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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main gastric cancer page for current regimens.

8 regimens on this page 9 variants on this page

Adjuvant therapy

Doxifluridine & Mitomycin

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Kang et al. 2013 (AMC0101)	2001-2007	Phase 3 (C)	iceMFP	Seems to have inferior OS
Kang et al. 2013 (AMC0201)	2002-2006	Phase 3 (C)	MFP	Did not meet primary endpoint of RFS36

Preceding treatment

Gastrectomy, 3 to 6 weeks prior

Chemotherapy

Doxifluridine (Didox) as follows:
- Cycle 2: 460 mg/m² PO once per day
Mitomycin (Mutamycin) as follows:
- Cycle 1: 20 mg/m² IV once on day 1

28-day course, then 3-month course

References

AMC0201: Kang YK, Chang HM, Yook JH, Ryu MH, Park I, Min YJ, Zang DY, Kim GY, Yang DH, Jang SJ, Park YS, Lee JL, Kim TW, Oh ST, Park BK, Jung HY, Kim BS. Adjuvant chemotherapy for gastric cancer: a randomised phase 3 trial of mitomycin-C plus either short-term doxifluridine or long-term doxifluridine plus cisplatin after curative D2 gastrectomy (AMC0201). Br J Cancer. 2013 Apr 2;108(6):1245-51. Epub 2013 Feb 28. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00296335
AMC0101: Kang YK, Yook JH, Chang HM, Ryu MH, Yoo C, Zang DY, Lee JL, Kim TW, Yang DH, Jang SJ, Park YS, Lee YJ, Jung HY, Kim JH, Kim BS. Enhanced efficacy of postoperative adjuvant chemotherapy in advanced gastric cancer: results from a phase 3 randomized trial (AMC0101). Cancer Chemother Pharmacol. 2014 Jan;73(1):139-49. Epub 2013 Oct 27. link to original article PubMed NCT00296322

FA

FA: Fluorouracil & Adriamycin (Doxorubicin)

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Youn et al. 1990	NR	Randomized (C)	FA & poly A:U	Seems to have inferior OS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.

Preceding treatment

Gastrectomy

Chemotherapy

Fluorouracil (5-FU) 12 mg/kg IV once per day on days 1, 8, 15
Doxorubicin (Adriamycin) 40 mg/m² IV once on day 1

21-day cycles

References

Youn JK, Kim BS, Min JS, Lee KS, Choi HJ, Lee YB, Lee DW, Park IS, Roh JK, Chung JB, Koh EH, Park YJ, Kim HI, Lee JB. Adjuvant treatment of operable stomach cancer with polyadenylic-polyuridylic acid in addition to chemotherapeutic agents: a preliminary report. Int J Immunopharmacol. 1990;12(3):289-95. link to original article contains dosing details in abstract PubMed
1. Update: Jeung HC, Moon YW, Rha SY, Yoo NC, Roh JK, Noh SH, Min JS, Kim BS, Chung HC. Phase III trial of adjuvant 5-fluorouracil and adriamycin versus 5-fluorouracil, adriamycin, and polyadenylic-polyuridylic acid (poly A:U) for locally advanced gastric cancer after curative surgery: final results of 15-year follow-up. Ann Oncol. 2008 Mar;19(3):520-6. Epub 2007 Nov 20. link to original article PubMed

FAM

FAM: Fluorouracil, Adriamycin (Doxorubicin), Mitomycin

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Kim et al. 1998	1988-1991	Phase 3 (C)	FAM-P	Seems to have inferior OS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.

Preceding treatment

Gastrectomy

Chemotherapy

Fluorouracil (5-FU) 750 mg/m² IV once per day on days 1, 8, 29, 36
Doxorubicin (Adriamycin) 30 mg/m² IV once per day on days 1 & 29
Mitomycin (Mutamycin) 10 mg/m² IV once on day 1

8-week cycle for 5 cycles

References

Kim SY, Park HC, Yoon C, Yoon HJ, Choi YM, Cho KS. OK-432 and 5-fluorouracil, doxorubicin, and mitomycin C (FAM-P) versus FAM chemotherapy in patients with curatively resected gastric carcinoma: a randomized Phase III trial. Cancer. 1998 Nov 15;83(10):2054-9. link to original article contains dosing details in manuscript PubMed

Fluorouracil monotherapy

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Chang et al. 2002	1990-1993	Phase 3 (C)	1. 5-FU & Mitomycin 2. 5-FU, Doxorubicin, Mitomycin	Did not meet primary endpoint of OS
Lee et al. 2004a	1996-1999	Phase 3 (C)	PELF	Did not meet primary endpoint of DFS60

Preceding treatment

Gastrectomy

Chemotherapy

Fluorouracil (5-FU) 500 mg/m² IV once per day on days 1 to 4

21-day cycle for 6 cycles

References

Lee JJ, Kim SY, Shin IS, Cho KS, Joo HZ, Yoon C, Kim YW, Yoon HJ. Randomized phase III trial of cisplatin, epirubicin, leucovorin, 5-fluorouracil (PELF) combination versus 5-fluorouracil alone as adjuvant chemotherapy in curative resected stage III gastric cancer. Cancer Res Treat. 2004 Apr;36(2):140-5. Epub 2004 Apr 30. link to original article link to PMC article contains dosing details in manuscript PubMed
Chang HM, Jung KH, Kim TY, Kim WS, Yang HK, Lee KU, Choe KJ, Heo DS, Bang YJ, Kim NK. A phase III randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil and mitomycin C versus 5-fluorouracil alone in curatively resected gastric cancer. Ann Oncol. 2002 Nov;13(11):1779-85. link to original article PubMed

Fluorouracil & Mitomycin

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Allum et al. 1989	1976-NR	Phase 3 (E-esc)	Observation	Did not meet primary endpoint of OS
Nakazato et al. 1994	1985-1987	Phase 3 (C)	5-FU, Mitomycin, PSK	Seems to have inferior OS

Preceding treatment

Gastrectomy

Chemotherapy

Fluorouracil (5-FU) 15 mg/kg IV once on day 1
Mitomycin (Mutamycin) 0.15 mg/kg IV once on day 1

21-day cycle for up to 35 cycles (2 years)

References

Allum WH, Hallissey MT, Kelly KA; British Stomach Cancer Group. Adjuvant chemotherapy in operable gastric cancer: 5 year follow-up of first British Stomach Cancer Group trial. Lancet. 1989 Mar 18;1(8638):571-4. link to original article contains dosing details in manuscript PubMed
Nakazato H, Koike A, Saji S, Ogawa N, Sakamoto J; Study Group of Immunochemotherapy with PSK for Gastric Cancer. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Lancet. 1994 May 7;343(8906):1122-6. link to original article PubMed

Metastatic or locally advanced disease, first-line

FAM

FAM: Fluorouracil, Adriamycin (Doxorubicin), Mitomycin

Regimen variant #1, "Georgetown regimen"

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
MacDonald et al. 1979	1974-1977	Phase 2
Cullinan et al. 1985	NR	Phase 3 (C)	1. 5-FU 2. FA	Did not meet primary endpoint of OS
Wils et al. 1991	NR-1989	Phase 3 (C)	FAMTX	Inferior OS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.

