Neoadjuvant Chemotherapy Compared With Surgery Alone for Locally Advanced Cancer of the Stomach and Cardia: European Organisation for Research and Treatment of Cancer Randomized Trial 40954

Schuhmacher, Christoph; Gretschel, Stephan; Lordick, Florian; Reichardt, Peter; Hohenberger, Werner; Eisenberger, Claus Ferdinand; Haag, C.; Mauer, Murielle; Hasan, Baktiar; Welch, John J.; Ott, Katja; Hoelscher, Arnulf H.; Schneider, Paul M.; Bechstein, Wolf O.; Wilke, H.; Lutz, Manfred P.; Nordlinger, Bernard; Cutsem, Éric Van; Siewert, J. R.; Schlag, Peter M.

doi:10.1200/jco.2009.26.6114

Cited by 620 publications

(526 citation statements)

References 17 publications

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“…The European group has reported recently that R0 surgery increased but did not affect overall survival. 28 Kochi and his colleagues have reported the efficacy of neoadjuvant S-1þCDDP. 29 Before any conclusive results come out by the well-organized studies, we should be careful in adopting neoadjuvant chemotherapy in the clinical settings.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Stage IV Gastric Cancer

Baba

Kuwabara

Ishiguro

et al. 2013

International Surgery

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Stage IV Gastric Cancer

Baba

Kuwabara

Ishiguro

et al. 2013

International Surgery

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“…In this trial, three ECF cycles (5-fluorouracil , cisplatin, and epirubicin) were given before and after surgery, and there was a significant improvement in OS of 7.4 and 12.5 % after 4 and 5 years compared with surgery alone, respectively. Data on neoadjuvant chemotherapy has been available from at least five randomized trials that included patients with lower esophageal adenocarcinoma [5,[35][36][37][38][39].…”

Section: Surgerymentioning

confidence: 99%

“…Several metaanalyses have demonstrated a statistically significant benefit for neoadjuvant chemotherapy [40][41][42]. The EORTC 40954 trial, which primarily included patients with AEG junction, contributed to the evidence for neoadjuvant chemotherapy [37]. In this trial, cisplatin/5-FU as a PLF regimen was used only preoperatively.…”

Section: Surgerymentioning

confidence: 99%

International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus

et al. 2014

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Background Clinical guidelines are essential in implementing and maintaining nationwide stage-specific diagnostic and therapeutic standards. In 2011, the first German expert consensus guideline defined the evidence for diagnosis and treatment of early and locally advanced esophagogastric cancers. Here, we compare this guideline with other national guidelines as well as current literature.Methods The German S3-guideline used an approved development process with de novo literature research, international guideline adaptation, or good clinical practice. Other recent evidence-based national guidelines and current references were compared with German recommendations.

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“…40 In recent years, there have been advances in the surgical approach with combining gastrectomy with limited lymphadenectomy in a Western setting 41 and D2 lymphadenectomy in an Asian setting 42 and the use of preoperative chemotherapy to increase the R0 resection rate. 43 It has also been shown that combination chemotherapy significantly improves survival compared to single agent 5-fluorouracil, however, at the expensive of increased toxicity. 44 Most recently, the ToGA study as previously alluded to, demonstrated the efficacy of combining trastuzumab with chemotherapy.…”

Section: Presence Of Metastases (M)mentioning

confidence: 99%

Clinicopathologic factors associated with HER2‐positive gastric cancer and its impact on survival outcomes—A systematic review

Chua

Merrett

2011

Intl Journal of Cancer

163

111

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With the availability of a therapeutic target and an effective agent in trastuzumab, a systematic examination of the literature to investigate the role of human epidermal growth factor 2 (HER2) as a prognostic factor for survival and its association with clinicopathologic markers may improve treatment. An electronic search of the MEDLINE and PubMed databases (January 1990 to January 2011) was undertaken to identify translational studies that correlated HER2 with clinicopathologic markers and/or survival outcome. This review included 49 studies totaling 11,337 patients. Forty-four percent of patients had Stage I/II, and 56% had Stage III/IV disease. Immunohistochemistry was most commonly used to assess HER2 expression, identifying a median rate of 18% (range, 4-53%) of gastric cancer demonstrating HER2 overexpression. In patients with and without HER2 overexpression, the median 3-year disease-free survival rate was 58% (range, 50-88%) and 86% (range, 62-97%), respectively. Of the 35 studies reporting the impact of HER2 overexpression on survival, 20 studies (57%) reported no difference in overall survival, two studies (6%) reported significantly longer overall survival in patients with HER2 overexpression and 13 studies (37%) reported significantly poorer overall survival in patients with HER2 overexpression. The median overall survival and 5-year survival rate was 21 (range, 10-57) months and 42%, and 33 (range, 13-80) months and 52% in patients with and without HER2 overexpression, respectively. HER2 overexpression appears to be associated with poorer survival and with intestinal-type gastric cancer in this group of patients for whom majority undergone curative gastrectomy.On a global scale, gastric cancer remains the second most common cause of cancer-related death with an estimated 930,000 new cases diagnosed each year albeit an overall decline in incidence. 1 Noncardia gastric cancers have steadily declined. However, it has been observed that proximal gastric cancers (cardia and oesophago-gastric tumors) are increasing at a rate of up to 10% per year, far exceeding that of any other type of cancer. Metastatic or advanced unresectable gastric cancer is an aggressive malignancy with a poor prognosis despite chemotherapy treatment with median survival of 7.5 to 12 months and a median survival of 3 to 5 months if managed by best supportive care. 2 Gastric cancer is a chemosensitive disease where a range of chemotherapy agents may achieve response rates of 30 to 40%; however, in the advanced setting, the disease is limited by a low complete response rate and the response duration is protracted often leading to disease progression and treatment related toxicities. 3 Combination chemotherapy with a Japanese standard doublet of fluoropyrimidine and platinum or western triplet regimens has shown better response rates and outcomes over single agent chemotherapy. However, there remains no established global standard for treatment.The human epidermal growth factor 2 (HER2) gene is a proto-oncogene where high amplifica...

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Neoadjuvant Chemotherapy Compared With Surgery Alone for Locally Advanced Cancer of the Stomach and Cardia: European Organisation for Research and Treatment of Cancer Randomized Trial 40954

Cited by 620 publications

References 17 publications

Prognostic Factors for Stage IV Gastric Cancer

Prognostic Factors for Stage IV Gastric Cancer

International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus

Clinicopathologic factors associated with HER2‐positive gastric cancer and its impact on survival outcomes—A systematic review

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