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Annals of Oncology Advance Access originally published online on February 14, 2008
Annals of Oncology 2008 19(6):1045-1052; doi:10.1093/annonc/mdn024
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

reviews

The role of UFT in advanced gastric cancer

N. F. Aykan1,* and E. Idelevich2

1 Department of Medical Oncology, Institute of Oncology, Istanbul University, Capa 34390 Istanbul, Turkey
2 Institute of Oncology, Kaplan Medical Center, Rehovot, Israel

* Correspondence to: Prof. N. F. Aykan, Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey. Tel: +90-533-265-8907; Fax: +90-212-661-9028; E-mail: nfaruk{at}superonline.com

Background: Advanced gastric cancer has a poor prognosis, with a relative 5-year survival rate of 7%–27%. Chemotherapy, which improves overall survival (OS) and quality of life, is the main treatment option. Although numerous regimens have been investigated, there is no standard treatment. Combination chemotherapy, however, is associated with a significant survival benefit compared with monotherapy and i.v. 5-fluorouracil (5-FU) is one of the most widely used agents. UFT (tegafur–uracil) has similar efficacy to continuous infusion 5-FU with improved tolerability and is more convenient for patients.

Design: The efficacy and safety of UFT in the treatment of advanced gastric cancer have been demonstrated in a number of phase II studies.

Results: UFT with leucovorin (folinic acid) monotherapy shows overall response rates (ORRs) of 16%–29% and median OS of 5.8 months. Combination of UFT with cisplatin, etoposide, or paclitaxel shows ORRs of 35%–51% and median OS of 8.3–10.1 months. UFT-based three-drug combinations show ORRs of 41%–57% and median OS of 8.6–15 months. UFT-based combinations have a good tolerability profile, particularly a low incidence of myelosuppression, mucositis, and hand–foot syndrome.

Conclusion: UFT represents a logical replacement for 5-FU in chemotherapy regimens for the treatment of advanced gastric cancer.

Key words: advanced gastric cancer, combination therapy, phase II study, tegafur, UFT, uracil

Received for publication September 30, 2007. Revision received January 9, 2008. Accepted for publication January 10, 2008.


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