Chemotherapy

Fluorouracil (5-FU) 600 mg/m² IV once per day on days 1, 8, 29, 36
Doxorubicin (Adriamycin) 30 mg/m² IV once per day on days 1 & 29
Mitomycin (Mutamycin) 10 mg/m² IV once on day 1

8-week cycles

Regimen variant #2

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Kim et al. 1993	1986-1990	Phase 3 (C)	1. 5-FU 2. FP	Did not meet endpoint of OS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.

Chemotherapy

Fluorouracil (5-FU) 800 mg/m² IV over 12 hours once per day on days 1 to 5
Doxorubicin (Adriamycin) 30 mg/m² IV once on day 1
Mitomycin (Mutamycin) 8 mg/m² IV once on day 1

4-week cycles

References

MacDonald JS, Woolley PV, Smythe T, Ueno W, Hoth D, Schein PS. 5-fluorouracil, adriamycin, and mitomycin-C (FAM) combination chemotherapy in the treatment of advanced gastric cancer. Cancer. 1979 Jul;44(1):42-7. link to original article contains dosing details in manuscript PubMed
Cullinan SA, Moertel CG, Fleming TR, Rubin JR, Krook JE, Everson LK, Windschitl HE, Twito DI, Marschke RF, Foley JF, Pfeifle DM, Barlow JF. A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma: fluorouracil vs fluorouracil and doxorubicin vs fluorouracil, doxorubicin, and mitomycin. JAMA. 1985 Apr 12;253(14):2061-7. link to original article contains dosing details in manuscript PubMed
Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, Conroy T, Fickers M, Leyvraz S, Buyse M, Duez N; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol. 1991 May;9(5):827-31. link to original article contains dosing details in manuscript PubMed
Kim NK, Park YS, Heo DS, Suh C, Kim SY, Park KC, Kang YK, Shin DB, Kim HT, Kim HJ, Kang WK, Suh CI, Bang YJ. 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 Jun 15;71(12):3813-8. link to original article contains dosing details in manuscript PubMed

FAMTX

FAMTX: Fluorouracil, Adriamycin (Doxorubicin), MTX (Methotrexate)

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Wils et al. 1991	NR-1989	Phase 3 (E-switch-ic)	FAM	Superior OS
Kelsen et al. 1992	1988-1990	Randomized (E-switch-ic)	EAP	Did not meet secondary endpoint of OS
Vanhoefer et al. 2000 (EORTC 40902)	1991-1995	Phase 3 (C)	1. ELF 2. FP	Did not meet primary endpoint of ORR
Webb et al. 1997	1992-1995	Randomized (C)	ECF	Inferior OS

Note: Vanhoefer et al. 2000 stated that cycles were repeated every 29 days which is likely a mistake.

Chemotherapy

Fluorouracil (5-FU) 1500 mg/m² IV once on day 1, given second, one hour after methotrexate
Doxorubicin (Adriamycin) 30 mg/m² IV once on day 15
Methotrexate (MTX) 1500 mg/m² IV once on day 1, given first

28-day cycles

References

Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, Conroy T, Fickers M, Leyvraz S, Buyse M, Duez N; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol. 1991 May;9(5):827-31. link to original article PubMed
Kelsen D, Atiq OT, Saltz L, Niedzwiecki D, Ginn D, Chapman D, Heelan R, Lightdale C, Vinciguerra V, Brennan M. FAMTX versus etoposide, doxorubicin, and cisplatin: a random assignment trial in gastric cancer. J Clin Oncol. 1992 Apr;10(4):541-8. link to original article PubMed
Webb A, Cunningham D, Scarffe JH, Harper P, Norman A, Joffe JK, Hughes M, Mansi J, Findlay M, Hill A, Oates J, Nicolson M, Hickish T, O'Brien M, Iveson T, Watson M, Underhill C, Wardley A, Meehan M. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol. 1997 Jan;15(1):261-7. link to original article PubMed
1. Update: Waters JS, Norman A, Cunningham D, Scarffe JH, Webb A, Harper P, Joffe JK, Mackean M, Mansi J, Leahy M, Hill A, Oates J, Rao S, Nicolson M, Hickish T. Long-term survival after epirubicin, cisplatin and fluorouracil for gastric cancer: results of a randomized trial. Br J Cancer. 1999 Apr;80(1-2):269-72. link to original article link to PMC article PubMed
EORTC 40902: Vanhoefer U, Rougier P, Wilke H, Ducreux MP, Lacave AJ, Van Cutsem E, Planker M, Santos JG, Piedbois P, Paillot B, Bodenstein H, Schmoll HJ, Bleiberg H, Nordlinger B, Couvreur ML, Baron B, Wils JA; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. 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 Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group. J Clin Oncol. 2000 Jul;18(14):2648-57. link to original article contains dosing details in manuscript PubMed

FEMTX

FEMTX: Fluorouracil, Epirubicin, MTX (Methotrexate)

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Pyrhönen et al. 1995	1986-1992	Phase 3 (E-esc)	Best supportive care	Superior OS

Chemotherapy

Fluorouracil (5-FU) 1500 mg/m² IV once on day 1, given second
Epirubicin (Ellence) 60 mg/m² IV once on day 15
Methotrexate (MTX) 1500 mg/m² IV once on day 1, given first

Supportive therapy

Leucovorin (Folinic acid) 30 mg PO once every 6 hours on days 2 & 3

28-day cycles

References

Pyrhönen 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 Mar;71(3):587-91. link to original article link to PMC article contains dosing details in manuscript PubMed

