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64

65

NCCN Guidelines for Patients

®

Stomach Cancer, Version 1.2016

NCCN Guidelines for Patients

®

Stomach Cancer, Version 1.2016

5

Treatment guide

Metastatic cancer

Guide 11. First-line systemic treatments*

Preferred regimens

Other regimens

Fluoropyrimidine

¥

+ cisplatin

Paclitaxel + cisplatin or carboplatin

Fluoropyrimidine

¥

+ oxaliplatin

Docetaxel + cisplatin

¥

5-FU or capecitabine

Docetaxel

5-FU + irinotecan

Docetaxel + cisplatin + fluorouracil

Docetaxel + oxaliplatin + fluorouracil

Docetaxel + carboplatin + fluorouracil

ECF (epirubicin + cisplatin + fluorouracil)

Epirubicin + oxaliplatin + fluorouracil

Epirubicin + cisplatin + capecitabine

Epirubicin + oxaliplatin + capecitabine

*Trastuzumab should be received with chemotherapy if the cancer cells have too many HER2 receptors.

5

Treatment guide

Metastatic cancer

Systemic treatment

Doctors use the term “systemic” when talking about a

cancer treatment for the whole body. Chemotherapy

is the type of systemic treatment most often used for

stomach cancer.

Targeted therapy is a newer drug treatment for

advanced stomach cancers. Trastuzumab is one such

drug. It should be received with fist-line chemotherapy

if the cancer cells have too many HER2 receptors

except if taking an anthracycline. Epirubicin is an

anthracycline.

Guide 11

lists the regimens first used to manage

advanced cancers. Your doctor will choose a regimen

based on your health and treatment side effects.

Regimens consisting of two drugs have less severe

side effects than three-drug regimens. If you are

given 5-FU, leucovorin may be added to limit side

effects of the chemotherapy. No matter what regimen

you receive, you should be assessed for side effects

on a regular basis.

Guide 12

lists the regimens that are given if the

cancer doesn’t respond to first-line regimens.

The regimen that is best for you depends on your

prior treatment and performance status. Preferred

regimens in Guide 12 have been shown within well-

designed clinical trials to control cancer growth better

than other treatments.

Guide 12. Second-line systemic treatments

Preferred regimens

Other regimens

Ramucirumab + paclitaxel

Irinotecan + cisplatin

Docetaxel

Irinotecan + fluoropyrimidine (5-FU or capecitabine)

Paclitaxel

Docetaxel + irinotecan

Irinotecan

Docetaxel + irinotecan

Ramucirumab