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Intense Chemotherapy May Not Be Better for Gastric Cancer

Study does not support earlier evidence

FRIDAY, April 20 (HealthDay News) --Despite earlier evidence, a more intensive chemotherapy regimen for gastric cancer has no benefit in terms of survival or relapse than less intensive regimens, according to a study in the April 18 issue of the Journal of the National Cancer Institute.

Stefano Cascinu, M.D., from Universita Politecnica delle Marche in Ancona, Italy, and colleagues randomly assigned 400 patients with gastric cancer at high risk of recurrence to either eight weekly administrations of cisplatin, leucovorin, epidoxorubicin, 5-fluorouracil, and glutathione (PELFw), or six monthly administrations of a 5-day course of 5-fluorouracil and leucovorin (FU/LV).

The researchers found that 5-year survival was similar in the PELFw and FU/LV groups (52 percent vs. 50 percent, respectively). The PELFw regimen did not affect the risk of death (hazard ratio 0.95) or relapse (hazard ratio 0.98). However, only 9.4 percent of the PELFw group completed treatment compared with 43 percent of patients in the FU/LV group.

"What do we learn from this trial?" Susan Ellenberg, Ph.D., and Weijing Sun, M.D., from the University of Pennsylvania School of Medicine in Philadelphia asked in an accompanying editorial. "First, we are reminded that many new regimens, despite initial enthusiasm based on preliminary studies, are ultimately shown to be ineffective or at least no more effective than other available treatments."

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