Standard First-Line Chemotherapy for Metastatic Gastric Cancer in Japan Has Met the Global Standard: Evidence From Recent Phase III Trials.

In Japan, standard first-line chemotherapy for metastatic gastric cancer was initially 5-fluorouracil (5-FU) monotherapy. This is based on the Japan Clinical Oncology Group (JCOG) 9205 phase III trial. Based on recent Japanese phase III trials, S1 plus cisplatin combination chemotherapy was established as the standard first-line chemotherapy, and this combination has met the global standard regimen of 5-FU (capecitabine) plus a platinum analog (cisplatin or oxaliplatin). Since the same standard regimen has been established outside Japan, many global trials are currently ongoing in other countries aside from Japan. With the recent development of many molecular targeted agents, global collaboration in clinical trials is necessary for their immediate evaluation. We review the results of recent phase III trials of first-line chemotherapy for metastatic gastric cancer in Japan and other countries.