Condition

Stomach cancer

Clinical trials and treatment information for Stomach cancer

2.4M
People Affected
200
Active Trials
838K
New Cases/Year
954K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
D2 Gastrectomy (Surgery)
90% Effectiveness• 95% Confidence• 25% Safety• 95 trials• 500K participants
HIGH EvidenceExcellent ValueDose: Surgical procedure
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
25
DangerousModerateSafe

Time to Effect

Immediate (tumor removal)

Duration

Single procedure + recovery

Response Rate

%

Remission Rate

70%

Common Side Effects:

Dumping syndrome: 30%
Anastomotic leak: 5%
Surgical site infection: 10%
Bleeding: 3%
Malnutrition/Weight loss: 40%
Postoperative pain: 80%

Annual Cost of Care

Drug Cost

$0

Monitoring

$15,000

Side Effects

$10,000

Total Annual

$100,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

8

ICER

$20,000/QALY

Cost per Remission

$142,857.14

Treatment Outcomes
Primary Outcomes
5-year Overall Survival Rate30%
+66.67% (+20 percentage points)
5-year Disease-Free Survival Rate25%
+80% (+20 percentage points)
5-year Local-Regional Recurrence Rate20%
-75% (-15 percentage points)
R1/R2 Resection Rate15%
-66.67% (-10 percentage points)
Secondary Benefits
Global Health Status (EORTC QLQ-C30, 0-100)60/100
+16.67% (+10 points)
Pain Score (VAS, 0-10)6/10
-66.67% (-4 points)
Carcinoembryonic Antigen (CEA)15 ng/mL
-80% (-12 ng/mL)
Common Side Effects
Dumping syndrome
+30%
Anastomotic leak
+5%
Surgical site infection
+10%

Clinical Trial Phases:

N/A
2
Trastuzumab + Chemotherapy (for HER2-positive)
85% Effectiveness• 90% Confidence• 35% Safety• 30 trials• 10K participants
HIGH EvidencePoor ValueDose: Trastuzumab: 8 mg/kg loading dose, then 6 mg/kg every 3 weeks (with chemotherapy)
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
35
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

Until progression or unacceptable toxicity

Response Rate

47%

Remission Rate

5%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

10

Common Side Effects:

Chemotherapy-related (Nausea, Neutropenia, Fatigue): 80%
Cardiac dysfunction/CHF: 10%
Infusion-related reactions: 15%
Diarrhea: 30%

Annual Cost of Care

Drug Cost

$80,000

Monitoring

$15,000

Side Effects

$10,000

Total Annual

$105,000

Cost-Effectiveness

POOR

QALYs Gained

0.7

ICER

$200,000/QALY

Cost per Remission

$2,100,000

Cost per Responder

$223,404

Treatment Outcomes
Primary Outcomes
Overall Survival (median)11.1 months (chemotherapy alone)
+24.3% (+2.7 months)
Progression-Free Survival (median)5.5 months (chemotherapy alone)
+21.8% (+1.2 months)
Objective Response Rate (ORR)34.7% (chemotherapy alone)
+36.6% (+12.7% response rate)
Secondary Benefits
Disease Control Rate (DCR)66.7% (chemotherapy alone)
+20.4% (+13.6% disease control rate)
Quality of Life (EORTC QLQ-C30 Global Health Status)60/100 points (relative baseline)
+5% (+3 points)
Common Side Effects
Chemotherapy-related (Nausea, Neutropenia, Fatigue)
+80%
Cardiac dysfunction/CHF
+10%
Infusion-related reactions
+15%

Clinical Trial Phases:

Phase 3Phase 4
3
FLOT Chemotherapy
80% Effectiveness• 90% Confidence• 25% Safety• 46 trials• 5K participants
HIGH EvidenceModerate ValueDose: Standard BSA-based regimen (Docetaxel 50mg/m2, Oxaliplatin 85mg/m2, Leucovorin 200mg/m2, 5-FU 2600mg/m2 over 24h, bi-weekly)
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
25
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

Perioperative (4 cycles pre-op, 4 cycles post-op)

Response Rate

50%

Remission Rate

15%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

4

Common Side Effects:

Neutropenia (Grade 3/4): 52%
Nausea/Vomiting: 75%
Peripheral neuropathy (Oxaliplatin): 70%
Diarrhea: 50%
Fatigue: 85%
Alopecia (Docetaxel): 70%