Fluorouracil & RT

5-FU & RT: 5-FluoroUracil & Radiation Therapy

Regimen

Study	Dates of enrollment	Evidence
Moertel et al. 1969	NR	Non-randomized

Chemotherapy

Fluorouracil (5-FU)

Radiotherapy

Concurrent radiation therapy

References

Moertel CG, Childs DS Jr, Reitemeier RJ, Colby MY Jr, Holbrook MA. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer. Lancet. 1969 Oct 25;2(7626):865-7. link to original article PubMed

Metastatic or locally advanced disease, subsequent lines of therapy

Apatinib monotherapy

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Kang et al. 2024 (ANGEL)	2017-03-14 to 2018-10-31	Phase 3 (E-esc)	Placebo	Did not meet primary endpoint of OS

Note: ANGEL included patients with GEJ malignancy

Targeted therapy

Apatinib (Aitan) 700 mg PO once per day on days 1 to 28

28-day cycles

References

ANGEL: Kang YK, Ryu MH, Di Bartolomeo M, Chau I, Yoon H, Kim JG, Lee KW, Oh SC, Takashima A, Kryzhanivska A, Chao Y, Evesque L, Schenker M, McGinn A, Zhao Y, Lee J, Wyrwicz L, Boku N. Rivoceranib, a VEGFR-2 inhibitor, monotherapy in previously treated patients with advanced or metastatic gastric or gastroesophageal junction cancer (ANGEL study): an international, randomized, placebo-controlled, phase 3 trial. Gastric Cancer. 2024 Mar;27(2):375-386. Epub 2024 Jan 28. link to original article link to PMC article PubMed NCT03042611

