[A current overview of chemotherapy in advanced gastric cancer]

Four drugs including 5-fluorouracil (5-FU), adriamycin (ADM), mitomycin C (MMC) and cisplatin (CDDP) can produce response rates ranging from 15% to 20% when used as single agents for advanced gastric cancer. Various combinations employing these agents have been tested and FAM (5-FU, ADM, MMC) has been the most extensively studied, obtaining response rates ranging from 21% to 45% by the original regimen. More recently FAP (5-FU, ADM, CDDP) has been studied and response rates reported were ranged from 29% to 50%, and therefore it was judged that the efficacy is comparable to FAM. However, overall survival gain has been limited when used these combinations. Consequently a serious question has been raised whether past combinations are superior over single agent 5-FU. Prospective randomized trials compared 5-FU alone vs various combination failed to show advantage of combinations over 5-FU alone.