DOI QR코드

DOI QR Code

Recent Advances in Chemotherapy of Gastric Cancer

위암 항암치료의 최신지견

  • Park, Se-Hoon (Division of Hematology-Oncology, Department of Internal Medicine, Sungkyunkwan University Samsung Medical Center) ;
  • Lee, Soon-Il (Division of Hematology and Oncology, Department of Internal Medicine, Dankook University Hospital)
  • 박세훈 (성균관대학교 의과대학 삼성서울병원 혈액종양내과) ;
  • 이순일 (단국대학교 의과대학 단국대학교병원 혈액종양내과)
  • Published : 2012.04.01

Abstract

Surgery is the best and the only treatment modality for cure if a patient has resectable gastric cancer. The outcome can be improved by a strategy of perioperative (neoadjuvant or adjuvant) chemotherapy or chemoradiotherapy. Whereas, advanced gastric cancer is treated primarily with chemotherapy; however, no chemotherapy regimen has been considered a standard. First-line chemotherapy generally includes fluoropyrimidine and cisplatin, sometimes with the addition of a third drug (epirubicin or docetaxel). In second-line setting, chemotherapy with single-agent irinotecan or docetaxel has emerged as a new standard of care. With improved understanding of the biology of gastric cancer and the identification of key signaling pathways, a number of promising molecularly-targeted agents have been studied that broaden the therapeutic options in the future. Regardless of the extent of disease or treatment modality, a multidisciplinary team approach is always desired since it can provide best treatment options for the patients.