@@ Line 1: / Line 1: @@
-The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? See the [[Gastric_cancer|main gastric cancer page]] for current regimens.
+<span id="BackToTop"></span>
+<div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px">
+[[#top|Back to Top]]
+</div>
+The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the [[Gastric_cancer|main gastric cancer page]] for current regimens.
 {| class="wikitable" style="float:right; margin-right: 5px;"
 |-
-|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
+|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
-<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
+<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 |}
 {{TOC limit|limit=3}}
 =Adjuvant therapy=
 ==Doxifluridine & Mitomycin {{#subobject:958354|Regimen=1}}==
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:895ddd|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
@@ Line 22: / Line 24: @@
 |2001-2007
 |style="background-color:#1a9851"|Phase 3 (C)
-|[[#iceMFP_88|iceMFP]]
+|[[#iceMFP_888|iceMFP]]
 | style="background-color:#fc8d59" |Seems to have inferior OS
 |-
@@ Line 28: / Line 30: @@
 |2002-2006
 |style="background-color:#1a9851"|Phase 3 (C)
-|[[#MFP_99|MFP]]
+|[[#MFP_999|MFP]]
 | style="background-color:#ffffbf" |Did not meet primary endpoint of RFS36
 |-
 |}
+<div class="toccolours" style="background-color:#cbd5e8">
 ====Preceding treatment====
-*[[Surgery#Gastrectomy|Gastrectomy]]
+*[[Surgery#Gastrectomy|Gastrectomy]], 3 to 6 weeks prior
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Doxifluridine (Didox)]]
+*[[Doxifluridine (Didox)]] as follows:
-*[[Mitomycin (Mutamycin)]]
+**Cycle 2: 460 mg/m<sup>2</sup> PO once per day
+*[[Mitomycin (Mutamycin)]] as follows:
+**Cycle 1: 20 mg/m<sup>2</sup> IV once on day 1
+'''28-day course, then 3-month course'''
+</div></div>
 ===References===
-# '''AMC0201:''' Kang YK, Chang HM, Yook JH, Ryu MH, Park I, Min YJ, Zang DY, Kim GY, Yang DH, Jang SJ, Park YS, Lee JL, Kim TW, Oh ST, Park BK, Jung HY, Kim BS. Adjuvant chemotherapy for gastric cancer: a randomised phase 3 trial of mitomycin-C plus either short-term doxifluridine or long-term doxifluridine plus cisplatin after curative D2 gastrectomy (AMC0201). Br J Cancer. 2013 Apr 2;108(6):1245-51. Epub 2013 Feb 28. [https://www.nature.com/articles/bjc201386 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619263/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/23449357 PubMed] NCT00296335
+# '''AMC0201:''' Kang YK, Chang HM, Yook JH, Ryu MH, Park I, Min YJ, Zang DY, Kim GY, Yang DH, Jang SJ, Park YS, Lee JL, Kim TW, Oh ST, Park BK, Jung HY, Kim BS. Adjuvant chemotherapy for gastric cancer: a randomised phase 3 trial of mitomycin-C plus either short-term doxifluridine or long-term doxifluridine plus cisplatin after curative D2 gastrectomy (AMC0201). Br J Cancer. 2013 Apr 2;108(6):1245-51. Epub 2013 Feb 28. [https://doi.org/10.1038/bjc.2013.86 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619263/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23449357/ PubMed] [https://clinicaltrials.gov/study/NCT00296335 NCT00296335]
-# '''AMC0101:''' Kang YK, Yook JH, Chang HM, Ryu MH, Yoo C, Zang DY, Lee JL, Kim TW, Yang DH, Jang SJ, Park YS, Lee YJ, Jung HY, Kim JH, Kim BS. Enhanced efficacy of postoperative adjuvant chemotherapy in advanced gastric cancer: results from a phase 3 randomized trial (AMC0101). Cancer Chemother Pharmacol. 2014 Jan;73(1):139-49. Epub 2013 Oct 27. [https://doi.org/10.1007/s00280-013-2332-5 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24162381 PubMed] NCT00296322
+# '''AMC0101:''' Kang YK, Yook JH, Chang HM, Ryu MH, Yoo C, Zang DY, Lee JL, Kim TW, Yang DH, Jang SJ, Park YS, Lee YJ, Jung HY, Kim JH, Kim BS. Enhanced efficacy of postoperative adjuvant chemotherapy in advanced gastric cancer: results from a phase 3 randomized trial (AMC0101). Cancer Chemother Pharmacol. 2014 Jan;73(1):139-49. Epub 2013 Oct 27. [https://doi.org/10.1007/s00280-013-2332-5 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24162381/ PubMed] [https://clinicaltrials.gov/study/NCT00296322 NCT00296322]
 ==FA {{#subobject:9a8ca4|Regimen=1}}==
 FA: '''<u>F</u>'''luorouracil & '''<u>A</u>'''driamycin (Doxorubicin)
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:89ccc3|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
@@ Line 57: / Line 64: @@
 |NR
 |style="background-color:#1a9851"|Randomized (C)
-|[[#FA_.26_poly_A-U_88|FA & poly A:U]]
+|[[#FA_.26_poly_A-U_888|FA & poly A:U]]
 | style="background-color:#fc8d59" |Seems to have inferior OS
 |-
 |}
 ''Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.''
+<div class="toccolours" style="background-color:#cbd5e8">
 ====Preceding treatment====
 *[[Surgery#Gastrectomy|Gastrectomy]]
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
+*[[Fluorouracil (5-FU)]] 12 mg/kg IV once per day on days 1, 8, 15
+*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once on day 1
+'''21-day cycles'''
+</div></div>
+===References===
+# Youn JK, Kim BS, Min JS, Lee KS, Choi HJ, Lee YB, Lee DW, Park IS, Roh JK, Chung JB, Koh EH, Park YJ, Kim HI, Lee JB. Adjuvant treatment of operable stomach cancer with polyadenylic-polyuridylic acid in addition to chemotherapeutic agents: a preliminary report. Int J Immunopharmacol. 1990;12(3):289-95. [https://doi.org/10.1016/0192-0561(90)90084-z link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/2184135/ PubMed]
+## '''Update:''' Jeung HC, Moon YW, Rha SY, Yoo NC, Roh JK, Noh SH, Min JS, Kim BS, Chung HC. Phase III trial of adjuvant 5-fluorouracil and adriamycin versus 5-fluorouracil, adriamycin, and polyadenylic-polyuridylic acid (poly A:U) for locally advanced gastric cancer after curative surgery: final results of 15-year follow-up. Ann Oncol. 2008 Mar;19(3):520-6. Epub 2007 Nov 20. [https://doi.org/10.1093/annonc/mdm536 link to original article] [https://pubmed.ncbi.nlm.nih.gov/18029971/ PubMed]
+==FAM {{#subobject:5a147b|Regimen=1}}==
+FAM: '''<u>F</u>'''luorouracil, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>M</u>'''itomycin
+<div class="toccolours" style="background-color:#ee6b6e">
+===Regimen {{#subobject:6ecb8e|Variant=1}}===
+{| class="wikitable sortable" style="width: 100%; text-align:center;"
+!style="width: 20%"|Study
+!style="width: 20%"|Dates of enrollment
+!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 20%"|Comparator
+!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+|-
+|[https://doi.org/10.1002/%28SICI)1097-0142%2819981115%2983%3A10%3C2054%3A%3AAID-CNCR2%3E3.0.CO%3B2-1 Kim et al. 1998]
