Cancer 90(8):1521–1525. doi:10.1038/sj.bjc.6601752 PubMedCrossRef

Cascinu S, Labianca R, Barone C et al (2007) Adjuvant treatment of high-risk, radically resected gastric cancer patients with 5-fluorouracil, leucovorin, cisplatin, and epidoxorubicin in a randomized controlled trial. J Natl Cancer Inst 99(8):601–607. doi:10.1093/jnci/djk131 PubMedCrossRef

Crew KD, Neugut AI (2006) Epidemiology of gastric cancer. World J Gastroenterol 12(3):354–362PubMed

Cunningham D, Allum WH, Stenning SP et al (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20. doi:10.1056/NEJMoa055531 PubMedCrossRef

Cunningham D, Rao S, Starling N et al (2008) Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 358:36–46. doi:10.1056/NEJMoa073149 PubMedCrossRef

Cuschieri A, Weeden S, Fielding J (1999) Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Co-operative Group. Br J Cancer 79:1522–1530. doi:10.1038/sj.bjc.6690243 PubMedCrossRef

Dank M, Zaluski J, Barone C et al (2005) Randomized phase III trial of irinotecan (CPT-11) + 5-FU/folinic acid (FA) vs CDDP + 5-FU in first line advanced gastric cancer patients. J Clin Oncol 23:308S–1 Abstract

Doi T, Koizumi S, Sinea S et al (2003) Efficacy, tolerability, and pharmacokinetics of gefitinib in pretreated patients with metastatic gastric cancer. Proc Am Soc Clin Oncol 22:258A abstract

Dragovich T, McCoy S, Fenoglio-Preiser CM et al (2006) Phase II trial of erlotinib in gastro- esophageal junction and gastric adenocarcinomas: SWOG 0127. J Clin Oncol 24:4922–4927. doi:10.1200/JCO.2006.07.1316 PubMedCrossRef

Earle CC, Maroun JA (1999) Adjuvant chemotherapy after curative resection for gastric cancer in non-Asian patients: revisiting a meta-analysis of randomised trials. Eur J Cancer 35:1059–1064. doi:10.1016/S0959-8049(99)00076-3 PubMedCrossRef

Feussner H, Omote K, Fink U et al (1999) Pretherapeutic laparoscopic staging in advanced gastric carcinoma. Endoscopy 31:342–347. doi:10.1055/s-1999-28 PubMedCrossRef

Fondevila C, Metges JP, Fuster J et al (2004) p53 and VEGF expression are independent predictors of tumour recurrence and survival following curative resection of gastric cancer. Br J Cancer 90:206–215. doi:10.1038/sj.bjc.6601455 PubMedCrossRef

Gallardo-Rincon D, Onate-Ocana LF, Calderillo-Ruiz G (2000) Neoadjuvant chemotherapy with P-ELF (cisplatin, etoposide, leucovorin, 5-fluorouracil) followed by radical resection in patients with initially unresectable gastric adenocarcinoma: a phase II study. Ann Surg Oncol 7:45–50. doi:10.1007/s10434-000-0045-6 PubMedCrossRef

Glimelius B, Ekstrom K, Hoffman K et al (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8(2):163–168. doi:10.1023/A:1008243606668 PubMedCrossRef

Hermans J, Bonenkamp JJ, Bohn MC et al (1993) Adjuvant therapy after curative resection for gastric cancer: meta-analysis of randomized trials. J Clin Oncol 12:879–880

Hochwald SN, Kim S, Klimstra DS et al (2000) Analysis of 154 actual 5-year survivors of gastric cancer. J Gastrointest Surg 4:520–525. doi:10.1016/S1091-255X(00)80095-5 PubMedCrossRef

Janunger KG, Hafström L, Glimelius B (2002) Chemotherapy in gastric cancer: a review and updated meta-analysis. Eur J Surg 168(11):597–608. doi:10.1080/11024150201680005 PubMedCrossRef

Kang Y, Kang WK, Shin DB et al (2006) Randomized phase III trial of capecitabine/cisplatin (XP) vs. continuous infusion of 5-FU/cisplatin (FP) as first-line therapy in patients (pts) with advanced gastric cancer (AGC): efficacy and safety results. J Clin Oncol 24:183s. doi:10.1200/JCO.2006.06.7371 abstractCrossRef

Kim TW, Kang YK, Ahn JH et al (2002) Phase II study of capecitabine plus cisplatin as first-line chemotherapy in advanced gastric cancer. Ann Oncol 13(12):1893–1898. doi:10.1093/annonc/mdf323 PubMedCrossRef

Kim DY, Joo JK, Park YK et al (2007) Predictors of long-term survival in node-positive gastric carcinoma patients with curative resection. Langenbecks Arch Surg 392(2):131–134. doi:10.1007/s00423-006-0114-9 PubMedCrossRef

