Compared with surgery alone, adjuvant fluoropirimidine, either with or without platinum compounds, has demonstrated benefits in previous studies.
To further assess its potential, researchers evaluated whether disease-free survival improved with sequential FOLFIRI [irinotecan plus 5-fluorouracil/folinic acid (5-FU/LV)] followed by docetaxel plus cisplatin when compared with 5-FU/LV alone in patients who underwent surgery for gastric cancer.
A total of 1,100 patients with resectable adenocarcinoma of the stomach or gastroesophageal junction were randomly assigned sequential FOLFIRI followed by docetaxel or a De Gramont regimen (5-FU/LV).
After a median follow-up of 57.4 months, 297 patients in the sequential arm and 284 patients in the 5-FU/LV arm died or experienced recurrence, and 243 in the sequential arm and 240 in the 5-FU/LV arm died.
Disease-free survival and overall survival were not significantly different between the two study groups, according to the study results. At 5 years, disease-free survival and overall survival were 44.6% and 44.6% in the sequential arm and 51% and 50.6% in the 5-FU/LV arm.
These findings prompted the researchers to conclude that the more intensive regimen did not improve disease-free survival or overall survival when compared with monotherapy in this patient population.
Further study may yield different results, but for now, it appears that monotherapy may be the better course of action in patients with radically resected gastric cancer.
Some trial have demonstrated a benefit of adjuvant fluoropirimidine with or without platinum compounds compared with surgery alone. ITACA-S study was designed to evaluate whether a sequential treatment of FOLFIRI [irinotecan plus 5-fluorouracil/folinic acid (5-FU/LV)] followed by docetaxel plus cisplatin improves disease-free survival in comparison with 5-FU/LV in patients with radically resected gastric cancer.
This study offers insight into how a more aggressive treatment regimen affects outcomes in this patient population.