Gastric Cancer Treatment Regimens

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GASTRIC CANCER TREATMENT REGIMENS

Clinical Trials: The NCCN recommends cancer patient participation in clinical trials as the gold standard for treatment.

Cancer therapy selection, dosing, administration, and the management of related adverse events can be a complex process that should be handled by an experienced healthcare team. Clinicians must choose and verify treatment options based on the individual patient; drug dose modifications and supportive care interventions should be administered accordingly. The cancer treatment regimens below may include both U.S. Food and Drug Administration-approved and unapproved indications/regimens. These regimens are only provided to supplement the latest treatment strategies.

These Guidelines are a work in progress that may be refined as often as new significant data becomes available. The NCCN Guidelines® are a consensus statement of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines® is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way.

Principles of Systemic Therapy1

Chemotherapy regimens should be chosen in the context of performance status, medical comorbidities, toxicity profile, and HER2-neu expression (for adenocarcinoma only). Two-drug cytotoxic regimens are preferred for patients with advanced disease because of lower toxicity. Three-drug cytotoxic regimens should be reserved for medically fit patients with good performance status and access to frequent toxicity evaluation. Doses and schedules for any regimen that is not derived from category 1 evidence is a suggestion, and subject to appropriate modifications depending on the circumstances. Infusional fluorouracil and capecitabine may be used interchangeably (except as indicated). Cisplatin and oxaliplatin may be used interchangeably depending on toxicity profile.

Preoperative Chemoradiation (esophagogastric junction and gastric cardia)1

Preferred Regimens

REGIMEN

DOSING

Paclitaxel + carboplatin2

Day 1: Paclitaxel 50mg/m2 IV + carboplatin AUC 2mg/mL × min IV Repeat weekly for 5 weeks.

Cisplatin + 5-fluorouracil (5-FU)3,4

Days 1 and 29: Cisplatin 75–100mg/m2 IV

Days 1–4 and 29–32: 5-FU 750–1000mg/m2 IV continuous infusion over 24 hours

OR

Days 1–5: Cisplatin 15mg/m2 IV once daily plus 5-FU 800mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 21 days for 2 cycles.

Oxaliplatin + 5-FU5,6

Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV

Days 1–33: 5-FU 180mg/m2 IV

OR

Days 1, 8, 15, 22, and 29: Oxaliplatin 45mg/m2 IV.

Days 1–33: 5-FU 225mg/m2 IV continuous infusion over 24 hours

OR

Day 1: Oxaliplatin 85mg/m2 and leucovorin 200mg/m2 followed by 5-FU 400mg/m2 bolus, then 1600mg/m2 46-hour continuous infusion; the first 3 cycles were delivered during radiotherapy (RT), the other 3 after RT; 6 bimonthly (14 days) cycles.

Cisplatin + capecitabine7

Day 1: Cisplatin 30mg/m2 IV

Days 1–5: Capecitabine 800mg/m2 orally twice daily

Repeat cycle weekly for 5 weeks.

Oxaliplatin + capecitabine8

Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV

Days 1–5: Capecitabine 625mg/m2 orally twice daily for 5 weeks.

Other Regimens

Irinotecan + cisplatin9

Days 1, 8, 22, 29: Irinotecan 65mg/m2 IV plus cisplatin 30mg/m2 IV.

Paclitaxel + 5-FU10

Day 1: Paclitaxel 45mg/m2 IV weekly

Days 1–5: 5-FU 300mg/m2 IV continuous infusion

Weekly for 5 weeks.

Paclitaxel + capecitabine10

Day 1: Paclitaxel 45–50mg/m2 IV

Days 1–5: Capecitabine 625-825mg/m2 orally BID

Weekly for 5 weeks.

Docetaxel + 5-FU11

Day 1: Docetaxel 7.5mg/m2 IV

Days 1–5: 5-FU 200–300mg/m2 IV

Weekly for 5 weeks.

Docetaxel + capecitabine11

Day 1: Docetaxel 7.5mg/m2 IV

Days 1–5: Capecitabine 625-825mg/m2 orally BID

Weekly for 5 weeks.

Perioperative Chemotherapy (including esophagogastric junction)1

Epirubicin + cisplatin + 5-FU (ECF)12

Day 1: Epirubicin 50mg/m2 IV bolus + cisplatin 60mg/m2 IV

Days 1–21: 5-FU 200mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively.

