Chemotherapy for Advanced Gastric Carcinoma

Abstract

To the Editor.— Cullinan and co-workers 1 have provided us with an important contribution to help us evaluate claims for various treatments for patients with advanced gastric and pancreatic adenocarcinoma. They have reminded us of the need to compare any proposed new standard of therapy with a treatment commercially available for nearly a quarter of a century that has no critical cumulative toxic effect (eg, cardiac or hematologic) and whose drug costs (if not costs of drug administration) are far less expensive. As the authors state, little advantage is shown for the doxorubicin hydrochloride combinations in the treatment of pancreatic cancer. However, the data presented suggest that the jury is still out, as far as gastric cancer is concerned, despite the definitive statement in the abstract. Objective responses were reported for two of 11 patients in the fluorouracil-alone arm, for three of 11 patients who received fluorouracil and doxorubicin, and for