Keywords

References

  1. Won YJ, Sung J, Jung KW, et al. Nationwide cancer incidence in Korea, 2003-2005. Cancer Res Treat 2009;41:122-131. https://doi.org/10.4143/crt.2009.41.3.122
  2. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108. https://doi.org/10.3322/canjclin.55.2.74
  3. Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev 2010;19:1893-1907. https://doi.org/10.1158/1055-9965.EPI-10-0437
  4. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma: an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965;64:31-49. https://doi.org/10.1111/apm.1965.64.1.31
  5. Bollschweiler E, Boettcher K, Hoelscher AH, et al. Is the prognosis for Japanese and German patients with gastric cancer really different? Cancer 1993;71:2918-2925. https://doi.org/10.1002/1097-0142(19930515)71:10<2918::AID-CNCR2820711006>3.0.CO;2-V
  6. Ahn HS, Lee HJ, Yoo MW, et al. Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20-year period. Br J Surg 2011;98:255-260. https://doi.org/10.1002/bjs.7310
  7. Everett SM, Axon AT. Early gastric cancer in Europe. Gut 1997;41:142-150. https://doi.org/10.1136/gut.41.2.142
  8. Ohtsu A, Yoshida S, Saijo N. Disparities in gastric cancer chemotherapy between the East and West. J Clin Oncol 2006;24:2188-2196. https://doi.org/10.1200/JCO.2006.05.9758
  9. Lim DH, Kim DY, Kang MK, et al. Patterns of failure in gastric carcinoma after D2 gastrectomy and chemoradiotherapy: a radiation oncologist's view. Br J Cancer 2004;91:11-17. https://doi.org/10.1038/sj.bjc.6601896
  10. Pyrhonen S, Kuitunen T, Nyandoto P, Kouri M. 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 1995;71:587-591. https://doi.org/10.1038/bjc.1995.114
  11. Glimelius B, Ekstrom K, Hoffman K, et al. Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 1997;8:163-168. https://doi.org/10.1023/A:1008243606668
  12. Park SH, Cho MS, Kim YS, et al. Self-reported health-related quality of life predicts survival for patients with advanced gastric cancer treated with first-line chemotherapy. Qual Life Res 2008;17:207-214. https://doi.org/10.1007/s11136-008-9307-8
  13. Park SH, Kim DY, Heo JS, et al. Postoperative chemoradiotherapy for gastric cancer. Ann Oncol 2003;14:1373-1377. https://doi.org/10.1093/annonc/mdg366
  14. Ng K, Meyerhardt JA, Fuchs CS. Adjuvant and neoadjuvant approaches in gastric cancer. Cancer J 2007;13:168-174. https://doi.org/10.1097/PPO.0b013e318074e351
  15. Schuhmacher C, Gretschel S, Lordick F, 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;28:5210-5218. https://doi.org/10.1200/JCO.2009.26.6114
  16. 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. https://doi.org/10.1200/JCO.2010.33.0597
  17. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11-20. https://doi.org/10.1056/NEJMoa055531
  18. Li W, Qin J, Sun YH, Liu TS. Neoadjuvant chemotherapy for advanced gastric cancer: a meta-analysis. World J Gastroenterol 2010;16:5621-5628. https://doi.org/10.3748/wjg.v16.i44.5621
  19. Zhang ZX, Gu XZ, Yin WB, Huang GJ, Zhang DW, Zhang RG. Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia (AGC): report on 370 patients. Int J Radiat Oncol Biol Phys 1998;42:929-934. https://doi.org/10.1016/S0360-3016(98)00280-6
  20. Ajani JA, Mansfield PF, Janjan N, et al. Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma. J Clin Oncol 2004; 22:2774-2780. https://doi.org/10.1200/JCO.2004.01.015
  21. Ajani JA, Mansfield PF, Crane CH, et al. Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome. J Clin Oncol 2005;23:1237-1244. https://doi.org/10.1200/JCO.2005.01.305
  22. Lee DJ, Lee J, Lim DH, et al. Phase I study of neoadjuvant chemoradiotherapy with S-1 and oxaliplatin in patients with locally advanced gastric cancer.Cancer Chemother Pharmacol 2012 Feb 5 [Epub]. http://dx.doi.org/10.1007/s00280-012-1836-1838.
  23. Earle CC, Maroun JA. Adjuvant chemotherapy after curative resection for gastric cancer in non-Asian patients: revisiting a meta-analysis of randomised trials. Eur J Cancer 1999;35:1059-1064. https://doi.org/10.1016/S0959-8049(99)00076-3
  24. 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. https://doi.org/10.1056/NEJMoa010187
  25. Kim S, Lim DH, Lee J, et al. An observational study suggesting clinical benefit for adjuvant postoperative chemoradiation in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach. Int J Radiat Oncol Biol Phys 2005;63:1279-1285. https://doi.org/10.1016/j.ijrobp.2005.05.005
  26. Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 2007;357:1810-1820. https://doi.org/10.1056/NEJMoa072252
  27. Hermans J, Bonenkamp JJ, Boon MC, et al. Adjuvant therapy after curative resection for gastric cancer: meta-analysis of randomized trials. J Clin Oncol 1993;11:1441-1447. https://doi.org/10.1200/JCO.1993.11.8.1441
  28. Mari E, Floriani I, Tinazzi A, et al. Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: a meta-analysis of published randomised trials: astudy of the GISCAD (Gruppo Italiano per lo Studio dei Carcinomi dell'Apparato Digerente). Ann Oncol 2000;11:837-843. https://doi.org/10.1023/A:1008377101672