ECF modification: epirubicin + oxaliplatin + 5-FU13

Day 1: Epirubicin 50mg/m2 IV; oxaliplatin 130mg/m2 IV

Days 1–21: 5-FU 200mg/m2 IV continuous infusion over 24 hours

Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively.

ECF modification: epirubicin + cisplatin + capecitabine13

Day 1: Epirubicin 50mg/m2 IV; cisplatin 60mg/m2 IV

Days 1–21: Capecitabine 625mg/m2 orally twice daily

Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively.

ECF modification: epirubicin + oxaliplatin + capecitabine13

Day 1: Epirubicin 50mg/m2 IV; oxaliplatin 130mg/m2 IV

Days 1–21: Capecitabine 625mg/m2 orally twice daily

Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively.

5-FU + cisplatin14

Day 1: Cisplatin 100mg/m2 IV

Days 1–5: 5-FU 800mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 28 days for 2–3 cycles preoperatively and 3–4 cycles

postoperatively for a total of 6 cycles

Postoperative Chemoradiation (including esophagogastric junction)1

5-FU + leucovorin (category 1)15

Cycles 1, 3, and 4 (before and after radiation)

Days 1–5: Leucovorin 20mg/m2 IVP plus 5-FU 425mg/m2/day IVP

Repeat cycle every 28 days.

Cycle 2 (with radiation)

Days 1–4 and 31–33: Leucovorin 20mg/m2 IVP

Days 1–4: 5-FU 400mg/m2/day IVP

Repeat cycle every 35 days

The NCCN panel acknowledges that the Intergroup 0116 Trial formed the basis for postoperative adjuvant chemoradiation strategy. However, the panel does not recommend the above specified doses or schedule of cytotoxic agents because of concerns regarding toxicity. The panel recommends one of the following modifications instead.

Capecitabine16,17

Days 1–14: Capecitabine 750–1000mg/m2 orally twice daily

Repeat cycle every 28 days; 1 cycle before and 2 cycles after chemoradiation.

5-FU + leucovorin18

Days 1, 2, 15, and 16: Leucovorin 200mg/m2 IV as 2-hour infusion followed by 5-FU 400mg/m2 IVP and a 22-hour infusion of 5-FU 600mg/m2; 1 cycle before and 2 cycles after chemoradiation.

5-FU with radiation19

Days 1–5 OR Days 1–7: 5-FU 200–250mg/m2 IV continuous infusion over 24 hours once daily; weekly for 5 weeks.

Capecitabine with radiation20

Days 1–5 OR Days 1–7: Capecitabine 625–825mg/m2 orally twice daily; weekly for 5 weeks.

Postoperative Chemotherapy

Capecitabine + oxaliplatin21

Days 1–14: Capecitabine 1000mg/m2 orally twice daily

Day 1: Oxaliplatin 130mg/m2 IV

Repeat cycle every 21 days for 8 cycles.

Capecitabine + cisplatin22

Days 1–14: Capecitabine 1000mg/m2 orally twice daily

Day 1: Cisplatin 60mg/m2 IV

Repeat cycle every 21 days for 6 cycles.

Metastatic or Locally Advanced Cancer (where local therapy is not indicated)1

First-line Therapy

Trastuzumab + chemotherapy (NOTE: for HER2-neu malignancies)23

Day 1: Trastuzumab 8mg/kg IV loading dose (Cycle 1 only); followed by trastuzumab 6mg/kg IV every 3 weeks, plus chemotherapy

OR

Day 1 of Cycle 1: Trastuzumab 6mg/kg IV loading dose, then 4mg/kg IV every 4 days

Chemotherapy:

Day 1: Cisplatin 80mg/m2 IV, plus

Days 1–14: Capecitabine 1000mg/m2 orally twice daily OR

Days 1–5: 5-FU 800mg/m2 continuous IV infusion

Repeat cycle every 21 days for 6 cycles

Docetaxel + cisplatin + 5-FU (DCF)24-27

Day 1: Docetaxel 75mg/m2 IV + cisplatin 75mg/m2 IV

Days 1–5: 5-FU 1,000mg/m2 IV continuous infusion over 24 hours, daily

Repeat cycle every 28 days.

