FOLFOX6 Versus mFOLFIRINOX as First Line Chemotherapy in Metastatic Gastric Cancer or Esophagogastric Junction Adenocarcinoma (Type II-III)

Inclusion Criteria:

1. histologically confirmed locally advanced, recurrent or metastatic adenocarcinoma ofthe esophagogastric junction (Siewert type II-III) or the stomach
2. no prior palliative chemotherapy or radiation therapy
3. Age 18-70 years (female and male)
4. Eastern Cooperative Oncology Group ≤ 2
5. Neutrophils> 2.000/µl
6. Platelets > 100.000/µl
7. Normal value of Serum Creatinin
8. Albumin level > 29 г/л
9. Aspartate transaminase (AST) or alanine transaminase (ALT) less than 3 times the upperlimits of normal (ULN)
10. Total Bilirubin less than 1.5 times the ULN
11. Written informed consent.

Exclusion Criteria:

1. Previous palliative cytostatic chemotherapy
2. Cancer relapse
3. Complicated gastric cancer (perforation, bleeding, sub or decompensated stenosis,dysphagia IV)
4. Diarrhea ≥ 2 according to the criteria of Common Terminology Criteria for AdverseEvents (CTCAE) version 4.1;
5. Hypersensitivity against 5- Fluorouracil, Leucovorin, Oxaliplatin, irinotecan
6. Existence of contraindications against 5- Fluorouracil, Leucovorin, Oxaliplatin,Irinotecan or Docetaxel
7. Active coronary heart disease, Cardiomyopathy or cardiac insufficiency stage III-IVaccording to New York Heart Association (NYHA)
8. Severe non-surgical accompanying disease or acute infection (uncontrolled arterialhypertension, diabetes mellitus, stroke less than 6 months old, mental disorders,other tumors and others)
9. Malignant secondary disease, dated back < 5 years (exception: In-situ-carcinoma of thecervix uteri, adequately treated skin basal cell carcinoma)
10. Peripheral polyneuropathy > Grad II
11. Liver dysfunction (AST)/ALT>3,0xULN, ALT>3xULN, Bilirubin>1,5xULN) Serum Creatinin >1,0xULN
12. Chronic inflammable gastro-intestinal disease
13. Inclusion in another clinical trial
14. Pregnancy or lactation
15. Hepatitis B or C in the active stage
16. Human immunodeficiency virus(HIV) infected
17. Serious concomitant somatic and mental illnesses / deviations or territorial causesthat may prevent the patient from participating in the protocol and observing theprotocol schedule
18. Foreigners or persons with limited legal status