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The effectiveness of multiagent chemotherapy is limited in advanced gastric cancer: <50% of patients respond to treatment, and survival is usually <1 year. To assess whether adding the antiangiogenic agent bevacizumab to chemotherapy would improve overall survival (OS) in this setting, investigators conducted a multinational, randomized, double-blind, placebo-controlled phase III trial (AVAGAST) involving 774 patients with metastatic gastric or gastroesophageal junction adenocarcinoma.
Patients received chemotherapy with capecitabine (2000 mg/m2 on days 1–14) and cisplatin (80 mg/m2 on day 1) plus bevacizumab (7.5 mg/kg on day 1) or placebo cycled every 3 weeks. Patients unable to tolerate oral medications received infusional 5-fluorouracil …