Validity of neoadjuvant chemotherapy with docetaxel, cisplatin, and S-1 for resectable locally advanced gastric cancer

Abstract

Gastrectomy with D2 lymphadenectomy plus postoperative chemotherapy is the standard treatment for resectable locally advanced gastric cancer in Japan. However, the prognosis of patients with serosa-positive tumors remains unsatisfactory because of peritoneal recurrence. This study aimed to investigate the validity of neoadjuvant therapy with docetaxel, cisplatin, and S-1 (DCS) in patients with locally advanced gastric cancer. Thirty patients with locally advanced gastric cancer underwent neoadjuvant DCS therapy at Dokkyo Medical University Hospital between June 2013 and October 2015. Gastrectomy and D2 lymphadenectomy were performed after two cycles of preoperative DCS therapy. The clinical responses of the primary gastric tumors based on endoscopic findings were partial response in 17 patients (57%) and stable disease in 13 patients (43%). Analysis of pathological response in the primary gastric lesions showed grade 1a in five patients (17%), grade 1b in nine patients (30%), grade 2 in 11 patients (37%), and grade 3 in five patients (17%). Twenty-four patients (80%) remained alive after a median follow-up period of 31 months. The 2- and 3-year overall survival rates in all patients were 89 and 70%, respectively. The 2-year overall survival rate in pathological responders (grade 1b-3) was 96%, compared with 50% in pathological non-responders (grade 1a) (P = 0.00187). Pathological responders had a significantly higher survival rate than non-responders. These results indicate that neoadjuvant DCS therapy may improve the prognosis in patients with serosa-positive locally advanced gastric cancer.

Cisplatin resistance in gastric cancer cells is involved with GPR30‐mediated epithelial‐mesenchymal transition

“…Cisplatin-based treatment has been proved to effectively improve the survival rate of patients with advanced GC. 4,5 Nevertheless, with the widespread use of chemotherapeutic drugs, tumour cells often develop single or multiple drug resistance (MDR) through various mechanisms, which has become a major obstacle in GC chemotherapy. 6,7 Although some patients are initially sensitive to chemotherapy, almost all patients with GC will develop resistance and recurrence with the continued use of chemotherapeutic drugs.…”

“…Platinum drugs (cisplatin and oxaliplatin) are the first‐line treatment in chemotherapy of GC. Cisplatin‐based treatment has been proved to effectively improve the survival rate of patients with advanced GC . Nevertheless, with the widespread use of chemotherapeutic drugs, tumour cells often develop single or multiple drug resistance (MDR) through various mechanisms, which has become a major obstacle in GC chemotherapy .…”

Lidocaine alleviates cisplatin resistance and inhibits migration of MGC-803/DDP cells through decreasing miR-10b

“…As a means of treatment, chemotherapy is extensively applied [18,19]. Cisplatin is an effective drug of chemotherapy [20]. Although cisplatin could inhibit the proliferation of tumor cell and promote apoptosis to a certain degree, the resistance of cisplatin should be taken seriously by people [21].…”

Silencing of Long Non-coding RNA HOTAIR Suppresses Reverses Epithelial-Mesenchymal Transition in AGS Gastric Cancer Cell Line by Downregulation of Fibronectin 1 and Claudin-4

“…In recent decades, molecular targeted therapy for cancer has drawn attention to enhance selective anticancer therapy. Molecular targeted inhibitors efficaciously mark specific over-expressed molecules in pathways related to tumorigenesis (4). Long non-coding RNAs (lncRNAs) are lengthy transcripts and do not code functional proteins.…”