THERAPEUTIC TREATMENT OF STOMACH CANCER
About the author:
Chornobay A. V., Chornobay M. A.
Type of article:
Stomach cancer remains one of the most common oncological diseases and occupies the fourth place in frequency in the structure of cancer. The aggressive course of gastric cancer, early dissemination requires the development of additional systemic treatments. Adjuvant chemotherapy reduces the risk of death by 18.0% and improves overall survival by 6.0%. The efficacy of Adjuvant chemotherapy does not depend on the depth of tumor invasion into the stomach wall. Adjuvant chemotherapy is more effective in the presence of metastases in regional lymph nodes. The use of Adjuvant chemotherapy significantly reduces the number of relapses. Conducting neoadjuvant polychemotherapy in patients with locally common forms of gastric cancer improves long-term treatment outcomes than purely surgical group. The five-year overall survival rate increased by 13% and was 36%, respectively. The use of HT in a common Stomach cancer leads to a reduction in the risk of death compared with symptomatic therapy (risk ratio) 0.39, 95%, an increase in the median of overall survival from 4.3 months to 11 months. Perspective use of cytostatics: taxanes, irinotecan. The drug received the FOLFOX regimen for 31.8% of the time, until progression was 5.8 months, and overall survival was 9.0 months. Docetaxel was used to treat fetal oxaliphapen, a third generation platinum oxaliplatin, or oral fluoropyrimidine (capecitabine, UFT, S-1) and paclitaxel in monotherapy I and II lines would be shown direct efficacy of 11-24%. In polychemotherapy, paclitaxel content patterns showed an objective response of 22-51%, with a median survival of 6-14 months. In HER2-positive gastric cancer, the effect of chemotherapy increased by 12% with the addition of trastuzumab and the median survival increases to 13.8 months.
gastric cancer, medication therapy, chemotherapy
- Jemal A, Siegel R. Cancer statistics. J. Clin. Oncol. 2017;57:43-8.
- Chinese guidelines for diagnosis and treatment of gastric cancer (2011 edition). Gastric Cancer Diagnosis and Treatment Expert Panel of the Chinese Ministry of Health Transl. Gastrointest. Cancer. 2012;l:103-14.
- Strong VE, Song KY, Park CH. Comparison of gastric cancer survival following R0 resection in the United States and Korea using an internationally validated nomogram. Ann Surg. 2010;251:640-6.
- Diaz-Nieto R, Orti-Rodríguez R, Winslet M. Post-surgical chemotherapy versus surgery alone for resectable gastric cancer. Cochrane Database of Systematic Reviews. 2013;9:25.
- Bazyn YS. Lekarstvennaia terapyia raka zheludka y raka tolstoi kyshky [dyssertatsya]. Moskva: 2009. 347 s. [in Russiаn].
- Volkov NM. Lekarstvennaia terapyia meta statycheskoho raka zheludka. Praktycheskaia onkolohyia. 2009;1:41-8. [in Russiаn].
- Ohtsu A, Shimada Y, Shirao K. Randomized phase III 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. J. Clin. Oncol. 2003;21:54-9.
- Woll E, Devries A, Eisterer W. Chemotherapy in Gastric Cancer. Anticancer Research. 2008;28:1217-8.
- Ford H, Marshall A, Wadsley J. Cougar-02: a randomized phase III study of docetaxel versus active symptom control in advanced esophagogastric adenocarcinoma. J. Clin. Oncol. 2013;31:52-8.
- Kang JH, Lee SI, Lim DH. Salvage Chemotherapy for Pretreated Gastric Cancer: a Randomized Phase III Trial Comparing Chemotherapy Plus Best Supportive Care With Best Supportive Care Alone. J. Clin. Oncol. 2012;30:1513-8.
- Narymanov MN. Optymyzatsyia lekarstvennoho lechenyia dyssemynyrovanoho raka zheludka v zavysymosty ot faktorov prohnoza [dyssertatsya]. Moskva: 2015. 305 s. [in Russiаn].
