A phase II study of adjuvant S-1/cisplatin chemotherapy followed by S-1-based chemoradiotherapy for D2-resected gastric cancer

Abstract

The results of this phase II study show that intensified adjuvant treatment with S-1/cisplatin chemotherapy and S-1-based chemoradiotherapy was tolerable and effective in reducing disease recurrence. The addition of radiotherapy to chemotherapy may be effective in D2-resected gastric cancer. Although the data here are promising, a randomized trial is needed between patients treated with the current regimen and an appropriate comparator arm.

S-1 chemotherapy and intensity-modulated radiotherapy after D1/D2 lymph node dissection in patients with node-positive gastric cancer: a phase I/II study

“…However, the patients in the phase II portion of our study had more PLNs than those in this Korean study (median, 11.5 vs 8). Recently, another Korean phase II trial evaluating adjuvant S-1/cisplatin chemotherapy with concurrent S-1/radiotherapy in gastric cancer patients after D2 LND (63.1% of patients had stage III or IV (M0) disease, with a median number of PLNs of 5.5) reported 3-year DFS and OS rates of 65.2% and 76.1%, which are similar to our results (Shim et al , 2016).…”

“…In this study, the most common grade 3/4 haematological and gastrointestinal toxicities were leukopenia (11.5%) and nausea (9.6%), which were relatively less frequent than those in the aforementioned studies (Kim et al , 2012; Lee et al , 2012; Park et al , 2015; Shim et al , 2016). The exclusion of the remnant stomach from the radiation field and the application of IMRT may lead to a relatively lower rate of severe haematological (leukopenia/neutropenia) and gastrointestinal (nausea/vomiting) toxicities.…”

“…The exclusion of the remnant stomach from the radiation field and the application of IMRT may lead to a relatively lower rate of severe haematological (leukopenia/neutropenia) and gastrointestinal (nausea/vomiting) toxicities. The two Korean studies, which irradiated the remnant stomach and used the AP-PA conventional radiation technique, reported leukopenia/neutropenia in 17.4–19.6% of patients and nausea/vomiting in 17.4–28.2% of patients (Kim et al , 2012; Shim et al , 2016). Although the ARTIST trial did not routinely include the remnant stomach in the radiation field, it also reported that 48.4% and 12.3% of patients developed grade 3/4 neutropenia and nausea, respectively.…”

Stress-inducible Protein-1 promotes metastasis of gastric cancer via Wnt/β-catenin signaling pathway

“…Gastric cancer (GC) is a common and lethal cancer over the world [ 1 ], with marked morbidity and mortality in China [ 2 ]. In spite of some developments in the treatment of GC, the overall survival of GC patients remains poor because most GC patients have local and distant metastases at diagnosis [ 3 – 5 ]. Thus, it is of vital importance to investigate the molecular mechanisms underlying metastasis to provide novel biomarkers for treatment of GC.…”

Progress of preoperative and postoperative radiotherapy in gastric cancer

“…The ARTIST II trial is a phase III randomized trial of adjuvant chemotherapy with compound tegafur–oteracil potassium capsules (S-1) versus S-1/oxaliplatin ± RT for surgical patients with positive nodes [ 31 ]. Remarkably, the results of the phase II clinical trial based on S-1 and cisplatin showed that the postoperative concurrent CRT group improved 3 years of DFS relative to the postoperative chemotherapy group, and the toxicities were acceptable [ 32 ]. In recent years, several meta-analyses have demonstrated the role of perioperative RT in treating gastric cancer [ 33 – 35 ].…”