Different regimens of perioperative chemotherapy for esophagogastric and gastric adenocarcinoma: does a triplet therapy with taxane generate a survival benefit?

With new diagnoses in more than 39,000 patients annually, esophagogastric cancer (EGC) is the seventh most common cancer worldwide and a serious health problem. It is a highly lethal disease, causing more than 25,000 deaths per year (1). Surgery with a radical lymphadenectomy is the mainstay of therapy for operable adenocarcinoma of the esophagogastric junction cancer (EGJC) and gastric cancer not involving the GE-junction cancer (GC) but many patients relapse and the 5-year survival rate remains low (2). Because of the poor prognosis of locally advanced disease, additional therapy besides oncologic surgery is required to improve patient outcome. Recent studies demonstrated that preoperative chemotherapy improves overall survival (OS) of patients with locally advanced EGJC/GC and histopathologic response was identified as an independent prognostic parameter in these patients (3,4). Several neoadjuvant chemotherapy regimens are under discussion and currently in use but the optimal treatment regimen remains unclear.