[Docetaxel and gastric cancer]

There are very few active drugs in the treatment of metastatic gastric carcinoma. Among new drugs, docetaxel has shown one of the most important activity. With precise evaluation of objective response, this drug has demonstrated a 20% response rate in monotherapy. The favorable toxicity profile of this compound allowed combination therapy with other active drugs in this disease: 5-fluorouracil (5FU), cisplatin and epiadriamycin. Two of the most interesting combinations are: bitherapy with docetaxel cisplatin and three therapy with docetaxel, continuous infusion of 5FU and cisplatin (TCF). Several large phase III trials are on-going to compare these new schedules to classical combination chemotherapies of this disease (5FU cisplatin or ECF). The potential place of docetaxel in gastric cancer is not restricted to metastatic disease and the same three-therapy with TCF is currently under evaluation as a neoadjuvant or adjuvant treatment in resectable lesions. With a high activity in terms of radiosensitization, docetaxel could also become a major drug in the design of new radiochemotherapy protocols for neoadjuvant or adjuvant disease.