+|1988-1991
+| style="background-color:#1a9851" |Phase 3 (C)
+|[[#FAM-P_888|FAM-P]]
+| style="background-color:#fc8d59" |Seems to have inferior OS
+|-
+|}
+''Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.''
+<div class="toccolours" style="background-color:#cbd5e8">
+====Preceding treatment====
+*[[Surgery#Gastrectomy|Gastrectomy]]
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Fluorouracil (5-FU)]]
+*[[Fluorouracil (5-FU)]] 750 mg/m<sup>2</sup> IV once per day on days 1, 8, 29, 36
-*[[Doxorubicin (Adriamycin)]]
+*[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once per day on days 1 & 29
+*[[Mitomycin (Mutamycin)]] 10 mg/m<sup>2</sup> IV once on day 1
+'''8-week cycle for 5 cycles'''
+</div></div>
 ===References===
-# Youn JK, Kim BS, Min JS, Lee KS, Choi HJ, Lee YB, Lee DW, Park IS, Roh JK, Chung JB, Koh EH, Park YJ, Kim HI, Lee JB. Adjuvant treatment of operable stomach cancer with polyadenylic-polyuridylic acid in addition to chemotherapeutic agents: a preliminary report. Int J Immunopharmacol. 1990;12(3):289-95. [https://doi.org/10.1016/0192-0561(90)90084-z link to original article] [https://pubmed.ncbi.nlm.nih.gov/2184135 PubMed]
+# Kim SY, Park HC, Yoon C, Yoon HJ, Choi YM, Cho KS. OK-432 and 5-fluorouracil, doxorubicin, and mitomycin C (FAM-P) versus FAM chemotherapy in patients with curatively resected gastric carcinoma: a randomized Phase III trial. Cancer. 1998 Nov 15;83(10):2054-9. [https://doi.org/10.1002/%28SICI)1097-0142%2819981115%2983%3A10%3C2054%3A%3AAID-CNCR2%3E3.0.CO%3B2-1 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/9827708/ PubMed]
-## '''Update:''' Jeung HC, Moon YW, Rha SY, Yoo NC, Roh JK, Noh SH, Min JS, Kim BS, Chung HC. Phase III trial of adjuvant 5-fluorouracil and adriamycin versus 5-fluorouracil, adriamycin, and polyadenylic-polyuridylic acid (poly A:U) for locally advanced gastric cancer after curative surgery: final results of 15-year follow-up. Ann Oncol. 2008 Mar;19(3):520-6. Epub 2007 Nov 20. [https://doi.org/10.1093/annonc/mdm536 link to original article] [https://pubmed.ncbi.nlm.nih.gov/18029971 PubMed]
 ==Fluorouracil monotherapy {{#subobject:7b6f1c|Regimen=1}}==
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:da7bba|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
@@ Line 86: / Line 129: @@
 |1990-1993
 | style="background-color:#1a9851" |Phase 3 (C)
-|1. [[#Fluorouracil_.26_Mitomycin|5-FU & Mitomycin]]<br> 2. [[#Doxorubicin.2C_Fluorouracil.2C_Mitomycin_99|5-FU, Doxorubicin, Mitomycin]]
+|1. [[#Fluorouracil_.26_Mitomycin|5-FU & Mitomycin]]<br>2. [[#Doxorubicin.2C_Fluorouracil.2C_Mitomycin_999|5-FU, Doxorubicin, Mitomycin]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 |-
 |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855100/ Lee et al. 2004a]
@@ Line 93: / Line 136: @@
 | style="background-color:#1a9851" |Phase 3 (C)
 |[[Stub#PELF|PELF]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet primary endpoint of DFS60
 |-
 |}
+<div class="toccolours" style="background-color:#cbd5e8">
 ====Preceding treatment====
 *[[Surgery#Gastrectomy|Gastrectomy]]
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Fluorouracil (5-FU)]]
+*[[Fluorouracil (5-FU)]] 500 mg/m<sup>2</sup> IV once per day on days 1 to 4
+'''21-day cycle for 6 cycles'''
+</div></div>
 ===References===
-# Lee JJ, Kim SY, Shin IS, Cho KS, Joo HZ, Yoon C, Kim YW, Yoon HJ. Randomized phase III trial of cisplatin, epirubicin, leucovorin, 5-fluorouracil (PELF) combination versus 5-fluorouracil alone as adjuvant chemotherapy in curative resected stage III gastric cancer. Cancer Res Treat. 2004 Apr;36(2):140-5. Epub 2004 Apr 30. [https://doi.org/10.4143/crt.2004.36.2.140 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855100/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20396554 PubMed]
+# Lee JJ, Kim SY, Shin IS, Cho KS, Joo HZ, Yoon C, Kim YW, Yoon HJ. Randomized phase III trial of cisplatin, epirubicin, leucovorin, 5-fluorouracil (PELF) combination versus 5-fluorouracil alone as adjuvant chemotherapy in curative resected stage III gastric cancer. Cancer Res Treat. 2004 Apr;36(2):140-5. Epub 2004 Apr 30. [https://doi.org/10.4143/crt.2004.36.2.140 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855100/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/20396554/ PubMed]
-# Chang HM, Jung KH, Kim TY, Kim WS, Yang HK, Lee KU, Choe KJ, Heo DS, Bang YJ, Kim NK. A phase III randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil and mitomycin C versus 5-fluorouracil alone in curatively resected gastric cancer. Ann Oncol. 2002 Nov;13(11):1779-85. [https://doi.org/10.1093/annonc/mdf302 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12419751 PubMed]
+# Chang HM, Jung KH, Kim TY, Kim WS, Yang HK, Lee KU, Choe KJ, Heo DS, Bang YJ, Kim NK. A phase III randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil and mitomycin C versus 5-fluorouracil alone in curatively resected gastric cancer. Ann Oncol. 2002 Nov;13(11):1779-85. [https://doi.org/10.1093/annonc/mdf302 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12419751/ PubMed]
 ==Fluorouracil & Mitomycin {{#subobject:958354|Regimen=1}}==
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:895ddd|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
@@ Line 119: / Line 166: @@
 | style="background-color:#1a9851" |Phase 3 (E-esc)
 |[[Gastric_cancer_-_null_regimens#Observation|Observation]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 |-
-|[https://doi.org/10.1016/S014067369490233X Nakazato et al. 1994]
+|[https://doi.org/10.1016/s0140-6736(94)90233-x Nakazato et al. 1994]
 |1985-1987
 |style="background-color:#1a9851"|Phase 3 (C)
-|[[#Fluorouracil.2C_Mitomycin.2C_PSK_77|5-FU, Mitomycin, PSK]]
+|[[#Fluorouracil.2C_Mitomycin.2C_PSK_777|5-FU, Mitomycin, PSK]]
 | style="background-color:#fc8d59" |Seems to have inferior OS
 |-
 |}
+<div class="toccolours" style="background-color:#cbd5e8">
 ====Preceding treatment====
 *[[Surgery#Gastrectomy|Gastrectomy]]
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Fluorouracil (5-FU)]]
+*[[Fluorouracil (5-FU)]] 15 mg/kg IV once on day 1
-*[[Mitomycin (Mutamycin)]]
+*[[Mitomycin (Mutamycin)]] 0.15 mg/kg IV once on day 1
+'''21-day cycle for up to 35 cycles (2 years)'''
+</div></div>
 ===References===
-# Allum WH, Hallissey MT, Kelly KA; British Stomach Cancer Group. Adjuvant chemotherapy in operable gastric cancer: 5 year follow-up of first British Stomach Cancer Group trial. Lancet. 1989 Mar 18;1(8638):571-4. [https://doi.org/10.1016/S0140-6736(89)91607-3 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2564109 PubMed]
