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enrolled. Although all three regimens achieved response rates greater than 40 percent,
IC-C was the least efficacious and most toxic; although ECF-C demonstrated slightly greater tumor response compared with FOLFOX-C ( 57. 8 percent versus 53. 6 percent), FOLFOX-C was the least toxic. An added benefit of cetuximab was suggested by improvements in response rate (by 15 percent) and overall survival (by 2. 5 months) in both ECF-C and FOLFOX-C arms compared with historical phase III results in similar patient populations.
These studies, and others that
have yet to mature, add to
our growing understanding of
these diseases, but they also
underscore the significant gaps
in our knowledge. It remains
difficult to reconcile elements
of existing randomized studies
on resectable gastric cancer
(for example, the efficacy of
perioperative but not adjuvant
chemotherapy alone in the
U.S., and the apparent need
for adjuvant radiotherapy in
the U.S. but not in Asia).
It also remains clear that the promise of targeted therapies has not been fulfilled for many of the more aggressive malignancies. Further studies are needed to address these challenges and provide a basis for more effective treatments. ♦
JUL 2015 BULLETIN American College of Surgeons
These studies, and others that have yet to mature, add to our growing understanding of these diseases, but they also underscore the significant gaps in our knowledge.