OR

Day 1: Docetaxel 40mg/m2 IV + leucovorin 400mg/m2 IV + 5-FU 400mg/m2 IV, plus

Days 1 and 2: 5-FU 1,000mg/m2 IV continuous infusion over 24 hours (total 2,000mg/m2) followed by

Day 3: Cisplatin 40mg/m2 IV

Repeat cycle every 14 days.

OR

Day 1: Docetaxel 60mg/m2 IV plus cisplatin 60mg/m2 IV

Days 1–4: 5-FU 750mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 21 days.

OR

Day 1: Docetaxel 75mg/m2 IV plus cisplatin 75mg/m2 IV

Days 1–14: 5-FU 300mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 21 days.

Modified DCF (docetaxel + oxaliplatin + leucovorin + 5-FU)28

Day 1: Docetaxel 50mg/m2 IV plus leucovorin 200mg/m2 IV plus oxaliplatin 85mg/m2 plus 5-FU 2,600mg/m2 IV continuous infusion over 24 hours

Repeat cycle every 14 days.

Modified DCF (docetaxel + oxaliplatin + 5-FU)29

Day 1: Docetaxel 50mg/m2 IV plus oxaliplatin 85mg/m2

Days 1 and 2: 5-FU 1,200mg/m2 IV continuous infusion over 24 hours

Repeat cycle every 14 days.

Modified DCF (docetaxel + carboplatin + 5-FU)30

Day 1: Docetaxel 75mg/m2

Day 2: Carboplatin AUC 6mg/mL × min

Days 1–3: 5-FU 1,200mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 21 days.

ECF31,32

Day 1: Epirubicin 50mg/m2 IV bolus + cisplatin 60mg/m2 IV

Days 1–21: 5-FU 200mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 21 days.

ECF modifications (epirubicin + oxaliplatin + 5-FU)31

Days 1: Epirubicin 50mg/m2 IV plus oxaliplatin 130mg/m2 IV

Days 1–21: 5-FU 200mg/m2 IV continuous infusion over 24 hours

Repeat cycle every 21 days.

ECF modifications (epirubicin + cisplatin + capecitabine)31

Day 1: Epirubicin 50mg/m2 IV plus cisplatin 60mg/m2 IV

Days 1–21: Capecitabine 625mg/m2 orally twice daily

Repeat cycle every 21 days.

ECF modifications (epirubicin + oxaliplatin + capecitabine)33

Day 1: Epirubicin 50mg/m2 IV plus oxaliplatin 130mg/m2 IV

Days 1–21: capecitabine 625mg/m2 IV orally twice daily

Repeat cycle every 21 days.

Fluoropyrimidine and cisplatin (5-FU + cisplatin)34

Day 1: Cisplatin 100mg/m2 IV

Days 1–4: 5-FU 1,000mg/m2 IV continuous infusion over 24 hours daily

NOTE: May be coupled with cetuximab administered as an initial dose of cetuximab 400mg/m2 IV on Day 1 over 120 minutes; followed by weekly doses of 250mg/m2 IV over 60 minutes.

Fluoropyrimidine and cisplatin (5-FU + cisplatin + leucovorin)28,35

Day 1: Cisplatin 50mg/m2 IV plus leucovorin 200mg/m2 IV

Day 1: 5-FU 2,000mg/m2 IV continuous infusion over 24 hours

Repeat cycle every 14 days.

Fluoropyrimidine and cisplatin (capecitabine + cisplatin)34

Day 1: Cisplatin 80mg/m2 IV

Day 1–14: Capecitabine 1000mg/m2 orally twice daily

Repeat cycle every 3 weeks.

Fluoropyrimidine and oxaliplatin (oxaliplatin + leucovorin + 5-FU)28,36

Day 1: Oxaliplatin 85mg/m2 IV plus leucovorin 400mg/m2 IV plus 5-FU 400mg/m2 IVP

Days 1 and 2: 5-FU 1200mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 14 days.

OR

Day 1: Oxaliplatin 85mg/m2 IV plus leucovorin 200mg/m2 IV plus 5-FU 400mg/m2 IVP plus 5-FU 2600mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 14 days.

Fluoropyrimidine and oxaliplatin (oxaliplatin + capecitabine)37

Day 1: Oxaliplatin 130mg/m2 IV

Days 1–14: Capecitabine 1000mg/m2 orally twice daily

Repeat cycle every 21 days.