+# Allum WH, Hallissey MT, Kelly KA; British Stomach Cancer Group. Adjuvant chemotherapy in operable gastric cancer: 5 year follow-up of first British Stomach Cancer Group trial. Lancet. 1989 Mar 18;1(8638):571-4. [https://doi.org/10.1016/S0140-6736(89)91607-3 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/2564109/ PubMed]
-# Nakazato H, Koike A, Saji S, Ogawa N, Sakamoto J; Study Group of Immunochemotherapy with PSK for Gastric Cancer. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Lancet. 1994 May 7;343(8906):1122-6. [https://doi.org/10.1016/S014067369490233X link to original article] [https://pubmed.ncbi.nlm.nih.gov/7910230 PubMed]
+# Nakazato H, Koike A, Saji S, Ogawa N, Sakamoto J; Study Group of Immunochemotherapy with PSK for Gastric Cancer. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Lancet. 1994 May 7;343(8906):1122-6. [https://doi.org/10.1016/s0140-6736(94)90233-x link to original article] [https://pubmed.ncbi.nlm.nih.gov/7910230/ PubMed]
 =Metastatic or locally advanced disease, first-line=
 ==FAM {{#subobject:5a147b|Regimen=1}}==
 FAM: '''<u>F</u>'''luorouracil, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>M</u>'''itomycin
-===Regimen {{#subobject:6ecb8e|Variant=1}}===
+<div class="toccolours" style="background-color:#ee6b6e">
+===Regimen variant #1, "Georgetown regimen" {{#subobject:6ecb8e|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
 !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
-|[https://doi.org/10.1002/1097-0142(197907)44:1<42::AID-CNCR2820440108%3E3.0.CO;2-X MacDonald et al. 1979]
+|[https://doi.org/10.1002/1097-0142(197907)44:1%3C42::AID-CNCR2820440108%3E3.0.CO;2-X MacDonald et al. 1979]
 |1974-1977
 | style="background-color:#91cf61" |Phase 2
@@ Line 157: / Line 207: @@
 | style="background-color:#d3d3d3" |
 |-
-|[https://jamanetwork.com/journals/jama/fullarticle/397816 Cullinan et al. 1985]
+|[https://doi.org/10.1001/jama.1985.03350380077025 Cullinan et al. 1985]
 |NR
 | style="background-color:#1a9851" |Phase 3 (C)
-|1. [[Gastric_cancer#Fluorouracil_monotherapy|5-FU]]<br> 2. [[Stub#FA|FA]]
+|1. [[Gastric_cancer#Fluorouracil_monotherapy|5-FU]]<br>2. [[Stub#FA|FA]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 |-
 |[https://doi.org/10.1200/JCO.1991.9.5.827 Wils et al. 1991]
@@ Line 169: / Line 219: @@
 | style="background-color:#d73027" |Inferior OS
 |-
-|[https://doi.org/10.1002/1097-0142%2819930615%2971%3A12%3C3813%3A%3AAID-CNCR2820711205>3.0.CO%3B2-5 Kim et al. 1993]
+|}
+''Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.''
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
+*[[Fluorouracil (5-FU)]] 600 mg/m<sup>2</sup> IV once per day on days 1, 8, 29, 36
+*[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once per day on days 1 & 29
+*[[Mitomycin (Mutamycin)]] 10 mg/m<sup>2</sup> IV once on day 1
+'''8-week cycles'''
+</div></div><br>
+<div class="toccolours" style="background-color:#ee6b6e">
+===Regimen variant #2 {{#subobject:6ecjr3|Variant=1}}===
+{| class="wikitable sortable" style="width: 100%; text-align:center;"
+!style="width: 20%"|Study
+!style="width: 20%"|Dates of enrollment
+!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 20%"|Comparator
+!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+|-
+|[https://doi.org/10.1002/1097-0142%2819930615%2971%3A12%3C3813%3A%3AAID-CNCR2820711205%3E3.0.CO%3B2-5 Kim et al. 1993]
 |1986-1990
 | style="background-color:#1a9851" |Phase 3 (C)
-|1. [[Gastric_cancer#Fluorouracil_monotherapy|5-FU]]<br> 2. [[Gastric_cancer#Cisplatin_.26_Fluorouracil_.28CF.29_3|FP]]
+|1. [[Gastric_cancer#Fluorouracil_monotherapy|5-FU]]<br>2. [[Gastric_cancer#Cisplatin_.26_Fluorouracil_.28CF.29_3|FP]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet endpoint of OS
-|-
-|[https://doi.org/full/10.1002/%28SICI)1097-0142%2819981115%2983%3A10<2054%3A%3AAID-CNCR2>3.0.CO%3B2-1 Kim et al. 1998]
-|1988-1991
-| style="background-color:#1a9851" |Phase 3 (C)
-|[[#FAM-P_88|FAM-P]]
-| style="background-color:#fc8d59" |Seems to have inferior OS
 |-
 |}
 ''Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Fluorouracil (5-FU)]]
+*[[Fluorouracil (5-FU)]] 800 mg/m<sup>2</sup> IV over 12 hours once per day on days 1 to 5
-*[[Doxorubicin (Adriamycin)]]
+*[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once on day 1
-*[[Mitomycin (Mutamycin)]]
+*[[Mitomycin (Mutamycin)]] 8 mg/m<sup>2</sup> IV once on day 1
+'''4-week cycles'''
+</div></div>
 ===References===
-# MacDonald JS, Woolley PV, Smythe T, Ueno W, Hoth D, Schein PS. 5-fluorouracil, adriamycin, and mitomycin-C (FAM) combination chemotherapy in the treatment of advanced gastric cancer. Cancer. 1979 Jul;44(1):42-7. [https://doi.org/10.1002/1097-0142(197907)44:1<42::AID-CNCR2820440108%3E3.0.CO;2-X link to original article] [https://pubmed.ncbi.nlm.nih.gov/455263 PubMed]
+# MacDonald JS, Woolley PV, Smythe T, Ueno W, Hoth D, Schein PS. 5-fluorouracil, adriamycin, and mitomycin-C (FAM) combination chemotherapy in the treatment of advanced gastric cancer. Cancer. 1979 Jul;44(1):42-7. [https://doi.org/10.1002/1097-0142(197907)44:1%3C42::AID-CNCR2820440108%3E3.0.CO;2-X link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/455263/ PubMed]
-# Cullinan SA, Moertel CG, Fleming TR, Rubin JR, Krook JE, Everson LK, Windschitl HE, Twito DI, Marschke RF, Foley JF, Pfeifle DM, Barlow JF. A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma: fluorouracil vs fluorouracil and doxorubicin vs fluorouracil, doxorubicin, and mitomycin. JAMA. 1985 Apr 12;253(14):2061-7. [https://jamanetwork.com/journals/jama/fullarticle/397816 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2579257 PubMed]
+# Cullinan SA, Moertel CG, Fleming TR, Rubin JR, Krook JE, Everson LK, Windschitl HE, Twito DI, Marschke RF, Foley JF, Pfeifle DM, Barlow JF. A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma: fluorouracil vs fluorouracil and doxorubicin vs fluorouracil, doxorubicin, and mitomycin. JAMA. 1985 Apr 12;253(14):2061-7. [https://doi.org/10.1001/jama.1985.03350380077025 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/2579257/ PubMed]
-# Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, Conroy T, Fickers M, Leyvraz S, Buyse M, Duez N; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol. 1991 May;9(5):827-31. [https://doi.org/10.1200/JCO.1991.9.5.827 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2016625 PubMed]
+# Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, Conroy T, Fickers M, Leyvraz S, Buyse M, Duez N; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol. 1991 May;9(5):827-31. [https://doi.org/10.1200/JCO.1991.9.5.827 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/2016625/ PubMed]
-# Kim NK, Park YS, Heo DS, Suh C, Kim SY, Park KC, Kang YK, Shin DB, Kim HT, Kim HJ, Kang WK, Suh CI, Bang YJ. 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 Jun 15;71(12):3813-8. [https://doi.org/10.1002/1097-0142%2819930615%2971%3A12%3C3813%3A%3AAID-CNCR2820711205>3.0.CO%3B2-5 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8508349 PubMed]
+# Kim NK, Park YS, Heo DS, Suh C, Kim SY, Park KC, Kang YK, Shin DB, Kim HT, Kim HJ, Kang WK, Suh CI, Bang YJ. 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 Jun 15;71(12):3813-8. [https://doi.org/10.1002/1097-0142%2819930615%2971%3A12%3C3813%3A%3AAID-CNCR2820711205%3E3.0.CO%3B2-5 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/8508349/ PubMed]
-# Kim SY, Park HC, Yoon C, Yoon HJ, Choi YM, Cho KS. OK-432 and 5-fluorouracil, doxorubicin, and mitomycin C (FAM-P) versus FAM chemotherapy in patients with curatively resected gastric carcinoma: a randomized Phase III trial. Cancer. 1998 Nov 15;83(10):2054-9. [https://doi.org/full/10.1002/%28SICI)1097-0142%2819981115%2983%3A10<2054%3A%3AAID-CNCR2>3.0.CO%3B2-1 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9827708 PubMed]
 ==FAMTX {{#subobject:53382f|Regimen=1}}==
 FAMTX: '''<u>F</u>'''luorouracil, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>MTX</u>''' (Methotrexate)
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:1f4ecf|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
@@ Line 216: / Line 279: @@
 | style="background-color:#1a9851" |Randomized (E-switch-ic)
 |[[Stub#EAP|EAP]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet secondary endpoint of OS
 |-
 |[https://doi.org/10.1200/JCO.2000.18.14.2648 Vanhoefer et al. 2000 (EORTC 40902)]
 |1991-1995
 | style="background-color:#1a9851" |Phase 3 (C)
-|1. [[Stub#ELF|ELF]]<br> 2. [[Gastric_cancer#Cisplatin_.26_Fluorouracil_.28CF.29_3|FP]]
+|1. [[Stub#ELF|ELF]]<br>2. [[Gastric_cancer#Cisplatin_.26_Fluorouracil_.28CF.29_3|FP]]
-| style="background-color:#ffffbf" |Seems not superior
+| style="background-color:#ffffbf" |Did not meet primary endpoint of ORR
 |-
 |[https://doi.org/10.1200/JCO.1997.15.1.261 Webb et al. 1997]
@@ Line 231: / Line 294: @@
 |-
 |}
+''Note: Vanhoefer et al. 2000 stated that cycles were repeated every 29 days which is likely a mistake.''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Fluorouracil (5-FU)]]
+*[[Fluorouracil (5-FU)]] 1500 mg/m<sup>2</sup> IV once on day 1, '''given second, one hour after methotrexate'''
-*[[Doxorubicin (Adriamycin)]]
+*[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once on day 15
-*[[Methotrexate (MTX)]]
+*[[Methotrexate (MTX)]] 1500 mg/m<sup>2</sup> IV once on day 1, '''given first'''
+'''28-day cycles'''
+</div></div>
 ===References===
-# Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, Conroy T, Fickers M, Leyvraz S, Buyse M, Duez N; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol. 1991 May;9(5):827-31. [https://doi.org/10.1200/JCO.1991.9.5.827 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2016625 PubMed]
+# Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, Conroy T, Fickers M, Leyvraz S, Buyse M, Duez N; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin--a step ahead in the treatment of advanced gastric cancer: a trial of the European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. J Clin Oncol. 1991 May;9(5):827-31. [https://doi.org/10.1200/JCO.1991.9.5.827 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2016625/ PubMed]
-# Kelsen D, Atiq OT, Saltz L, Niedzwiecki D, Ginn D, Chapman D, Heelan R, Lightdale C, Vinciguerra V, Brennan M. FAMTX versus etoposide, doxorubicin, and cisplatin: a random assignment trial in gastric cancer. J Clin Oncol. 1992 Apr;10(4):541-8. [https://doi.org/10.1200/JCO.1992.10.4.541 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1548519 PubMed]
+# Kelsen D, Atiq OT, Saltz L, Niedzwiecki D, Ginn D, Chapman D, Heelan R, Lightdale C, Vinciguerra V, Brennan M. FAMTX versus etoposide, doxorubicin, and cisplatin: a random assignment trial in gastric cancer. J Clin Oncol. 1992 Apr;10(4):541-8. [https://doi.org/10.1200/JCO.1992.10.4.541 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1548519/ PubMed]
-# Webb A, Cunningham D, Scarffe JH, Harper P, Norman A, Joffe JK, Hughes M, Mansi J, Findlay M, Hill A, Oates J, Nicolson M, Hickish T, O'Brien M, Iveson T, Watson M, Underhill C, Wardley A, Meehan M. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol. 1997 Jan;15(1):261-7. [https://doi.org/10.1200/JCO.1997.15.1.261 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8996151 PubMed]
+# Webb A, Cunningham D, Scarffe JH, Harper P, Norman A, Joffe JK, Hughes M, Mansi J, Findlay M, Hill A, Oates J, Nicolson M, Hickish T, O'Brien M, Iveson T, Watson M, Underhill C, Wardley A, Meehan M. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol. 1997 Jan;15(1):261-7. [https://doi.org/10.1200/JCO.1997.15.1.261 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8996151/ PubMed]
-## '''Update:''' Waters JS, Norman A, Cunningham D, Scarffe JH, Webb A, Harper P, Joffe JK, Mackean M, Mansi J, Leahy M, Hill A, Oates J, Rao S, Nicolson M, Hickish T. Long-term survival after epirubicin, cisplatin and fluorouracil for gastric cancer: results of a randomized trial. Br J Cancer. 1999 Apr;80(1-2):269-72. [https://www.nature.com/articles/6690350 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363002/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/10390007 PubMed]
+## '''Update:''' Waters JS, Norman A, Cunningham D, Scarffe JH, Webb A, Harper P, Joffe JK, Mackean M, Mansi J, Leahy M, Hill A, Oates J, Rao S, Nicolson M, Hickish T. Long-term survival after epirubicin, cisplatin and fluorouracil for gastric cancer: results of a randomized trial. Br J Cancer. 1999 Apr;80(1-2):269-72. [https://doi.org/10.1038/sj.bjc.6690350 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363002/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/10390007/ PubMed]
-# '''EORTC 40902:''' Vanhoefer U, Rougier P, Wilke H, Ducreux MP, Lacave AJ, Van Cutsem E, Planker M, Santos JG, Piedbois P, Paillot B, Bodenstein H, Schmoll HJ, Bleiberg H, Nordlinger B, Couvreur ML, Baron B, Wils JA; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. 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 Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group. J Clin Oncol. 2000 Jul;18(14):2648-57. [https://doi.org/10.1200/JCO.2000.18.14.2648 link to original article] [https://pubmed.ncbi.nlm.nih.gov/10894863 PubMed]
