NCCN treatment guidelines for advanced gastric cancer

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The 2016 NCCN Clinical Guidelines for Gastric Cancer updated the systemic treatment plan for metastatic or locally advanced gastric cancer in the first edition (NCCN.2016.V1).

Among them, the DCF in the original first-line preferred plan was cancelled, the DCF improvement, ECF and ECF improvement were moved to other first-line programs, and docetaxel irinotecan in the other first-line programs was canceled.

The updated first-line preferred plan is 6 types in category 2 and 18 types in other types; the second-line preferred plan is 9 types in category 4 and 4 types in other types 3. It is hereby sorted as follows:


D-Docetaxel, docetaxel;

E-Epirubicin, epirubicin;

F-Fluorouracil (5-FU), fluorouracil;

FOL-Folinic acid (leucovorin), calcium leucovorin;

I- Irinotecan, irinotecan;

O / OX-Oxaliplatin, Oxaliplatin;

P-Cisplatin, cisplatin (PDD);

R-Ramucirumab, Ramucirumab

T-Paclitaxel, paclitaxel;

X / XEL-Capecitabine, capecitabine;

FOLFOX-A series of chemotherapy regimens for the treatment of gastric or colorectal cancer composed of a combination of calcium folinate and fluorouracil combined with different doses of oxaliplatin is often called FOLFOX regimen

The chemotherapy regimen of XELOX-capecitabine combined with oxaliplatin is often referred to as the XELOX regimen

First-line preferred solution

HER2-neu overexpression of metastatic adenocarcinoma should be combined with trastuzumab for first-line non-anthracycline chemotherapy.

Specific plan: Trastuzumab intravenous injection for the first time at 8 mg / kg, day 1, followed by 6 mg / kg intravenous injection, 21 days / cycle; or for the first intravenous injection at 6 mg / kg, day 1, then 4 mg / kg intravenous injection, 14 days / cycle.

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