Fluorouracil and irinotecan (irinotecan + leucovorin + 5-FU)38-40

Day 1: Irinotecan 80mg/m2 IV plus leucovorin 500mg/m2 IV plus 5-FU 2000mg/m2 IV continuous infusion over 24 hours

Weekly for 6 weeks followed by 1 week off treatment OR weekly for 6 weeks followed by 2 weeks off treatment.

OR

Day 1: Irinotecan 180mg/m2 IV plus leucovorin 400mg/m2 IV plus 5-FU 400mg/m2 IVP

Days 1–2: 5-FU 1200mg/m2 IV continuous infusion over 24 hours

Repeat cycle every 14 days.

Fluoropyrimidine and oxaliplatin (oxaliplatin + leucovorin + 5-FU)36

Day 1: Oxaliplatin 85mg/m2 IV plus leucovorin 400mg/m2 IV plus 5-FU 400mg/m2 IVP

Days 1 and 2: 5-FU 1200mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 14 days.

Other Regimens

Paclitaxel + cisplatin or carboplatin41–43

Day 1: Paclitaxel 135–200mg/m2 IV

Day 2: Cisplatin 75mg/m2 IV

Repeat cycle every 21 days.

OR

Day 1: Paclitaxel 90mg/m2 IV plus cisplatin 75mg/m2 IV

Repeat cycle every 14 days.

OR

Day 1: Paclitaxel 200mg/m2 IV plus carboplatin AUC 5mg/mL x min

Repeat cycle every 21 days.

Docetaxel + cisplatin27,44,45

Day 1: Docetaxel 70–85mg/m2 IV plus cisplatin 70–75mg/m2 IV

Repeat cycle every 21 days.

Docetaxel + irinotecan46

Days 1 and 8: Docetaxel 35mg/m2 IV plus irinotecan 50mg/m2 IV

Repeat cycle every 21 days.

Fluoropyridimine40,47,48

Day 1: Leucovorin 400mg/m2 IV plus 5-FU 400mg/m2 IVP

Days 1 and 2: 5-FU 1200mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 14 days.

OR

Days 1–5: 5-FU 800mg/m2 IV continuous infusion over 24 hours daily

Repeat cycle every 28 days.

OR

Days 1–14: Capecitabine 1000–1250mg/m2 orally twice daily

Repeat cycle every 21 days.

Taxane49–51

Day 1: Docetaxel 75–100mg/m2 IV

Repeat cycle every 21 days.

OR

Day 1: Paclitaxel 135–250mg/m2 IV

Repeat cycle every 21 days.

OR

Days 1, 8, 15 and 22: Paclitaxel 80mg/m2 IV once weekly

Repeat cycle every 28 days.

Second-line Therapy

Trastuzumab + chemotherapy (NOTE: for HER2-neu malignancies)23

Day 1: Trastuzumab 8mg/kg IV loading dose (Cycle 1 only); followed by trastuzumab 6mg/kg IV every 3 weeks, plus chemotherapy.

OR

Day 1 of Cycle 1: Trastuzumab 6mg/kg IV loading dose, then 4mg/kg IV every 4 days

Chemotherapy:

Day 1: Cisplatin 80mg/m2 IV, plus

Days 1–14: Capecitabine 1000mg/m2 orally twice daily OR

Days 1–5: 5-FU 800mg/m2 continuous IV infusion

Repeat cycle every 21 days for 6 cycles.

Second-line Therapy (preferred regimens)

Docetaxel49

Day 1: Docetaxel 75–100mg/m2 IV

Repeat cycle every 21 days

Paclitaxel50-52

Day 1: Paclitaxel 135–250mg/m2 IV

Repeat cycle every 21 days.

OR

Day 1: Paclitaxel 80mg/m2 IV once weekly

Repeat cycle every 28 days.

OR

Days 1, 8, and 15: Paclitaxel 80mg/m2 IV

Repeat cycle every 28 days.

Irinotecan52–55

Day 1: Irinotecan 250–350mg/m2 IV

Repeat cycle every 21 days.

OR

Day 1: Irinotecan 150–180mg/m2 IV

Repeat cycle every 14 days.

OR

Days 1 and 8: Irinotecan 125mg/m2 IV

Repeat cycle every 21 days.

Other Regimens

Irinotecan + cisplatin36,56

Days 1 and 8: Irinotecan 65mg/m2 IV plus cisplatin 25–30mg/m2 IV

Repeat cycle every 21 days.