- Bickenbach K. Comparisons of Gastric Cancer Treatments: East vs. West K. Bickenbach, V. Strong J Gastric Cancer. 2012;12:55-62.
- Lee JH, Kim JG, Jung HK. Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach. J Gastric Cancer. 2014;14: 87-104.
- Jung JY, Kwon JH, Kim JH. Phase II study of the paclitaxel, cisplatin, 5-fluorouracil and leucovorin (TPFL) regimen in the treatment of advanced or metastatic gastric cancer. Oncol. Rep. 2009;21:523-9.
- Schønnemann KR, Jensen HA, Yilmaz M. Phase II study of short-time oxaliplatin, capecitabine and epirubicin (EXE) as first-line therapy in patients with non-resectable gastric cancer. Br. J. Cancer. 2008;99:858-61.
- Cunningham D, Starling N, Rao S. Capecitabine and Oxaliplatin for Advanced Esophagogastric Cancer. N. Engl. J. Med. 2008;358:36-46.
- Ferry D, Dutton S, Mansoor W. Phase III multi-centre, randomized, double-blind, placebo-controlled trial of gefitinib versus placebo in esophageal cancer progressing after hemotherapy, COG (Cancer Oesophagus Gefitinib). Ann. Oncol. 2012;23:20-31.
- Lee JL, Kang YK. Capecitabine in the treatment of advanced gastric cancer. Future Oncol. 2008;4:179-98.
- Enzinger P, Burtness B, Hollis D. CALGB 80403/ECOG 1206: a randomized phase II study of three standard chemotherapy regimens (ECF, IC, FOLFOX) plus cetuximab in metastatic esophageal and GE junction cancer. J. Clin. Oncol. 2010;28:4006.
- Fujimoto-Ouchi K, Mori K. Antitumor activity of trastuzumab in combination with chemotherapy in human gastric cancer xenograft models. Cancer Chemother. Pharmacol. 2007;59:795-805.
- Kang YK, Kang WK, Shin DB. Capecitabine/cisplatin versus 5-luorouracil/cisplatin as first-line therapy in patients with advanced gastric cancer: a randomized phase III noninferiority trial. Ann. Oncol. 2009;20:666-73.
- Uedo N, Narahara H, Ishihara R. Phase II Study of a Combination of Irinotecan and S-1 in Patients with Advanced Gastric Cancer. Oncology. 2008;1-2:65-71.
- Lim JY, Cho JY, Paik YH. Salvage Chemotherapy with Docetaxel and Epirubicin for Advanced/Metastatic Gastric Cancer. Oncology. 2008;2:2-8.
- Kunisaki C, Imada T, Yamada R. Phase II study of docetaxel plus cisplatin as a second-line combined therapy in patients with advanced gastric carcinoma. Anticancer Res. 2005;4:2973-7.
- Kim JG, Sohn SK, Kim DH. Phase II study of docetaxel and capecitabine in patients with metastatic or recurrent gastric cancer. Oncology. 2005;68:190-5.
- Ajani JA, Rodriguez W, Bodoky G. Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J. Clin. Oncol. 2010;28:1547-53.
- Ferry D, Dutton S, Mansoor W. Phase III multi-centre, randomized, double-blind, placebo-controlled trial of gefitinib versus placebo in esophageal cancer progressing after chemotherapy, COG (Cancer Oesophagus Gefitinib). Ann. Oncol. 2012;23:20-31.
- Bang YJ, Van Cutsem E, Feyereislova A. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric gastro-oesophageal junction cancer (ToGA): a phase 3,open-label, randomised controlled trial. Lancet. 2010;376:687-97.
- Hudis CA. Trastuzumab-mechanism of action and use in clinical practice. N. Engl. J. Med. 2007;357:39-51.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 70-75 pages, index UDK 575.174.015.3:618.19-006.6-02