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See Latest ArticlesAdvances in the Pharmacological Treatment of Gastro-Oesophageal Cancer
Drugs & Aging, 08/19/09
Wagner AD et al. – This article reviews and discusses current medical treatment options for both the general population and elderly gastric cancer patients.
Management of localized gastric cancer has changed significantly over recent years. Adjuvant chemoradiation is not generally recommended outside the US. After decades of trials of adjuvant chemotherapy with inconclusive results, a significant survival benefit for perioperative combination chemotherapy – as compared with surgery alone – in patients with resectable or locally advanced gastro–oesophageal cancer was recently demonstrated in the UK MAGIC trial. Specific data on elderly patients are missing.
For patients with metastatic disease, oral fluoropyrimidines, such as capecitabine, have been developed. In Asian patients, treatment with the oral fluoropyrimidine S–1 is safe and effective. Docetaxel, oxaliplatin and irinotecan have demonstrated activity against gastric cancer in appropriately designed, randomized, phase III trials and have increased the available treatment options significantly. In addition, according to preliminary data, trastuzumab in combination with chemotherapy has significantly improved activity when compared to chemotherapy alone in patients with human epidermal receptor (HER)–2–positive gastric and gastro–oesophageal cancers. Data from retrospective analyses suggest that oxaliplatin seems to be better tolerated than cisplatin in elderly patients.
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