Kollmannsberger C, Quietzsch D, Haag C et al (2000) A phase II study of paclitaxel, weekly, 24-hour continous infusion 5-fluorouracil, folinic acid and cisplatin in patients with advanced gastric cancer. Br J Cancer 83(4):458–462. doi:10.1054/bjoc.2000.1295 PubMedCrossRef

Kollmannsberger C, Budach W, Stahl M et al (2005) Adjuvant chemoradiation using 5-fluorouracil/folinic acid/cisplatin with or without paclitaxel and radiation in patients with completely resected high-risk gastric cancer: two cooperative phase II studies of the AIO/ARO/ACO. Ann Oncol 16(8):1326–1333. doi:10.1093/annonc/mdi252 PubMedCrossRef

Kopp R, Ruge M, Rothbauer E et al (2002) Impact of epidermal growth factor (EGF) radioreceptor analysis on long-term survival of gastric cancer patients. Anticancer Res 22:1161–1167PubMed

Lenz HJ, Lee FC, Haller DG et al (2007) Extended safety and efficacy data on S-1 plus cisplatin in patients with untreated advanced gastric carcinoma in a multicenter phase II study. Cancer 109:33–40. doi:10.1002/cncr.22329 PubMedCrossRef

Lerner A, Gonin R, Steele GDJ et al (1992) Etoposide, doxorubicin, and cisplatin chemotherapy for advanced gastric adenocarcinoma: results of a phase II trial. J Clin Oncol 10:536–540PubMed

Lordick F, Ott K, Krause BJ et al (2007) PET to assess early metabolic response and to guide treatment of adenocarcinoma of the esophagogastric junction : the MUNICON phase II trial. Lancet Oncol 8:797–805. doi:10.1016/S1470-2045(07)70244-9 PubMedCrossRef

Lorenzen S, Hentrich M, Haberl C et al (2007) Split-dose docetaxel, cisplatin and leukovorin/fluorouracil as first-line therapy in advanced gastric cancer and adenocarcinoma of the gastroesophageal junction: results of a phase II trial. Ann Oncol 18:1673–1679. doi:10.1093/annonc/mdm269 PubMedCrossRef

Lutz MP, Wilke H, Wagener DJ et al (2007) Weekly infusional high-dose fluorouracil (HD-FU), HD-FU plus folinic acid (HD-FU/FA), or HD-FU/FA plus biweekly cisplatin in advanced gastric cancer: randomized phase II trial 40953 of the European Organisation for Research and Treatment of Cancer Gastrointestinal Group and the Arbeitsgemeinschaft Internistische Onkologie. J Clin Oncol 25(18):2580–2585. doi:10.1200/JCO.2007.11.1666 PubMedCrossRef

Macdonald JS, Smalley SR, Benedetti J et al (2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophagel junction. N Engl J Med 345:725–730. doi:10.1056/NEJMoa010187 PubMedCrossRef

Mari E, Floriani I, Tinazzi A et al (2000) Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: a meta-analysis of published randomised trials. Ann Oncol 11:837–843. doi:10.1023/A:1008377101672 PubMedCrossRef

Maruyama M, Takeshita K, Endo M et al (1998) Clinicopathological study of gastric carcinoma in high- and low mortality countries: comparison between Japan and the US. Gastric Cancer 1(1):64–70. doi:10.1007/s101200050056 PubMedCrossRef

Menges M, Schmidt C, Lindemann W et al (2003) Low toxic neoadjuvant cisplatin, 5-fluorouracil and folinic acid in locally advanced gastric cancer yields high R-0 resection rate. J Cancer Res Clin Oncol 129:423–429. doi:10.1007/s00432-003-0467-1 PubMedCrossRef

Nakagawa S, Nashimoto A, Yabusaki H (2007) Role of staging laparoscopy with peritoneal lavage cytology in the treatment of locally advanced gastric cancer. Gastric Cancer 10(1):29–34. doi:10.1007/s10120-006-0406-3 Epub aheadPubMedCrossRef

Nakajima T, Kinoshita T, Nashimoto A, Sairenji M, Yamaguchi T, Sakamoto J et al (2007) Randomized controlled trial of adjuvant uracil-tegafur versus surgery alone for serosa-negative, locally advanced gastric cancer. Br J Surg 94(12):1468–1476. doi:10.1002/bjs.5996 PubMedCrossRef

Nitti D, Wils J, Dos Santos JG, Fountzilas G, Conte PF, Sava C et al (2006) 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 17(2):262–269. doi:10.1093/annonc/mdj077 PubMedCrossRef

Panzini I, Gianni L, Fattori PP et al (2002) Adjuvant chemotherapy in gastric cancer: a meta-analysis of randomized trials and a comparison with previous meta-analyses. Tumori 88:21–7PubMed

