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Etoposide in gastric cancer
1Department of Medicine, Temple University Comprehensive Cancer Center, Philadelphia, PA 19140.
Seminars in Oncology
|December 1, 1992
Summary
Etoposide shows limited effectiveness alone for metastatic gastric cancer. Combinations with other drugs improve response rates, but myelosuppression is a key toxicity requiring further study.
Area of Science:
- Medical Oncology
- Gastrointestinal Oncology
- Chemotherapy Research
Background:
- Etoposide demonstrates modest single-agent activity in previously untreated metastatic gastric carcinoma.
- Combination chemotherapy regimens including etoposide are gaining interest among oncologists for advanced gastric cancer treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of etoposide-based chemotherapy in gastric cancer.
- To review response rates and toxicities associated with etoposide in various treatment settings.
Main Methods:
- Review of existing studies on etoposide in metastatic and advanced gastric carcinoma.
- Analysis of response rates (partial and complete) and disease-free survival following etoposide-containing regimens.
- Assessment of major toxicities, particularly myelosuppression.
Main Results:
- Etoposide as a single agent yields a 21% partial response rate in untreated metastatic gastric cancer.
- Etoposide combinations achieve 60%-70% overall response rates and up to 20% complete response rates in advanced gastric cancer.
- Neoadjuvant etoposide therapy can render approximately 60% of patients disease-free after resection, though superiority over surgery alone is unproven.
Conclusions:
- Etoposide-based chemotherapy warrants further investigation for gastric cancer treatment due to promising response rates in combination therapies.
- Significant myelosuppression is the primary toxicity associated with etoposide-based regimens.
- While effective in neoadjuvant settings, the definitive benefit over surgery alone requires further Phase III study validation.