More is not always better: triplet chemotherapy and advanced gastric cancer
Mené au Japon sur 741 patients atteints d'un cancer de l'estomac de stade avancé (âge : 20-75 ans), cet essai de phase III évalue l'efficacité, du point de vue de la survie globale, et la toxicité de l'ajout de docétaxel à un traitement de première ligne combinant cisplatine et S-1
Gastric and gastro-oesophageal cancers are some of the most commonly diagnosed cancers worldwide and are an important cause of cancer-related death. Advanced gastric cancer has a poor prognosis with available palliative chemotherapy; average overall survival does not exceed 12 months in non-Asian patients. The global standard for first-line chemotherapy is a platinum plus fluorouracil-based doublet; although the V325 randomised trial showed improved outcomes with a docetaxel, cisplatin, and fluorouracil triplet, this triplet has never been accepted as a standard of care due to substantial associated toxicity. Less toxic modifications of docetaxel, cisplatin, and fluorouracil have been studied in phase 2 trials but have never been compared with standard doublet chemotherapy in a randomised phase 3 trial.
The Lancet Gastroenterology & Hepatology , commentaire, 2018