Systemic Chemotherapy

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In order to understand the current literature in the neoadju-vant and adjuvant settings, a review of chemotherapy agents in the metastatic disease will be discussed. As with many cancers, gastric cancer was thought to be relatively insensitive to chemotherapy. Most agents used in gastric cancer did not induce a complete response, responses in general were poor, and time to progression was short. Table 1 shows a list of singleagent drugs with activity in gastric cancer.

The standard first-line salvage regimen through the 1980s was 5-fluorouracil (5FU), adriamycin, and mitomycin C (FAM) with an initial reported response rate of 50% (77). This combination, though, was subsequently evaluated by multiple other investigators with less-convincing response rates (78-81). Randomized trials subsequently followed, the largest from the

Table 1

Single-Agent Chemotherapeutic Agents for Gastric Cancer

Patients studied

Table 1

Single-Agent Chemotherapeutic Agents for Gastric Cancer

Patients studied

Drug

(first line/second line)

Responses (%)

5-Fluorouracil

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