A Phase II Trial of Epirubicin, Oxaliplatin and Capecitabine (EOX) Versus Docetaxel and Oxaliplatin (ElTax) in the Treatment of Advanced Gastro-oesophageal Cancer

Inclusion Criteria: * Unresectable or metastatic, histologically confirmed adenocarcinoma of the stomach, gastro-oesophageal junction or lower third of the oesophagus with measurable disease on CT scanning (see RECIST Criteria, Appendix C of the protocol for definition of measureable disease). * No previous treatment for advanced disease (previous adjuvant/neo-adjuvant treatment acceptable if \>12 months previously). * Absence of serious concomitant illness (i.e. MI within previous 6 months), uncontrolled angina, uncontrolled hypertension, severe COPD (\>3 admissions for infective exacerbation in past 12 months) etc. * ECOG performance status ≤ 2. * Age ≥ to 18. * Life expectancy ≥ 3 months * Adequate renal, hepatic and bone marrow function * Creatinine clearance ≥ 50 ml/min as calculated using the Cockcroft and Gault formula (see Appendix L). * Liver function tests: Bilirubin ≤ 1.0 x ULN, AST ≤ 1.5 x ULN, ALT ≤ 1.5 x ULN,Haemoglobin \> 10.0 g/dl, Absolute neutrophil count \>1.5 x 109 /L, Platelet count \> 100 x109/L. •Before randomisation, written informed consent must be given according to ICH/GCP, and national/local regulations. Exclusion Criteria: * Symptoms or signs of peripheral neuropathy. * Patients known to have second or third degree heart block. * Previous or concurrent malignancy, with the exception of basal cell carcinoma of the skin or in-situ neoplasia of the uterine cervix. * Known hypersensitivity to taxanes, oxaliplatin, or fluoropyrimidines. * Pregnant or nursing. * Female of child-bearing potential, or male partner of female of child bearing potential not taking adequate contraceptive precautions. * Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial