Cisplatin therapy for adenocarcinoma of the stomach.

Cisplatin-based chemotherapy has most recently emerged as among the most active combinations for patients with disseminated or locally unresectable adenocarcinoma of the stomach. This article provides the historical framework for understanding these trials. It reviews the results of clinical trials using cisplatin alone or in combination in almost 600 patients. Because a recent German trial has suggested that cisplatin in combination with etoposide and doxorubicin increases gastric cancer resection rates, the rationale for cisplatin combination therapy in the neoadjuvant setting now has a foundation. Preliminary results from such a neoadjuvant approach used at the University of Southern California Medical Center are discussed. Finally, new areas of clinical and laboratory research in the treatment of gastric cancer are outlined as possibilities for future studies of the therapy of gastric cancer.