The Effect of Obesity on Response to Neoadjuvant Therapy in Locally Advanced Gastric Cancer

Şahin, Süleyman; Sakin, Abdullah; Aldemir, Mehmet Naci; Bayram, İrfan; Kotan, Çetin

doi:10.31557/apjcp.2020.21.9.2723

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…For locally-advanced GC, the phase III MAGIC study performed in 2006 which demonstrated survival bene t of NACt over surgery alone has been a milestone in this area, leading to a positive trend towards NACt, and the results of this study were supported by recent clinical trials from [4]. Moreover, recent studies have shown that NACt is well tolerated and does not affect postoperative morbidity and mortality in GC patients [9,10].…”

Section: Introductionsupporting

confidence: 54%

The Comparison of FLOT vs. mDCF Regimens in Neoadjuvant Setting for Locally-advanced Gastric Cancer

ÜRÜN

Şahin

URUN

et al. 2023

Preprint

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Aim:To compare the pathological tumor response and survival of mDCF(modified docetaxel+cisplatin+5-flourosil) vs. FLOT(5-flourosil+oxaliplatin+dosataxel) regimens in the neoadjuvant setting for patients with locally-advanced gastric adenocarcinoma. Methods: A total of 72 patients, 44 males and 28 females, who were diagnosed with locally-advanced gastric adenocarcinoma and treated with neoadjuvant chemotherapy were included. Postoperative pathological tumor response was compared between the two treatment groups. Results: There was no significant difference between the treatment regimens in terms of response to treatment, DFS, and OS. Discussion: Since no significant difference was observed between the regimens in terms of treatment response and survival, we think that cisplatin can be preferred instead of oxaliplatin as a part of neoadjuvant treatment regimen in elderly patients with diabetic neuropathy or high risk of neuropathy.

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Section: Introductionsupporting

confidence: 54%

The Comparison of FLOT vs. mDCF Regimens in Neoadjuvant Setting for Locally-advanced Gastric Cancer

ÜRÜN

Şahin

URUN

et al. 2023

Preprint

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“…There were 38 studies 43,45,46,59‐91,211,212 (40 cohorts; 2,361,275 participants) of cancer populations (Table S3); 17 cohorts were in East Asia, 10 cohorts in North America, 7 in Europe, 2 were international cohorts, 2 were in West Asia, and 1 each in South America and Africa. Mean age of participants ranged from 17 to 75 years.…”

Section: Resultsmentioning

confidence: 99%

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

2023

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SummaryFasting insulin and c‐reactive protein confound the association between mortality and body mass index. An increase in fat mass may mediate the associations between hyperinsulinemia, hyperinflammation, and mortality. The objective of this study was to describe the “average” associations between body mass index and the risk of mortality and to explore how adjusting for fasting insulin and markers of inflammation might modify the association of BMI with mortality. MEDLINE and EMBASE were searched for studies published in 2020. Studies with adult participants where BMI and vital status was assessed were included. BMI was required to be categorized into groups or parametrized as non‐first order polynomials or splines. All‐cause mortality was regressed against mean BMI squared within seven broad clinical populations. Study was modeled as a random intercept. β coefficients and 95% confidence intervals are reported along with estimates of mortality risk by BMIs of 20, 30, and 40 kg/m2. Bubble plots with regression lines are drawn, showing the associations between mortality and BMI. Splines results were summarized. There were 154 included studies with 6,685,979 participants. Only five (3.2%) studies adjusted for a marker of inflammation, and no studies adjusted for fasting insulin. There were significant associations between higher BMIs and lower mortality risk in cardiovascular (unadjusted β −0.829 [95% CI −1.313, −0.345] and adjusted β −0.746 [95% CI −1.471, −0.021]), Covid‐19 (unadjusted β −0.333 [95% CI −0.650, −0.015]), critically ill (adjusted β −0.550 [95% CI −1.091, −0.010]), and surgical (unadjusted β −0.415 [95% CI −0.824, −0.006]) populations. The associations for general, cancer, and non‐communicable disease populations were not significant. Heterogeneity was very large (I2 ≥ 97%). The role of obesity as a driver of excess mortality should be critically re‐examined, in parallel with increased efforts to determine the harms of hyperinsulinemia and chronic inflammation.

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“…Another study found that survival was better in patients who received neoadjuvant treatment and achieved a response. [37] In our study, although there was no comparator arm in the BSC programme, we believe that this patient population should not be left untreated because OS was 10.5 months in patients with ECOG PS 0-1, 13.8 months in patients receiving two lines or more, and the frequency of side effects was acceptable. As there are acceptable survival outcomes even with single-agent therapies, monotherapy should be recommended for patients with poor ECOG PS and combination therapies for patients with good PS without comorbidities.…”

Section: Discussionmentioning

confidence: 71%

Chemotherapy Efficacy and Tolerability in Metastatic Gastric Cancer Patients Aged 75 Years and Older

Sezigin

2023

EJMI

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A lthough the incidence of gastric cancer has decreased with the preservation of food under more suitable conditions, the incidence is still increasing in the elderly population. Gastric cancer is the 5 th most frequently common cancer worldwide and the 3 rd most leading cause of malignancy-related deaths. [1][2][3][4][5] Despite the development of surgical, targeted therapies and combined chemotherapy treatments, 5-year overall survival (OS) rates are less than 30%. [3,6] Most patients with gastric cancer are diagnosed at an advanced stage. [3] The average age of diagnosis is 71 and the average age of death is 74. [4,5] More than half of patients have no chance of resection at the time of diagnosis. [7] There are many studies in which multimodal treatment is recommended in the treatment of non-metastatic gastric cancer. In multimodal treatment, preoperative neoadjuvant treatment, followed by surgical treatment and then adjuvant treatment is recommended. [8][9][10] Treatment for metastatic gastric cancer is palliative. Chemotherapy has favorable OS than best supportive care (BSC) in metastatic gastric cancer. [11,12] In a meta-analysis comparing combina-Objectives: More than half of gastric cancer patients have no chance of resection at the time of diagnosis. In gastric cancer, which has increased frequency with age, chemotherapy efficacy and tolerability in metastatic gastric cancer aged 75 and over have been investigated due to the fact that the elderly patient population is not sufficiently involved in the studies. Methods: In our study, the clinical and demographic characteristics of patients, treatment regimens and responses, prognostic factors, grad 3-4 toxicity, progression-free survival (PFS) and overall survival (OS) were examined. Results: In the study involving 118 patients, PFS was 5.8 months and OS was 8.4 months. A disease control rate of 38.1% was achieved with chemotherapy. Conclusion:Since the OS in this study was 10.5 months in patients with ECOG PS 0-1, 13.8 months in patients who received two lines or more, and the frequency of side effects was acceptable, we believe that this patient population should not be left untreated. Since there are acceptable survival values even with single-agent therapies, monotherapy can be recommended for patients with poor ECOG PS and combination therapies can be recommended for patients with good PS without comorbidities.

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The Effect of Obesity on Response to Neoadjuvant Therapy in Locally Advanced Gastric Cancer

Cited by 5 publications

References 31 publications

The Comparison of FLOT vs. mDCF Regimens in Neoadjuvant Setting for Locally-advanced Gastric Cancer

The Comparison of FLOT vs. mDCF Regimens in Neoadjuvant Setting for Locally-advanced Gastric Cancer

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

Chemotherapy Efficacy and Tolerability in Metastatic Gastric Cancer Patients Aged 75 Years and Older

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