Annual Cost of Care

Drug Cost

$25,000

Monitoring

$12,000

Side Effects

$18,000

Total Annual

$55,000

Cost-Effectiveness

MODERATE

QALYs Gained

1

ICER

$130,000/QALY

Cost per Remission

$366,667

Cost per Responder

$110,000

Treatment Outcomes
Primary Outcomes
Median Overall Survival35 months (with ECF/ECX regimen)
+42.86% (+15 months)
Median Progression-Free Survival18 months (with ECF/ECX regimen)
+66.67% (+12 months)
R0 Resection Rate70% (with ECF/ECX regimen)
+20% (+14% absolute increase (from 70% to 84%))
Pathological Complete Response (pCR) Rate6% (with ECF/ECX regimen)
+166.67% (+10% absolute increase (from 6% to 16%))
Secondary Benefits
Major Tumor Regression (Mandard TRG 1-2) Rate29% (with ECF/ECX regimen)
+55.17% (+16% absolute increase (from 29% to 45%))
Complete Lymph Node Downstaging (ypN0) Rate30% (with ECF/ECX regimen)
+70% (+21% absolute increase (from 30% to 51%))
3-Year Distant Metastasis-Free Survival40% (with ECF/ECX regimen)
+45% (+18% absolute increase (from 40% to 58%))
Common Side Effects
Neutropenia (Grade 3/4)
+52%
Nausea/Vomiting
+75%
Peripheral neuropathy (Oxaliplatin)
+70%

Clinical Trial Phases:

Phase 3Phase 4
4
FOLFOX Chemotherapy
75% Effectiveness• 90% Confidence• 25% Safety• 65 trials• 25K participants
HIGH EvidenceModerate ValueDose: Standard BSA-based regimen (Oxaliplatin 85mg/m2, Leucovorin 400mg/m2, 5-FU 400mg/m2 bolus + 2400mg/m2 infusion over 46h, bi-weekly)
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
25
DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

6 months (adjuvant) or until progression (palliative)

Response Rate

40%

Remission Rate

10%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

3

Common Side Effects:

Nausea/Vomiting: 70%
Neutropenia: 60%
Peripheral neuropathy (Oxaliplatin): 70%
Diarrhea: 50%
Fatigue: 80%
Mucositis: 40%

Annual Cost of Care

Drug Cost

$20,000

Monitoring

$10,000

Side Effects

$15,000

Total Annual

$45,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.8

ICER

$110,000/QALY

Cost per Remission

$450,000

Cost per Responder

$112,500

Treatment Outcomes
Primary Outcomes
Median Overall Survival8 months (with best supportive care/less effective therapy)
+37.5% (+3 months)
Median Progression-Free Survival4 months (with best supportive care/less effective therapy)
+50% (+2 months)
Sum of Target Lesion Diameters (RECIST)10.0 cm
-35% (-3.5 cm)
Secondary Benefits
Cancer-related Pain Score (NRS 0-10)6 points (moderate pain)
-33.3% (-2 points)
ECOG Performance Status2 (symptomatic, 50% ambulatory)
-25% (-0.5 points)
Common Side Effects
Nausea/Vomiting
+70%
Neutropenia
+60%
Peripheral neuropathy (Oxaliplatin)
+70%

Clinical Trial Phases:

Phase 3Phase 4
5
Pembrolizumab
70% Effectiveness• 85% Confidence• 40% Safety• 161 trials• 15K participants
HIGH EvidencePoor ValueDose: 200 mg IV every 3 weeks or 400 mg IV every 6 weeks
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
40
DangerousModerateSafe

Time to Effect

4-12 weeks

Duration

Up to 2 years or until progression/unacceptable toxicity

Response Rate

15%

Remission Rate

2%

Number Needed to Treat (NNT)

8

Number Needed to Harm (NNH)

20

Common Side Effects:

Fatigue: 25%
Nausea: 15%
Diarrhea: 10%
Immune-mediated pneumonitis: 3%
Immune-mediated colitis: 2%
Hypothyroidism: 8%

