Phase 2 study of adjuvant chemotherapy with docetaxel, capecitabine, and cisplatin in patients with curatively resected stage IIIB–IV gastric cancer

Yoon, Shinkyo; Yoo, Changhoon; Ryu, Min‐Hee; Kang, Myoung Joo; Ryoo, Baek‐Yeol; Park, Sook Ryun; Yook, Jeong Hwan; Oh, Seok‐Young; Yoo, Moon‐Won; Kim, Byung Sik; Kang, Yoon‐Koo

doi:10.1007/s10120-015-0580-2

Cited by 6 publications

(8 citation statements)

References 24 publications

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“…conducted a phase II clinical study about docetaxel, capecitabine, and cisplatin (DXP) triplet chemotherapy in advanced gastric cancer. e result showed that DXP was safe and might be better in terms of recurrence-free survival (RFS) [16,20]. Swiss group for clinical cancer research conducted a randomized phase II clinical trial to make a comparison between docetaxel + cisplatin + 5FU (DCF) and ECF to see which would be most promising according to the overall response rate (ORR) [17,21].…”

Section: Discussionmentioning

confidence: 99%

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FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

Zhang

Yan

Sun

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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Background. The prognosis of patients with advanced gastric cancer remains unsatisfactory, highlighting the need for improved therapeutic strategies. We analyzed 23 resectable advanced gastric cancer patients who received FLOT followed by laparoscopic gastrectomy with D2 lymphadenectomy to evaluate the efficacy and safety. Methods. Patients aged 18–75 years with gastric adenocarcinoma (stage cT3–4 and/or N + M0) underwent neoadjuvant FLOT therapy (four preoperative and four postoperative 2-week cycles) at Shanghai East Hospital. Laparoscopic gastrectomy was scheduled 3-4 weeks after completion of the last cycle of preoperative chemotherapy. The type of surgical procedure was determined by the location and extent of the primary tumor. Results. 23 patients were reviewed in the study. 20 patients (81.2%) received four courses of FOLT therapy, while 3 patients (18.8%) received three courses of treatment. There were 3 (13.0%) complete responses, 13 (56.5%) partial responses, 4 (26.1%) of stable disease, and 1 (4.3%) of progressive disease. The clinical efficacy response rate was 69.6%. The R0 resection rate was 91.3%. Only one patient exhibited grade III postoperative complications. The pathologic complete remission was 13%. The common grade 3/4 adverse events from chemotherapy were leucopenia (17.4%), neutropenia (30.4%), anemia (13%), anorexia (13%), and nausea (17.4%). Postoperative complications occurred in 5 patients (26.1%). There was no treatment-related mortality or reoperation. The most reason for not completing chemotherapy was the patient’s request. Conclusions. These findings suggest that FLOT neoadjuvant chemotherapy, followed by laparoscopic D2 gastrectomy, is effective and safe in advanced, resectable advanced gastric cancer.

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Section: Discussionmentioning

confidence: 99%

“…e influence of neoadjuvant chemotherapy on the operative morbidity and mortality is another critical problem due to the degree of toxicity [20,24]. e most noticeable postoperative complications are surgical site infections including wound infections and intra-abdominal abscess, followed by anastomotic leakage [21,25].…”

Section: Discussionmentioning

confidence: 99%

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

Zhang

Yan

Sun

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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“…The ACTS-GC trial (24) and CLASSIC trial (25) proved the efficacy of S-1 and XELOX regimens as adjuvant chemotherapy for East Asian patients with gastric cancer who received curative surgery with D2 lymphadenectomy. Moreover, taxane has been used extensively as part of neoadjuvant chemoradiotherapy (26), chemotherapy (27)(28)(29), and adjuvant chemotherapy regimens (30,31) due to its high efficacy as palliative chemotherapy for advanced gastric cancer (23). Our department (30) has previously reported a study of 32 patients with gastric cancer who received the DCF regimen as adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Although the 2-year disease-free survival rate was lower than the 3-year disease-free survival rate in the ACTS-GC trial (72.2%) and the CLASSIC trial (74.0%), the patients in our study generally harbored more advanced disease, as nearly 70% of the patients were diagnosed with stage III disease. Yoon et al (31) administered the docetaxel + capecitabine + cisplatin (DXP) regimen as adjuvant chemotherapy to patients with stage IIIB-IV disease according to the AJCC 6.0; the results showed that the median relapse-free survival was 26.9 months, and the 5-year relapse-free survival rate was 39.1%. Hence, in this study, we used taxane-based chemotherapy as modified adjuvant chemotherapy after surgery.…”

Section: Discussionmentioning

confidence: 99%

Graded histologic response after neoadjuvant chemotherapy is an optimal criterion for treatment change in patients with locally advanced gastric cancer

Wang¹,

Li²,

Zhou³

et al. 2019

Ann. Transl. Med.

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Background:The necessity for changing the postoperative therapy regimen for locally advanced gastric cancer after ineffective neoadjuvant chemotherapy and surgery is unclear because there are no criteria to determine which patients can benefit from this treatment. We assessed whether graded histologic regression of <50% could be the criterion for regimen modification. Methods:The study was designed as a matched-pair case-control investigation to minimize intergroup heterogeneity. Patients were stratified into two groups in which they either continued in the same course of treatment or changed the regimen to neoadjuvant chemotherapy.Results: Thirty-six patients were stratified into two groups. The adjuvant chemotherapy regimen of 12 patients was changed, while 24 patients continued on the same regimen. During an average follow-up period of 36 months, there was no difference observed in overall survival in the two groups (median, 24.0 vs. 31.0 months, P=0.863). In a subgroup analysis, however, patients in the changed regimen group with ypTNM stage III disease tended to have superior overall survival, though this effect was not significant (median, 23.0 vs. 14.0 months, P=0.123). Post-therapy nodal status was associated with overall survival in the multivariate analysis (P=0.014, HR 12.503, 95% CI: 1.664-93.919). Most adverse events were categorized as grade 1 or 2, and all treatments were well tolerated.Conclusions: Changing treatment based on a graded histologic regression of <50% after neoadjuvant chemotherapy did not prolong overall survival in patients with gastric cancer. However, changing the adjuvant regimen did reveal a trend towards improved overall survival in the ypTNM stage III subgroup, which merits further investigation using a larger sample size.

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“…Reports have described the effectiveness of DCX for unresectable gastric cancer[ 10 , 16 ], as preoperative chemotherapy[ 17 ], as adjuvant chemotherapy[ 18 ] and as perioperative chemotherapy[ 12 ]. These reports indicate that DCX is highly effective but also rather toxic, particularly in hematologic respects.…”

Section: Discussionmentioning

confidence: 99%

Modified docetaxel, cisplatin and capecitabine for stage IV gastric cancer in Japanese patients: A feasibility study

Maeda¹,

Matsuoka²,

Miyahara³

et al. 2017

WJG

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AIMTo evaluate the feasibility of chemotherapy including fluoropyrimidine, platinum and taxane with modified dosages for unresectable gastric cancer in Japanese patients.METHODSWe performed a feasibility study of a modified docetaxel, cisplatin and capecitabine (DCX) regimen for stage IV gastric cancer. In particular, 30 or 40 mg/m2 of docetaxel on day 1, 60 mg/m2 of cisplatin on day 1, and 2000 mg/m2 of capecitabine for 2 wk were administered every three weeks.RESULTSThree patients were treated with modified DCX (mDCX) with 30 mg/m2 docetaxel, and five patients were treated with this regimen with 40 mg/m2 docetaxel. Grade 3 or 4 neutropenia was observed in six of the eight patients; no patients exhibited febrile neutropenia. Partial response was achieved in four of the eight patients. Three patients underwent gastrectomy, which achieved R0 resection without residual tumors in dissected lymph nodes. In one of these three patients, resected specimens revealed pathological complete response in the primary lesion and in lymph nodes.CONCLUSIONmDCX was well tolerated by Japanese patients with stage IV gastric cancer. This regimen might be useful for allowing gastric cancer patients with distant lymph node metastasis to undergo conversion surgery.

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Phase 2 study of adjuvant chemotherapy with docetaxel, capecitabine, and cisplatin in patients with curatively resected stage IIIB–IV gastric cancer

Cited by 6 publications

References 24 publications

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

Graded histologic response after neoadjuvant chemotherapy is an optimal criterion for treatment change in patients with locally advanced gastric cancer

Modified docetaxel, cisplatin and capecitabine for stage IV gastric cancer in Japanese patients: A feasibility study

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