Metastatic gastric cancer is a relatively chemosensitive disease. With curr
ent regimens, 25% to 40% of patients can be expected to respond, and median
survival of 6 to 8 months is achievable. These outcomes may be improved by
the use of infusional fluorouracil (5-FU) in combination with cisplatin (P
latinol) or the newer agents docetaxel (Taxotere) and irinotecan (Cainptosa
r). Phase II studies using these approaches have reported response rates of
50% to 60% and median survival of 11 months. Chemotherapy may also have a
role in earlier stages of gastric cancer. However; the value of adjuvant th
erapy ill improving survival following successful resection has still to be
demonstrated, as has the survival benefit of preoperative treatment. Never
theless, primary chemotherapy has demonstrated a capacity to downstage dise
ase in certain otherwise inoperable cases.