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Chemotherapy drugs used for stomach cancer

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This page tells you about the different chemotherapy drugs used to treat stomach cancer. There is information about

 

A quick guide to what's on this page

Chemotherapy drugs used for stomach cancer

Doctors most often use combinations of chemotherapy drugs together. Which drugs you have will depend on why you are having the treatment.

The most commonly used drug combinations for stomach cancer before or after surgery are ECF (epirubicin, cisplatin and 5FU) and ECX (epirubicin, cisplatin and capecitabine). You have ECF by injection and through a portable pump. You will need a central line. This is a tube that goes into a main blood vessel in your neck. You may have up to 4 to 6 months of treatment, depending on how your cancer responds.

If you have ECX, you have 2 of the drugs into a vein and the other as a tablet. There is information about these and other combinations of chemotherapy drugs used for stomach cancer further down this page. 

Chemotherapy side effects vary, depending on the particular drugs you are having. The commonest side effects are a drop in your blood counts causing an increased risk of infection, feeling or being sick, hair loss, diarrhoea and a sore mouth.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating stomach cancer section.

 

 

Chemotherapy combinations

Doctors most often use combinations of chemotherapy drugs together. Which drugs you have will depend on why you are having the treatment. You should be given written information about the drugs you are to have by your chemotherapy nurse or doctor.

 

ECF and ECX chemotherapy

You usually have 3 cycles of chemotherapy before surgery and again after surgery. Each cycle lasts 3 weeks. The most commonly used drug combinations for stomach cancer are ECF and ECX

ECF contains the drugs epirubicin, cisplatin and fluorouracil. We have a page on the specific side effects of ECF.

You have ECF by injection and through a pump. You will need a central line. This is a tube that goes into a main blood vessel in your neck. The end of the tube comes out of your chest. It is this that attaches to the pump. 

ECX contains the drugs epirubicin, cisplatin and capecitabine (Xeloda). There is a page about the side effects of ECX in our section on cancer drugs. You have the epirubicin and cisplatin into a vein but the capecitabine is taken as a tablet.

You are likely to have a 5 to 6 week break from chemotherapy before you have surgery. And you will start chemotherapy again about 6 to 10 weeks after your operation, depending on your recovery.

 

Chemotherapy for advanced stomach cancer

Chemotherapy is used to try to shrink and control advanced stomach cancers. Doctors are always trying to find combinations of chemotherapy drugs that work better than current treatments. So they test new drugs and new combinations of drugs.

A clinical trial called REAL 2 looked at 4 different combinations of chemotherapy drugs used for stomach and oesophageal cancer that had already spread. The drug combinations were

This trial showed that capecitabine tablets worked as well as fluorouracil through a pump, and oxaliplatin worked as well as cisplatin when given with epirubicin and fluorouracil or capecitabine. And the quality of life of people on the different chemotherapy combinations was similar. 

You may have any one of these drug combinations. EOX and ECX are commonly used as you do not need a central line. In some cases, if your doctor does not think you are fit enough to have a combination of 3 chemotherapy drugs, they may offer you 2 instead (such as capecitabine and cisplatin or oxaliplatin).

 

Chemotherapy side effects

Chemotherapy side effects vary, depending on the particular drugs you are having. The most common side effects are

Not everyone has the same side effects, or gets them to the same extent. You won't know exactly how the treatment affects you until you start.

We have specific pages on the side effects of fluorouracil, cisplatin, oxaliplatin, epirubicin and capecitabine.

 

Checking how the treatment is working

If your cancer can be seen clearly on a scan, your doctor will take a note of its size before your treatment starts. Then, after about 3 or 4 cycles of chemo, you'll have another scan. Your doctor can measure the tumour again and see how much it has shrunk. In some people, the chemotherapy does not shrink the cancer. If your tumour doesn't appear to be shrinking, your doctor may suggest stopping the chemotherapy. There is no point in you having the side effects if the chemotherapy isn't working.

Your doctor may then suggest another combination of drugs or a different type of treatment. If your cancer comes back more than 6 months after your initial chemotherapy treatment, you might have the same combination of chemotherapy drugs again.

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Updated: 13 February 2014