Abstract
The Gastrointestinal Oncology Study Group of Japan Clinical Oncology Group (GIOSG/JCOG) has conducted several clinical trials to establish standard chemotherapy for unresectable or recurrent gastric cancer. From the late 1980s to early 1990s, two phase II studies by JCOG evaluated oral fluoropyrimidines, and others introduced Western chemotherapy regimens. Thereafter, the first phase III study (JCOG9205), comparing 5-fluorouracil (5-FU), 5-FU plus ciplatin (CDDP) (FP), and uracil and tegafur (UFT) plus mitomycin (UFTM), could not show a survival benefit of either FP or UFTM over 5-FU alone. In the late 1990s, new active agents such as irinotecan (CPT-11) and S-1 (new oral fluoropyrimidine) showed promising results in their phase II trials. The latest phase III study (JCOG9912), comparing 5-FU, CPT-11 plus CDDP, and S-1, showed significant noninferiority of S-1 to 5-FU in overall survival, associated with a better response rate and progression-free survival and acceptable toxicities, and concluded that S-1 should be considered for the standard chemotherapy of unresectable or recurrent gastric cancer. Simultaneously, another Japanese phase III trial comparing S-1 with S-1 plus CDDP showed a survival benefit of S-1 plus CDDP. At present, S-1 plus CDDP is recognized as standard chemotherapy for unresectable or recurrent gastric cancer, and new treatment with molecular target agents is under development.
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Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150
Murad AM, Santiago FF, Petroianu A, et al. (1993) Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer (Phila) 72:37–41
Glimelius B, Hotfmann K, Haglund U, et al. (1994) Initial or delayed chemotherapy with best supportive care in advanced gastric cancer. Ann Oncol 5:189–190
Pyrhonen S, Kuitumen T, Nyandoto P, et al. (1995) Randomized comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus best supportive care alone in patients with nonresectable gastric cancer. Br J Cancer 71:587–591
Cullinan SA, Moertel CG, Fleming TR, et al. (1985) A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma. Fluorouracil versus fluorouracil and doxorubicin versus fluorouracil, doxorubicin, and mitomycin. JAMA 253:2061–2067
Wils O, Klein HO, Wagener DJT, et al. (1991) Sequential high-dose methotrexate and fluorouracil, combined with doxorubicin: a step ahead in the treatment of gastric cancer. A trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Co-operative Group. J Clin Oncol 9:827–831
Kelsen D, Atiq OT, Saltz L, et al. (1992) FAMTX versus etoposide, doxorubicin and cisplatin: a randomized trial in gastric cancer. J Clin Oncol 10:541–548
Kim NK, Park YS, Heo DS, et al. (1993) 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 (Phila) 71:3813–3818
Cullinan SA, Moertel CG, Wieand H, et al. (1994) Controlled evaluation of three drug combination regimen versus fluorouracil alone in the therapy of advanced gastric cancer. J Clin Oncol 12:412–416
Cocconi G, Carlini P, Gamboni A, et al. (1994) Fluorouracil, doxorubicin, and mitomycin combination versus PELF chemotherapy in advanced gastric cancer: a prospective randomized trial of the Italian Oncology Group for Clinical Research. J Clin Oncol 12(12):2687–2693
Webb A, Cunnhingham D, Scarffe JH, et al. (1997) Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol 15(1):261–267
Vanhoefer U, Rougier P, Wilke H, et al. (2000) 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 18(14):2648–2657
Kurihara M, Izumi T, Yoshida S, et al. (1991) A cooperative randomized study on tegafur plus mitomycin C in the treatment of advanced gastric cancer. Jpn J Cancer Res 82:613–620
Shimada Y, Yoshida S, Ohtsu A, et al. (1991) A phase II study of EAP (etoposide, adriamycin and cisplatin) in the patients with advanced gastric cancer: multi-institutional study. Annual Meeting of Japan Clinical Oncology (abstract 227)