Irinotecan + fluoropyridimine57

Day 1: Irinotecan 250mg/m2 IV

Days 1–14: Capecitabine 1000mg/m2 PO BID daily

Repeat cycle every 21 days.

Irinotecan + fluoropyridimine40,58

Day 1: Irinotecan 180mg/m2 IV plus leucovorin 400mg/m2 IV plus 5-FU 400mg/m2 IVP

Days 1 and 2: 5-FU 600–1200mg/m2/day IV continuous infusion on Days 1 and 2

Repeat cycle every 14 days.

Docetaxel + irinotecan46

Days 1 and 8: Docetaxel 35mg/m2 IV plus irinotecan 50mg/m2 IV

Repeat cycle every 21 days.

Alternative Regimens for Consideration

Mitomycin + irinotecan59–61

Day 1: Mitomycin 6mg/m2 IV

Days 2 and 9: Irinotecan 125mg/m2

Repeat cycle every 28 days.

OR

Days 1 and 15: Irinotecan 150mg/m2 IV

Day 1: Mitomycin 8mg/m2 IV

Repeat cycle every 28 days.

OR

Day 1: Irinotecan 125mg/m2 IV plus mitomycin 5mg/m2 IV

Repeat cycle every 14 days.

Mitomycin + leucovorin + 5-FU62

Days 1 and 22: Mitomycin 10mg/m2 IV

Day 1: Leucovorin 500mg/m2 IV plus 5-FU 2600mg/m2/day IV continuous infusion

Weekly for 6 weeks, followed by 2 weeks off treatment.

Etoposide63,64

Days 1–3: Etoposide 90–120mg/m2

Repeat cycle every 28 days.

References

1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology™. Gastric Cancer. v 2.2013. Available at: http://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf. Accessed April 30, 2014.

2. van Hagen P, Hulshof MC, van Lanschot JJ, et al. CROSS Group. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–2084.

3. Tepper J, Krasna MJ, Niedzwiecki D, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26:1086–1092.

4. Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol. 2007;25:1160–1168.

5. Conroy T, Galais M-P, Raoul JL, et al. UNICANCER-GI/FFCD PRODIGE Intergroup. Phase III randomized trial of definitive chemoradiotherapy (CRT) with FOLFOX or cisplatin and fluorouracil in esophageal cancer (EC): Final results of the PRODIGE 5/ACCORD 17 trial [abstract]. J Clin Oncol. 2012;30 (Suppl 18): LBA4003.

6. Khushalani NI, Leichman CG, Proulx G, et al. Oxaliplatin in combination with protracted-infusion fluorouracil and radiation: report of a clinical trial for patients with esophageal cancer. J Clin Oncol. 2002;20:2844–2850.

7. Lee SS, Kim SB, Park SI, et al. Capecitabine and cisplatin chemotherapy (XP) alone or sequentially combined chemoradiotherapy containing XP regiment in patients with three different settings of stage IV esophageal cancer. Jpn J Clin Oncol. 2007;37:829–835.

8. Javle MM, Yang G, Nwogu CE, et al. Capecitabine, oxaliplatin and radiotherapy: a phase 1B neoadjuvant study for esophageal cancer with gene expression analysis. Cancer Invest. 2009;27:193–200.

9. Sharma R, Yang GY, Nwogu CE at al. A single institution experience with neoadjuvant chemoradiation (CRT) with irinotecan (I) and cisplatin ( C ) in locally advanced esophageal carcinoma (LAEC) [abstract]. J Clin Oncol. 2009;27(Suppl 15): Abstract e15619.

10. Ajani JA, Winter K, Okawara GS, et al. Phase II trial of preoperative chemoradiation in patients with localized gastric adenocarcinoma (RTOG 9904): quality of combined modality therapy and pathologic response. J Clin Oncol. 2006;24:3953–3958.

11. Hihara J, Yoshida K, Hamai Y, et al. Phase I study of docetaxel (TXT) and 5-fluorouracil (5-FU) with concurrent radiotherapy in patients with advanced esophageal cancer. Anticancer Res. 2007;27(4C):2597–2603.

12. Cunningham D, Allum WH, Stenning SP, et al. MAGIC Trial Participants. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.

13. Sumpter K, Harper-Wynne C, et al. Report of two protocol planned interim analyses in a randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer receiving ECF. Br J Cancer. 2005;92:1976–1983.