  29. Bang YJ, Kim YW, Yang HK, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet 2012;379:315-321. https://doi.org/10.1016/S0140-6736(11)61873-4
  30. Ajani JA, Barthel JS, Bekaii-Saab T, et al. Gastric cancer. J Natl Compr Canc Netw 2010;8:378-409. https://doi.org/10.6004/jnccn.2010.0030
  31. Macdonald JS, Benedetti J, Smalley S, et al. Chemoradiation of resected gastric cancer: a 10-year follow-up of the phase III trial INT0116 (SWOG 9008). J Clin Oncol [Abstract] 2009;27 Suppl:S15. https://doi.org/10.1200/JCO.2008.21.7695
  32. Lee J, Lim DH, 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. https://doi.org/10.1200/JCO.2011.39.1953
  33. Cullinan SA, Moertel CG, Wieand HS, et al. Controlled evaluation of three drug combination regimens versus fluorouracil alone for the therapy of advanced gastric cancer: North Central Cancer Treatment Group. J Clin Oncol 1994;12:412-416. https://doi.org/10.1200/JCO.1994.12.2.412
  34. 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. https://doi.org/10.1200/JCO.2003.04.130
  35. Murad AM. Chemotherapy for advanced gastric cancer: focus on new agents and combinations. Cancer Control 1999;6:361-368. https://doi.org/10.1177/107327489900600406
  36. Kim NK, Park YS, Heo DS, et al. A phase III randomized study of 5-fluorouracil and cisplatin versus 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil alone in the treatment of advanced gastric cancer. Cancer 1993;71:3813-3818. https://doi.org/10.1002/1097-0142(19930615)71:12<3813::AID-CNCR2820711205>3.0.CO;2-5
  37. Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol 2006;24:2903-2909. https://doi.org/10.1200/JCO.2005.05.0245
  38. Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358:36-46. https://doi.org/10.1056/NEJMoa073149
  39. Liu G, Franssen E, Fitch MI, Warner E. Patient preferences for oral versus intravenous palliative chemotherapy. J Clin Oncol 1997;15:110-115. https://doi.org/10.1200/JCO.1997.15.1.110
  40. 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 noninferiority trial. Ann Oncol 2009;20:666-673. https://doi.org/10.1093/annonc/mdn717
  41. Koizumi W, Narahara H, Hara T, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 2008;9:215-221. https://doi.org/10.1016/S1470-2045(08)70035-4
  42. Webb A, Cunningham D, Scarffe JH, et al. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol 1997;15:261-267. https://doi.org/10.1200/JCO.1997.15.1.261
  43. Van Cutsem E, Moiseyenko VM, Tjulandin S, 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;24:4991-4997. https://doi.org/10.1200/JCO.2006.06.8429
  44. Yun J, Lee J, Park SH, et al. A randomised phase II study of combination chemotherapy with epirubicin, cisplatin and capecitabine (ECX) or cisplatin and capecitabine (CX) in advanced gastric cancer. Eur J Cancer 2010;46:885-891. https://doi.org/10.1016/j.ejca.2009.12.015
  45. Park SH, Nam E, Park J, et al. Randomized phase II study of irinotecan, leucovorin and 5-fluorouracil (ILF) versus cisplatin plus ILF (PILF) combination chemotherapy for advanced gastric cancer. Ann Oncol 2008;19:729-733.
  46. Ohtsu A, Shah MA, Van Cutsem E, et al. Bevacizumab in combination with chemotherapy as first-line therapy in advanced gastric cancer: a randomized, double-blind, placebocontrolled phase III study. J Clin Oncol 2011;29:3968-3976. https://doi.org/10.1200/JCO.2011.36.2236
  47. Bang YJ, Van Cutsem E, Feyereislova A, 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, openlabel, randomised controlled trial. Lancet 2010;376:687-697. https://doi.org/10.1016/S0140-6736(10)61121-X
  48. Wesolowski R, Lee C, Kim R. Is there a role for second-line chemotherapy in advanced gastric cancer? Lancet Oncol 2009;10:903-912. https://doi.org/10.1016/S1470-2045(09)70136-6
  49. Ji SH, Lim do H, Yi SY, et al. A retrospective analysis of second-line chemotherapy in patients with advanced gastric cancer. BMC Cancer 2009;9:110. https://doi.org/10.1186/1471-2407-9-110
  50. Thuss-Patience PC, Kretzschmar A, Bichev D, et al. Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer: a randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Eur J Cancer 2011;47:2306-2314. https://doi.org/10.1016/j.ejca.2011.06.002
  51. Kang JH, Lee SI, Lim DH, 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 Mar 15 [Epub]. http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2011.39.4585.
  52. Wils JA, Klein HO, Wagener DJ, et al. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol 1991;9:827-831. https://doi.org/10.1200/JCO.1991.9.5.827
  53. Vanhoefer U, Rougier P, Wilke H, 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;18:2648-2657. https://doi.org/10.1200/JCO.2000.18.14.2648
  54. 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;201996-2004. https://doi.org/10.1200/JCO.2002.08.105
  55. 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. https://doi.org/10.1093/annonc/mdn166

Cited by

  1. Expression of SIRT1 and DBC1 in Gastric Adenocarcinoma vol.46, pp.6, 2012, https://doi.org/10.4132/koreanjpathol.2012.46.6.523
  2. A case of Advanced Gastric cancer patient treated by Korean Medicine monotherapy vol.40, pp.4, 2012, https://doi.org/10.13048/jkm.19044