Chemotherapy for stomach cancer

Chemotherapy uses anticancer, or cytotoxic, drugs to destroy cancer cells. It is sometimes used to treat stomach cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is given for different reasons. You may have chemotherapy to:

  • destroy cancer cells in the body
  • shrink a tumour before other treatments such as surgery or radiation therapy (called neoadjuvant chemotherapy)
  • destroy cancer cells left behind after surgery and reduce the risk of the cancer recurring (called adjuvant chemotherapy) - radiation therapy may be given at the same time (called adjuvant chemoradiation)
  • relieve pain or control the symptoms of advanced stomach cancer (called palliative chemotherapy)

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the stomach.

Chemotherapy drugs used for stomach cancer

Chemotherapy for stomach cancer may be given as a single drug or as a combination of 2 or more drugs. The most common chemotherapy drugs used to treat stomach cancer are:

  • 5-fluorouracil (Adrucil, 5-FU) – leucovorin (folinic acid) is often given along with 5-fluorouracil to make 5-fluorouracil work better
  • capecitabine (Xeloda)
  • cisplatin (Platinol AQ)
  • carboplatin (Paraplatin)
  • epirubicin (Pharmorubicin)
  • docetaxel (Taxotere)
  • irinotecan (Camptosar)
  • oxaliplatin (Eloxatin)
  • paclitaxel (Taxol)
  • doxorubicin (Adriamycin)
  • mitomycin (Mutamycin)
  • methotrexate
  • etoposide (Vepesid)
Some examples of chemotherapy regimens (a combination of 2 or more drugs) used for stomach cancer are:
  • ECX – epirubicin, cisplatin and capecitabine
  • ECF – epirubicin, cisplatin and 5-fluorouracil
  • DCF (TCF) – docetaxel, cisplatin and 5-fluorouracil
Lonsurf (trifluridine/tipiracil) may be used to treat stage 4 stomach cancer. It is used after you have had at least 2 different types of chemotherapy, including oxaliplatin and fluorouracil, along with docetaxel or paclitaxel, or irinotecan.

Chemoradiation

Radiation therapy is sometimes given during the same time period as chemotherapy for stomach cancer. This is called chemoradiation. The type of radiation therapy usually given in combination with chemotherapy is external beam radiation therapy, and it’s most often given with 5-fluoruracil, cisplatin or both. Carboplatin and paclitaxel may also be given with radiation therapy. These chemotherapy drug combinations help make the cancer cells more sensitive to the effects of radiation therapy.

Information about specific cancer drugs

Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.

Questions to ask about chemotherapy

Find out more about chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.

Expert review and references

  • Alberta Health Services. Gastric Cancer. Alberta Health Services; 2013.
  • Alberts SR & Grothey A . Gastrointestinal tract cancers. Casciato DA & Territo MC (eds.). Manual of Clinical Oncology. 7th ed. Lippincott Williams & Wilkins; 2012: 9: pp. 227-284.
  • American Cancer Society. Stomach Cancer. Atlanta, GA: American Cancer Society; 2014: http://www.cancer.org/acs/groups/cid/documents/webcontent/003141-pdf.pdf.
  • American Society of Clinical Oncology (ASCO). Stomach cancer. Alexandria, VA.: American Society of Clinical Oncology (ASCO); 2014.
  • Avital, I. et al . Cancer of the stomach. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011: 80: pp. 924-954.
  • BC Cancer Agency (BCCA). Stomach Cancer Management Guidelines. BC Cancer Agency; 2013: http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Gastrointestinal/02.Stomach/default.htm.
  • Kelsen, D. P., Van De Velde, C. J. H., & Minsky, B. D . Gastric cancer: clinical management. Kelsen, D. P., Daly, J. M., Kern, S. E., Levin, B., Tepper, J. E., & Van Cutsem, E. (eds.). Principles and Practice of Gastrointestinal Oncology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008: 23: pp. 285-316.
  • Knight G, Earle CC, Cosby R, et al . Neoadjuvant or Adjuvant Therapy for Resectable Gastric Cancer. Cancer Care Ontario. Evidence-Based Series (EBS) and Practice Guidelines (PG). Toronto, ON: Cancer Care Ontario; 2013.
  • MacKenzie M, Spithoff K, Jonker D, et al . Systemic therapy for advanced gastric cancer. Cancer Care Ontario. Evidence-Based Series (EBS) and Practice Guidelines (PG). Toronto, ON: Cancer Care Ontario; 2014.
  • National Cancer Institute. Gastric Cancer Treatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2014.
  • National Cancer Institute. Drugs Approved for Stomach (Gastric) Cancer. Bethesda, MD: National Cancer Institute; 2014.
  • National Comprehensive Cancer Network. Gastric Cancer (Version 1.2014). National Comprehensive Cancer Network; 2014.
  • Russell MC, Hsu C & Mansfield PF . Primary gastric malignancies. Feig BW & Ching CD. The MD Anderson Surgical Oncology Handbook. 5th ed. Lippincott Williams & Wilkins; 2012: 9: pp. 270-315.

Side effects of chemotherapy for stomach cancer

Chemotherapy kills cancer cells but can also damage healthy cells. Learn about side effects of chemotherapy for stomach cancer and how they are managed.