14. Ychou M, Boige V, Pignon JP, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011;29:1715–1721.

15. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–730.

16. Jansen EP, Boot H, Saunders MP, et al. A phase I-II study of postoperative capecitabine-based chemoradiotherapy in gastric cancer. Int J Radiat Oncol Biol Phys. 2007;69:1424–1428.

17. Chua YJ, Barbachano Y, Cunningham D, et al. Neoadjuvant capecitabine and oxaliplatin before chemoradiotherapy and total mesorectal excision in MRI-defined poor-risk rectal cancer: a phase 2 trial. Lancet Oncol. 2010;11:241–248.

18. André T, Quinaux E, Louvet C, et al. Phase III study comparing a semimonthly with a monthly regimen of fluorouracil and leucovorin as adjuvant treatment for stage II and III colon cancer patients: final results of GERCOR C96.1. J Clin Oncol. 2007;25:3732–3738.

19. Leong T, Joon DL, Willis D, et al. Adjuvant chemoradiation for gastric cancer using epirubicin, cisplatin, and 5-fluorouracil before and after three-dimensional conformal radiotherapy with concurrent infusional 5-fluorouracil: a multicenter study of the Trans-Tasman Radiation Oncology Group. Int J Radiat Oncol Biol Phys. 2011;79:690–695.

20. Lee HS, Choi Y, Hur WJ, et al. Pilot study of postoperative adjuvant chemoradiation for advanced gastric cancer: adjuvant 5-FU/cisplatin and chemoradiation with capecitabine. World J Gastroenterol. 2006;12:603–607.

21. Bang YJ, Kim YW, Yang HK, et al. CLASSIC trial investigators. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379:315-321.

22. Lee J, Lim do H, Kim S, 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;30:268–273.

23. Bang YJ, Van Cutsem E, Feyereislova A, et al. ToGA Trial Investigators. 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):687–697.

24. Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. V325 Study Group. 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;24:4991–4997.

25. Shah MA, Shibata S, Stoller RG, et al. MSKCC Gastric Cancer Consortium. Random assignment multicenter phase II study of modified docetaxel, cisplatin, fluorouracil (mDCF) versus DCF with growth factor support (GCSF) in metastatic gastroesophageal adenocarcinoma (GE). J Clin Oncol. 2010;28 (Suppl 15): 4010.

26. Ozal G, Dogan M, Akbulut H, et al. The safety and efficacy of modified-dose docetaxel, cisplatin, and 5-fluorouracil (mDCF) combination in the front-line treatment of advanced gastric cancer [abstract 113]. Presented at the 2010 Gastrointestinal Cancers Symposium.

27. Roth AD, Fazio N, Stupp R, et al. Swiss Group for Clinical Cancer Research. Docetaxel, cisplatin, and fluorouracil; docetaxel and cisplatin; and epirubicin, cisplatin, and fluorouracil as systemic treatment for advanced gastric carcinoma: a randomized phase II trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol. 2007;25:3217–3223.

28. Al-Batran S-E, Hartmann JT, Probst S, 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. 2008;26:1435–1442.

29. Shankaran V, Mulcahy MF, Hochster HS, et al. Docetaxel, oxaliplatin, and 5-fluorouracil for the treatment of metastatic or unresectable gastric or gastroesophageal junction (GEJ) adenocarcinomas: Preliminary results of a phase II study [abstract 47]. Presented at the 2009 Gastrointestinal Cancers Symposium.

30. Elkerm YM, Elsaid A, Al-Batran SE, et al. Final results of a phase II trial of docetaxel-carboplatin-FU in locally advanced gastric carcinoma. Presented at the Gastrointestinal Cancers Symposium, January 25–27, 2008, Orlando, FL.

31. Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358:36–46.

32. Ross P, Nicolson M, Cunningham D, et al. 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. 2002;20:1996–2004.

33. Lorenzen S, Schuster T, Porschen R, et al. Cetuximab plus cisplatin-5-fluorouracil versus cisplatin-5-fluorouracil alone in first-line metastatic squamous cell carcinoma of the esophagus: a randomized phase II study of the Arbeitsgemeinschaft Internistische Onkologie. Ann Oncol. 2009;20:1667–1673.

34. Kang YK, Kang WK, Shin DB, et al. Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomised phase III non-inferiority trial. Ann Oncol. 2009;20:666–673.

35. Bouché O, Raoul JL, Bonnetain F, et al. Fédération Francophone de Cancérologie Digestive Group. Randomized multicenter phase II trial of a biweekly regimen of fluorouracil and leucovorin (LV5FU2), LV5FU2 plus cisplatin, or LV5FU2 plus irinotecan in patients with previously untreated metastatic gastric cancer: a Federation Francophone de Cancerologie Digestive Group Study—FFCD 9803. J Clin Oncol. 2004;22:43194328.

36. Enzinger PC, Burtness B, Hollis D, et al. CALGB 80403/ECOG 1206: A randomized phase II study of three standard chemotherapy regimens (ECF, IC, FOLFOX) plus cetuximab in metastatic esophageal and GE junction cancer [abstract 4006]. J Clin Oncol. 2010; 28 (suppl 15):4007.

37. Kim GM, Jeung HC, Rha SY, et al. A randomized phase II trial of S-1-oxaliplatin versus capecitabine-oxaliplatin in advanced gastric cancer. Eur J Cancer. 2012;48:518–526.

38. Dank M, Zaluski J, Barone C, 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;19:1450–1457.

39. Wolff K, Wein A, Reulbach U, et al. Weekly high-dose 5-fluorouracil as a 24-h infusion and sodium folinic acid (AIO regimen) plus irinotecan in patients with locally advanced nonresectable and metastatic adenocarcinoma or squamous cell carcinoma of the oesophagus: a phase II trial. Anticancer Drugs. 2009;20:165–173.

40. Ilson DH, Forastiere A, Arquette M, et al. A phase II trial of paclitaxel and cisplatin in patients with advanced carcinoma of the esophagus. Cancer J. 2000;6:316–323.

41. Petrasch S, Welt A, Reinacher A, et al. Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer. Br J Cancer. 1998;78:511–514.

42. Gadgeel SM, Shields AF, Heilbrun LK, et al. Phase II study of paclitaxel and carboplatin in patients with advanced gastric cancer. Am J Clin Oncol. 2003;26:37–41.

43. Ajani JA, Fodor MB, Tjulandin SA, et al. Phase II multi- institutional randomized trial of docetaxel plus cisplatin with or without fluorouracil in patients with untreated, advanced gastric, or gastroesophageal adenocarcinoma. J Clin Oncol. 2005;23:5660–5667.

44. Kim JY, Do YR, Park KU, et al. A multi-center phase II study of docetaxel plus cisplatin as first-line therapy in patients with metastatic squamous cell esophageal cancer. Cancer Chemother Pharmacol. 2010;66:31–36.

45. Burtness B, Gibson M, Egleston B, et al. Phase II trial of docetaxel-irinotecan combination in advanced esophageal cancer. Ann Oncol. 2009;20:1242–1248.

46. André T, Louvet C, Maindrault-Goebel F, et al. CPT-11 (irinotecan) addition to bimonthly, high-dose leucovorin and bolus and continuous-infusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancer. GERCOR. Eur J Cancer. 1999; 35:1343–1347.

47. Ohtsu A, Shimada Y, Shirao K, et al. Randomized phase III trial of fluorouracil alone versus fluorouracil plus cisplatin versus uracil and tegafur plus mitomycin in patients with unresectable, advanced gastric cancer: The Japan Clinical Oncology Group Study (JCOG9205). J Clin Oncol. 2003;21:54–59.

48. Hong YS, Song SY, Lee SI, et al. A phase II trial of capecitabine in previously untreated patients with advanced and/or metastatic gastric cancer. Ann Oncol. 2004;15:1344–1347.

(Revised 5/2014)

© 2014 Haymarket Media, Inc.


Gastrointestinal Cancer Drug Monographs

Colorectal and Other GI Cancers

Adriamycin Adriamycin Solution Adrucil
Avastin Camptosar Eloxatin
Erbitux Fusilev Gleevec
Leucovorin Nexavar Photofrin
Sutent Taxotere Vectibix
Xeloda

Pancreatic, Thyroid, And Other Endocrine Cancers

Adriamycin Adriamycin Solution Adrucil
Afinitor Caprelsa Gemzar
Lysodren Tarceva Thyrogen
Zanosar

Data provided by the Monthly Prescribing Reference (MPR) Hematology/Oncology Edition.
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