Is there a role for second-line chemotherapy in advanced gastric cancer?
Gastric cancer remains one of the most common forms of cancer worldwide. Unfortunately, most patients will present with advanced-stage disease, and will therefore need palliative chemotherapy. Some chemotherapy regimens have been well established as first-line therapy, and have been shown to increase survival; however, almost all patients with metastatic gastric cancer will develop progressive disease after first-line therapy. With the availability of several active chemotherapy drugs, many patients who retain a good performance status after the initial treatment remain good candidates for additional therapy; however, no standard approach for second-line therapy exists. Many small, phase 2 trials have been done and the findings are variable. No data from randomised-controlled trials suggest a benefit of second-line chemotherapy compared with supportive care alone. We review the published data concerning the use of chemotherapy in the second-line setting for the treatment of advanced gastric cancer.
Wesolowski
Robert
R
Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Lee
Chan
C
Kim
Richard
R
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives; D016503:Drug Delivery Systems; D005472:Fluorouracil; D006801:Humans; D000077146:Irinotecan; D017671:Platinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D016879:Salvage Therapy / Q000379:methods*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use; D059004:Topoisomerase I Inhibitors
D000970:Antineoplastic Agents; D017671:Platinum Compounds; D043823:Taxoids; D059004:Topoisomerase I Inhibitors; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin