| [ Summary ] |
The best chemotherapy regimen for unresectable or metastatic scirrhous gastric cancer has not been established. In Japan, S-1 plus cisplatin is recognized as the standard first line chemotherapy for advanced gastric cancer. Recently, the addition of trastuzumab to chemotherapy regimens has been shown to provide survival benefits for HER2 positive gastric cancer patients. In general, these standard chemotherapy regimens should also be applied to unresectable or metastatic scirrhous gastric cancer. However, positive rates of HER2 are low in many of scirrhous gastric cancers. Moreover, a number of scirrhous gastric cancer patients have complications due to ascites and / or bowel obstructions, due to peritoneal metastasis. Therefore standard chemotherapy can seldom be used for those patients. At this time, various chemotherapy regimens employing 5-fluorouracil, leucovorin and / or paclitaxel are under investigation, for patients with ascites. Second line chemotherapy, with irinotecan, paclitaxel and docetaxel are generally utilized, but irinotecan is not appropriate for patients with severe peritoneal metastasis. Thus, the development of new therapies for scirrhous gastric cancer is warranted. |