imm- MAGIC trial, page 1 (NEJM 2006)
- Pre & post-operative ECF and surgery, vs surgery alone (503 patients)
- Decreased tumour size and stage
- Significantly improved progression free and overall survival
- 5yr survival 23% vs 36%
- Inclusions:
- Any age, WHO 0-1
- Histologically confirmed adenocarcinoma
- ≥ T2
- Gastric or distal 1/3 oesophagus
- NB: 74% of study was Gastric Ca
- No metastatic disease, resectable
- Exclusions
- Previous chemo/rad, poor heart/kidneys
- Epirubicin, Cisplatin, 5FU (ECF)
- 3 x pre-op cycles and 3 x post-op cycles
- Surgery
- 6/52 post chemo, then restart 6-12/52 post surgery
- NB: Only 40% completed post-op cycles
- Type and extent of surgery operator dependent
ECF