Ohtsu A, Shimada Y, Yoshida S, et al. (1994) Phase II study of protracted infusional 5-fluorouracil combined with cisplatinum for advanced gastric cancer: report from the Japan Clinical Oncology Group (JCOG). Eur J Cancer 30A:2091–2093
Ohtsu A, Shimada Y, Shirao K, et al. (2003) 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 21(1):54–59
Boku N, Ohtsu A, Shimada Y, et al. (1999) A phase II study of a combination of irinotecan and cisplatin against metastatic gastric cancer. J Clin Oncol 17(1):319–323
Sakata Y, Ohtsu A, Horikoshi N, et al. (1998) Late phase II study of novel oral fluoropyrimidine aniticancer drug S-1 (1 M tegafur-0.4 M gimestat-1 M otastat potassium) in advanced gastric cancer patients. Eur J Cancer 34:1715–1720
Koizumi W, Kurihara M, Nakano S, et al. (2000) Phase II study of S-1, a novel oral derivative of 5-fluorouracil, in advanced gastric cancer. Oncology 58:191–197
Yamada Y, Ohtsu A, Boku N, et al. (2001) Phase II trial of paclitaxel by three-hour infusion for advanced gastric cancer with short premedication for prophylaxis against paclitaxel-associated hypersensitivity reactions. Ann Oncol 12:1133–1137
Sulkes A, Smyth J, Sessa C, et al. (1994) Docetaxel (Taxotere) in advanced gastric cancer: results of a phase II clinical trial. EORTC Early Clinical Trials Group. Br J Cancer 70(2):380–383
Koizumi W, Tanabe S, Saigenji K, et al. (2003) Phase I/II study of S-1 combined with cisplatin in patients with advanced gastric cancer. Br J Cancer 89(12):2207–2212
Uedo N, Narahara H, Ishihara R, et al. (2008) Phase II study of a combination of irinotecan and S-1 in patients with advanced gastric cancer (OGSG0002). Oncology 73(1–2):65–71
Yamaguchi K, Shimamura T, Hyodo I, et al. (2006) Phase I/II study of docetaxel and S-1 impatients with advanced gastric cancer. Br J Cancer 94(12):1803–1808
Yoshida K, Ninomiya M, Takakura N, et al. (2006) Phase II study of docetaxel and S-1 combination therapy for advanced or recurrent gastric cancer. Clin Cancer Res 12(11 pt 1):3402–3407
Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. (2006) 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 24(31):4991–4997
Kang Y, Lee J, Min Y, et al. (2007) A randomized multi-center phase II trial of capecitabine (X) versus S-1 (S) as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Annual Meeting of ASCO (abstract 4546)
Cunningham D, Starling N, Rao S, et al. (2008) Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Eng J Med 358(1):36–46
Dank M, Zaluski J, Barone C, et al. (2003) CPT-11 plus 5-fluorouracil (5-FU)/leucovorin (LV) versus cisplatinum (CDDP) plus 5-FU: a randomized, multinational phase III study in first line metastatic and locally recurrent gastric cancer (MGC). Annual Meeting of ASCO (abstract 1000)
Al-Batran S, Stöhlmacher J, Probst S, et al. (2005) Fluorouracil, leucovorin and oxaliplatin (FLO) versus fluorouracil, leucovorin and cisplatin (FLP) as a first line therapy for patients. Annual Meeting of ASCO (abstract 4015)
Boku N, Yamamoto S, Shirao K, et al. (2007) Randomized phase III study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG9912). Annual Meeting of ASCO (abstract LBA4513)
Koizumi W, Narahara H, Hara T, et al. (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9(3): 215–221
Imamura H, Hishi H, Tsuburaya A, et al. (2008) Randomized phase III study of irinotecan plus S-1 (IRIS) versus S-1 alone as first-line treatment for advanced gastric cancer (GC0301/TOP-002). ASCO Gastrointestinal Symposium (abstract 5)
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Boku, N. Chemotherapy for metastatic disease: review from JCOG trials. Int J Clin Oncol 13, 196–200 (2008). https://doi.org/10.1007/s10147-008-0784-0
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DOI: https://doi.org/10.1007/s10147-008-0784-0