Annual Cost of Care

Drug Cost

$150,000

Monitoring

$10,000

Side Effects

$5,000

Total Annual

$165,000

Cost-Effectiveness

POOR

QALYs Gained

0.5

ICER

$400,000/QALY

Cost per Remission

$8,250,000

Cost per Responder

$1,100,000

Treatment Outcomes
Primary Outcomes
Overall SurvivalMedian OS with chemotherapy: 11.5 months
+12.17% (+1.4 months)
Progression-Free SurvivalMedian PFS with chemotherapy: 5.6 months
+23.21% (+1.3 months)
Objective Response Rate (ORR)ORR with chemotherapy: 42.0%
+22.14% (+9.3 percentage points)
Duration of Response (DOR)Median DOR with chemotherapy: 7.1 months
+46.48% (+3.3 months)
Secondary Benefits
Global Health Status/QoL (EORTC QLQ-C30)Baseline score: 60/100 points
+11.67% (+7 points)
Cancer-Related Fatigue (EORTC QLQ-C30)Baseline score: 55/100 points
-18.18% (-10 points)
Pain Severity (EORTC QLQ-C30)Baseline score: 45/100 points
-17.78% (-8 points)
Common Side Effects
Fatigue
+25%
Nausea
+15%
Diarrhea
+10%

Clinical Trial Phases:

Phase 3Phase 4
6
Ramucirumab + Paclitaxel (Second-line)
65% Effectiveness• 85% Confidence• 30% Safety• 16 trials• 5K participants
HIGH EvidencePoor ValueDose: Ramucirumab: 8 mg/kg IV on days 1 and 15 of a 28-day cycle, Paclitaxel: 80 mg/m2 IV on days 1, 8, and 15 of a 28-day cycle
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
30
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

Until progression or unacceptable toxicity

Response Rate

28%

Remission Rate

2%

Number Needed to Treat (NNT)

14

Number Needed to Harm (NNH)

10

Common Side Effects:

Neutropenia (Paclitaxel): 40%
Hypertension: 15%
Fatigue: 40%
Peripheral neuropathy (Paclitaxel): 30%
Hemorrhage: 10%

Annual Cost of Care

Drug Cost

$120,000

Monitoring

$10,000

Side Effects

$8,000

Total Annual

$138,000

Cost-Effectiveness

POOR

QALYs Gained

0.3

ICER

$350,000/QALY

Cost per Remission

$6,900,000

Cost per Responder

$492,857

Treatment Outcomes
Primary Outcomes
Overall Survival (OS)7.4 months
+29.7% (+2.2 months)
Progression-Free Survival (PFS)2.9 months
+51.7% (+1.5 months)
Objective Response Rate (ORR)16.1%
+72.7% (+11.7 percentage points)
Secondary Benefits
Disease Control Rate (DCR)64.4%
+24.4% (+15.7 percentage points)
Duration of Response (DoR)4.4 months
+27.3% (+1.2 months)
Time to Definitive Deterioration of Quality of Life (EORTC QLQ-C30 Global Health Status)4.0 months
+40% (+1.6 months)
Common Side Effects
Neutropenia (Paclitaxel)
+40%
Hypertension
+15%
Fatigue
+40%

Clinical Trial Phases:

Phase 3Phase 4
7
Nivolumab
60% Effectiveness• 80% Confidence• 40% Safety• 104 trials• 8K participants
HIGH EvidencePoor ValueDose: 240 mg IV every 2 weeks or 480 mg IV every 4 weeks
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
40
DangerousModerateSafe

Time to Effect

4-12 weeks

Duration

Until progression or unacceptable toxicity

Response Rate

12%

Remission Rate

1%

Number Needed to Treat (NNT)

10

Number Needed to Harm (NNH)

25

Common Side Effects:

Fatigue: 20%
Pruritus: 10%
Diarrhea: 8%
Immune-mediated pneumonitis: 2%
Immune-mediated colitis: 1.5%
Hypothyroidism: 7%

Annual Cost of Care

Drug Cost

$140,000

Monitoring

$10,000

Side Effects

$5,000

Total Annual

$155,000

Cost-Effectiveness

POOR

QALYs Gained

0.4

ICER

$380,000/QALY

Cost per Remission

$15,500,000

Cost per Responder

$1,291,667

Treatment Outcomes
Primary Outcomes
Overall Survival4.1 months (median for chemotherapy)
+26.8% (+1.1 months)
Objective Response Rate (ORR)2% of patients (placebo arm)
+460% (+9.2 percentage points)
Progression-Free Survival1.5 months (median for chemotherapy)
+6.7% (+0.1 months)
Secondary Benefits
Duration of Response2.3 months (median for chemotherapy responders)
+260% (+6 months)
Quality of Life (Global Health Status)55 points (EORTC QLQ-C30 scale 0-100)
+9.1% (+5 points)
Common Side Effects
Fatigue
+20%
Pruritus
+10%
Diarrhea
+8%

Clinical Trial Phases:

Phase 3Phase 4