The MAGIC trial (Cunningham et al., NEJM 2006) established which chemotherapy regimen as standard perioperative treatment for resectable gastric/GEJ adenocarcinoma?
- A FOLFOX (oxaliplatin + leucovorin + 5-FU)
- B Docetaxel + cisplatin + 5-FU (DCF) adjuvant only
- C S-1 monotherapy adjuvant (ACTS-GC protocol)
- D ECF (epirubicin, cisplatin, 5-FU) or modified ECX/EOF perioperatively ✓
Explanation
The MAGIC trial demonstrated that perioperative ECF (3 cycles pre-operative + 3 cycles post-operative) significantly improved 5-year overall survival (36% vs 23%) and curative resection rates compared with surgery alone in resectable gastric and lower esophageal adenocarcinoma. Subsequently, FLOT4 (Al-Batran et al., Lancet 2019) showed FLOT (docetaxel, oxaliplatin, leucovorin, 5-FU) superior to ECF/ECX with improved pCR rates (16% vs 6%) and OS, making FLOT the preferred perioperative regimen in current European practice. S-1 adjuvant is standard in Japan (ACTS-GC). FOLFOX is used in colorectal cancer.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.