Chemotherapy plays a central role in the management of advanced-stage gastric cancer, helping to extend survival and improve quality of life. However, there is still no consensus on whether doublet or triplet chemotherapy regimens should be used as the standard treatment for these patients. This retrospective study examines first-line chemotherapy options for metastatic gastric cancer at five medical centers in Turkey. The inclusion criteria required patients to have metastatic gastric adenocarcinoma, no prior treatment for localized gastric cancer (including surgery, chemotherapy, or radiotherapy), treatment with chemotherapy for metastatic disease (with at least two drugs), and HER-2 negative status. The analysis showed that patients treated with triplet chemotherapy had significantly longer survival compared to those who received oxaliplatin-based doublet chemotherapy (11.1 months vs. 8.1 months, P = 0.007). However, no significant survival difference was observed between the triplet chemotherapy group and those on cisplatin-based doublet chemotherapy (11.13 months vs. 10.57 months, P = 0.665). The findings suggest that triplet chemotherapy regimens should be considered as the first choice for first-line treatment in metastatic gastric cancer when possible, while cisplatin-based doublet regimens may be an appropriate alternative, especially in Turkey.
