Abstract
A subanalysis of the ACTC-GC trial revealed no benefit of postoperative chemotherapy with S-1 in stage III gastric cancer. Neoadjuvant chemotherapy (NAC) for resectable advanced gastric cancer has thus been studied to improve survival. The JCOG0210 trial (a phase II study) showed that NAC with S-1 plus cisplatin was beneficial in resectable advanced gastric cancer, and a phase III study (JCOG0501) is ongoing. The results of the MAGIC trial and ACCORD-07 trial have shown that NAC is effective for advanced gastric cancer, but this has been questioned by the results of the EORTC-04954 trial. S-1 plus cisplatin is currently standard therapy for advanced or unresectable gastric cancer in Japan. However, several regimens have been proposed for triplet therapy, such as docetaxel, cisplatin, and S-1 (DCS), docetaxel, capecitabine (Xeloda), and cisplatin (DXP), and docetaxel, cisplatin, and 5-flurorouracil (DCF). Triplet therapy is expected to improve outcomes in unresectable or advanced gastric cancer. After the results of the JCOG0501 trial become available, phase III trials comparing doublet therapy with triplet therapy will be needed.
