Gastric cancer - historical

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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

7 regimens on this page
7 variants on this page


Adjuvant therapy

Doxifluridine & Mitomycin

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Regimen

Study Evidence Comparator Comparative Efficacy
Kang et al. 2013 (AMC0201) Phase III (C) MFP Seems not superior
Kang et al. 2013 (AMC0101) Phase III (C) iceMFP Seems to have inferior OS

Preceding treatment

Chemotherapy

References

  1. 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 PubMed
  2. 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

Doxorubicin & Fluorouracil

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FA: Fluorouracil & Adriamycin (Doxorubicin)

Regimen

Study Evidence Comparator Comparative Efficacy
Youn et al. 1990 Phase III (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 prior to becoming a standard comparator arm.

Preceding treatment

Chemotherapy

References

  1. 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 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

Fluorouracil monotherapy

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Regimen

Study Evidence Comparator Comparative Efficacy
Chang et al. 2002 Phase III (C) 1. 5-FU & Mitomycin
2. 5-FU, Doxorubicin, Mitomycin
Seems not superior
Lee et al. 2004a Phase III (C) PELF Seems not superior

Preceding treatment

Chemotherapy

References

  1. 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 PubMed
  2. 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

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Regimen

Study Evidence Comparator Comparative Efficacy
Allum et al. 1989 Phase III (E-esc) Observation Seems not superior
Nakazato et al. 1994 Phase III (C) 5-FU, Mitomycin, PSK Seems to have inferior OS

Preceding treatment

Chemotherapy

References

  1. 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 PubMed
  2. 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

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FAM: Fluorouracil, Adriamycin (Doxorubicin), Mitomycin

Regimen

Study Evidence Comparator Comparative Efficacy
MacDonald et al. 1979 Phase II
Cullinan et al. 1985 Phase III (C) 1. 5-FU
2. FA
Seems not superior
Wils et al. 1991 Phase III (C) FAMTX Inferior OS
Kim et al. 1993 Phase III (C) 1. 5-FU
2. FP
Seems not superior
Kim et al. 1998 Phase III (C) FAM-P Seems to have inferior OS

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

Chemotherapy

References

  1. 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 PubMed
  2. 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 PubMed
  3. 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
  4. 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 PubMed
  5. 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 PubMed

FAMTX

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

Regimen

Study Evidence Comparator Comparative Efficacy
Wils et al. 1991 Phase III (E-switch-ic) FAM Superior OS
Kelsen et al. 1992 Phase III (E-switch-ic) EAP Seems not superior
Webb et al. 1997 Phase III (C) ECF Inferior OS
Vanhoefer et al. 2000 (EORTC 40902) Phase III (C) 1. ELF
2. FUP
Seems not superior

Chemotherapy

References

  1. 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
  2. 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
  3. 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
  4. 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 PubMed

FEMTX

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FEMTX: Fluorouracil, Epirubicin, MTX (Methotrexate)

Regimen

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

Chemotherapy

References

  1. 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 PubMed

Fluorouracil & RT

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

Regimen

Study Evidence
Moertel et al. 1969 Non-randomized

Chemotherapy

Radiotherapy

References

  1. 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