+# '''EORTC 40902:''' Vanhoefer U, Rougier P, Wilke H, Ducreux MP, Lacave AJ, Van Cutsem E, Planker M, Santos JG, Piedbois P, Paillot B, Bodenstein H, Schmoll HJ, Bleiberg H, Nordlinger B, Couvreur ML, Baron B, Wils JA; European Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cooperative Group. 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 Organisation for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group. J Clin Oncol. 2000 Jul;18(14):2648-57. [https://doi.org/10.1200/JCO.2000.18.14.2648 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/10894863/ PubMed]
 ==FEMTX {{#subobject:412e7b|Regimen=1}}==
 FEMTX: '''<u>F</u>'''luorouracil, '''<u>E</u>'''pirubicin, '''<u>MTX</u>''' (Methotrexate)
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:700bc8|Variant=1}}===
 {| class="wikitable sortable" style="width: 100%; text-align:center;"
 !style="width: 20%"|Study
-!style="width: 20%"|Years of enrollment
+!style="width: 20%"|Dates of enrollment
 !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 !style="width: 20%"|Comparator
@@ Line 261: / Line 327: @@
 |-
 |}
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
-*[[Fluorouracil (5-FU)]]
+*[[Fluorouracil (5-FU)]] 1500 mg/m<sup>2</sup> IV once on day 1, '''given second'''
-*[[Epirubicin (Ellence)]]
+*[[Epirubicin (Ellence)]] 60 mg/m<sup>2</sup> IV once on day 15
-*[[Methotrexate (MTX)]]
+*[[Methotrexate (MTX)]] 1500 mg/m<sup>2</sup> IV once on day 1, '''given first'''
+====Supportive therapy====
+*[[Leucovorin (Folinic acid)]] 30 mg PO once every 6 hours on days 2 & 3
+'''28-day cycles'''
+</div></div>
 ===References===
-# Pyrhönen 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 Mar;71(3):587-91. [https://www.nature.com/articles/bjc1995114 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2033628/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/7533517 PubMed]
+# Pyrhönen 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 Mar;71(3):587-91. [https://doi.org/10.1038/bjc.1995.114 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2033628/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7533517/ PubMed]
 ==Fluorouracil & RT {{#subobject:52e768|Regimen=1}}==
 -FU & RT: '''<u>5-F</u>'''luoro'''<u>U</u>'''racil & '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#ee6b6e">
 ===Regimen {{#subobject:f8576f|Variant=1}}===
-{| class="wikitable" style="width: 40%; text-align:center;"
+{| class="wikitable sortable" style="width: 60%; text-align:center;"
-!style="width: 25%"|Study
+!style="width: 33%"|Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|Dates of enrollment
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 |-
 |[https://doi.org/10.1016/S0140-6736(69)92326-5 Moertel et al. 1969]
+|NR
 | style="background-color:#91cf61" |Non-randomized
 |-
 |}
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
 *[[Fluorouracil (5-FU)]]
 ====Radiotherapy====
 *Concurrent [[External_beam_radiotherapy|radiation therapy]]
+</div></div>
+===References===
+# Moertel CG, Childs DS Jr, Reitemeier RJ, Colby MY Jr, Holbrook MA. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer. Lancet. 1969 Oct 25;2(7626):865-7. [https://doi.org/10.1016/S0140-6736(69)92326-5 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4186452/ PubMed]
+=Metastatic or locally advanced disease, subsequent lines of therapy=
+==Apatinib monotherapy {{#subobject:ao594c|Regimen=1}}==
+<div class="toccolours" style="background-color:#eeeeee">
+===Regimen {{#subobject:913ap2|Variant=1}}===
+{| class="wikitable sortable" style="width: 100%; text-align:center;"
+! style="width: 20%" |Study
+! style="width: 20%" |Dates of enrollment
+! style="width: 20%" |[[Levels_of_Evidence#Evidence|Evidence]]
+! style="width: 20%" |Comparator
+! style="width: 20%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+|-
+|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc10896803/ Kang et al. 2024 (ANGEL)]
+|2017-03-14 to 2018-10-31
+| style="background-color:#1a9851" |Phase 3 (E-esc)
+|[[Gastric cancer_-_null_regimens#Placebo|Placebo]]
+| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
+|-
+|}
+''Note: ANGEL included patients with GEJ malignancy''
+<div class="toccolours" style="background-color:#b3e2cd">
+====Targeted therapy====
+*[[Apatinib (Aitan)]] 700 mg PO once per day on days 1 to 28
+'''28-day cycles'''
+</div></div>
 ===References===
-# Moertel CG, Childs DS Jr, Reitemeier RJ, Colby MY Jr, Holbrook MA. Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal cancer. Lancet. 1969 Oct 25;2(7626):865-7. [https://doi.org/10.1016/S0140-6736(69)92326-5 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4186452 PubMed]
+#'''ANGEL:''' Kang YK, Ryu MH, Di Bartolomeo M, Chau I, Yoon H, Kim JG, Lee KW, Oh SC, Takashima A, Kryzhanivska A, Chao Y, Evesque L, Schenker M, McGinn A, Zhao Y, Lee J, Wyrwicz L, Boku N. Rivoceranib, a VEGFR-2 inhibitor, monotherapy in previously treated patients with advanced or metastatic gastric or gastroesophageal junction cancer (ANGEL study): an international, randomized, placebo-controlled, phase 3 trial. Gastric Cancer. 2024 Mar;27(2):375-386. Epub 2024 Jan 28. [https://doi.org/10.1007/s10120-023-01455-5 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc10896803/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/38281295/ PubMed] [https://clinicaltrials.gov/study/NCT03042611 NCT03042611]
 [[Category:Gastric cancer regimens]]

Difference between revisions of "Gastric cancer - historical"

Latest revision as of 17:36, 28 June 2024

Adjuvant therapy

Doxifluridine & Mitomycin

Regimen

Preceding treatment

Chemotherapy

References

FA

Regimen

Preceding treatment

Chemotherapy

References

FAM

Regimen

Preceding treatment

Chemotherapy

References

Fluorouracil monotherapy

Regimen

Preceding treatment

Chemotherapy

References

Fluorouracil & Mitomycin

Regimen

Preceding treatment

Chemotherapy

References

Metastatic or locally advanced disease, first-line

FAM

Regimen variant #1, "Georgetown regimen"

Chemotherapy

Regimen variant #2

Chemotherapy

References

FAMTX

Regimen

Chemotherapy

References

FEMTX

Regimen

Chemotherapy

Supportive therapy

References

Fluorouracil & RT

Regimen

Chemotherapy

Radiotherapy

References

Metastatic or locally advanced disease, subsequent lines of therapy

Apatinib monotherapy

Regimen

Targeted therapy

References

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