
    slow accrual
  
['esophagus cancer', 'stomach cancer', 'small bowel cancer', 'colon cancer', 'rectum cancer']
['s-1', 'capecitabine', 'oxaliplatin']

        Inclusion Criteria:

          -  Has given written informed consent.

          -  Is at least 18 years of age.

          -  Has advanced or metastatic gastrointestinal tract adenocarcinoma.

          -  No previous cancer chemotherapy for cancer.

          -  Measurable or evaluable lesions according to RECIST v1.1 criteria.

          -  Is able to take medications orally.

          -  Has ECOG performance status 0 or 1.

          -  Has a life expectancy of at least 3 months.

          -  Has adequate organ function.

        Exclusion Criteria:

          -  Cancer considered operable without prior chemotherapy.

          -  Prior chemotherapy to cancer.

          -  Previous therapy with fluoropyrimidines or anthracyclines for any indication.

          -  Inability to swallow tablets.

          -  Known brain metastasis or leptomeningeal metastasis.

          -  History of myocardial infarction, coronary stenting/graft.

          -  History of unstable angina, coronary/peripheral artery bypass graft.

          -  History of cerebrovascular accident or transient ischemic attack.

          -  History of pulmonary embolism or deep vein thrombosis.

          -  Symptomatic congestive heart failure.

          -  Ongoing cardiac dysrhythmias.

          -  Patients with any cardiac disease that requires regular medication.

          -  Hypertensive crisis or severe hypertension that is not controlled.

          -  Is a pregnant or lactating female.

          -  The cardiac arterial flow tests cannot be done.
      