Pera M (2000) Epidemiology of esophageal cancer, especially adenocarcinoma of the esophagogastric junction. Recent Results Cancer Res 155:1–14PubMed

Pinto C, Di Fabio F, Siena S et al (2007) Phase II study of cetuximab in combination with FOLFIRI in patients with untreated advanced gastric or gastroesophageal junction adenocarcinoma (FOLCETUX study). Ann Oncol 18(3):510–517. doi:10.1093/annonc/mdl459 PubMedCrossRef

Plukker JT, Mulder NH, Sleijfer DT et al (1991) Chemotherapy and surgery for locally advanced cancer of the cardia and fundus: phase II study with methotrexate and 5-fluorouracil. Br J Surg 78:955–958. doi:10.1002/bjs.1800780820 PubMedCrossRef

Pozzo C, Peschel C, Gorbunova V et al (2001) Irinotecan in combination with CDDP or 5-FU and folinic acid is active in patients with advanced gastric or gastro-oesophageal junction adenocarcinoma: final results of a randomized phase II study. Proc Am Soc Clin Oncol 20:531a

Pyrhonen S, Kuitunen T, Nyandoto P et al (1995) 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 71(3):587–591PubMed

Ridwelski K, Gebauer T, Fahlke J et al (2001) Combination chemotherapy with docetaxel and cisplatin for locally advanced and metastatic gastric cancer. Ann Oncol 12(1):47–51. doi:10.1023/A:1008328501128 PubMedCrossRef

Roder JD, Bottcher K, Siewert JR et al (1993) Prognostic factors in gastric carcinoma. Results of the German Gastric Carcinoma Study 1992. Cancer 72:2089–2097. doi :10.1002/1097-0142(19931001)72:7<2089::AID-CNCR2820720706>3.0.CO;2-HPubMedCrossRef

Ross P, Nicolson M, Cunningham D et al (2002) Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. J Clin Oncol 20(8):1996–2004. doi:10.1200/JCO.2002.08.105 PubMedCrossRef

Sakaguchi T, Watanabe A, Sawada H et al (1998) Characteristics and clinical outcome of proximal-third gastric cancer. J Am Coll Surg 187(4):352–357. doi:10.1016/S1072-7515(98)00191-4 PubMedCrossRef

Sakuramoto S, Sasako M, Yamaguchi T, A et al (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidin. N Engl J Med 357:1810–1820. doi:10.1056/NEJMoa072252 PubMedCrossRef

Shah MA, Ramanathan RK, Ilson DH et al (2006) Multicenter phase II study of irinotecan, cisplatin, and bevacizumab in patients with metastatic gastric or gastroesophageal junction adenocarcinoma. J Clin Oncol 24:5201–5206. doi:10.1200/JCO.2006.08.0887 PubMedCrossRef

Sumpter KA, Harper-Wynne C, Cunningham D et al (2003) Randomised, multicenter phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer: confirmation of dose escalation. Proc Am Soc Clin Oncol 22:a1031

Thuss-Patience PC, Kretzschmar A, Repp M et al (2005) Docetaxel and continuous-infusion fluorouracil versus epirubicin, cisplatin, and fluorouracil for advanced gastric adenocarcinoma: a randomized phase II study. J Clin Oncol 23(3):494–501. doi:10.1200/JCO.2005.02.163 PubMedCrossRef

Van Cutsem E, Moiseyenko VM, Tjulandin S et al (2006) 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 24(31):4991–4997. doi:10.1200/JCO.2006.06.8429 PubMedCrossRef

Varadhachary G, Ajani JA (2005) Gastric cancer. Clin Adv Hematol Oncol 3:118–124PubMed

Wagner Ad, Grothe W, Haerting J et al (2006) Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol 24(18):2903–2909. doi:10.1200/JCO.2005.05.0245 PubMedCrossRef

Webb A, Cunningham D, Scarffe JH et al (1997) Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol 15(1):261–267PubMed

Wilke H, Preusser P, Fink U et al (1989) Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol 7:1318–1326PubMed

Title: Current strategies in systemic treatment of gastric cancer and cancer of the gastroesophageal junction
Authors: Markus Menges
Thomas Hoehler
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Journal of Cancer Research and Clinical Oncology / Issue 1/2009
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-008-0425-z

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2009

Down-regulation of CXCL12 mRNA expression by promoter hypermethylation and its association with metastatic progression in human breast carcinomas

Serum-soluble interleukin-2 receptor (sIL-2R) is an extremely strong prognostic factor for patients with peripheral T-cell lymphoma, unspecified (PTCL-U)

Tiam1-deficiency impairs mammary tumor formation in MMTV-c-neu but not in MMTV-c-myc mice

Evolutionary maintenance of oncogenesis

Preoperative hemoglobin and platelet count and poor prognostic factors in patients with endometrial carcinoma

Cutaneous metastases of visceral tumours: a review

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage