エンドウ　シュンジ   Shunji Endo   遠藤　俊治    所属   川崎医科大学  医学部 臨床医学　消化器外科学    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	A phase II study of neoadjuvant chemotherapy with docetaxel, cisplatin, and S-1 followed by gastrectomy for type 4 or large type 3 gastric cancer (OGSG 1402).
掲載誌名	正式名：Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 略　 称：Gastric Cancer ISSNコード：14363305/14363291
掲載区分	国外
巻・号・頁	29(3),pp.622-634
著者・共著者	Ryo Tanaka, Sang-Woong Lee, Kazumasa Fujitani, Shunji Endo, Junji Kawada, Toshifumi Yamaguchi, Yusuke Akamaru, Ko Takachi, Noriko Wada, Osamu Takayama, Haruna Furukawa, Masaaki Motoori, Keijiro Sugimura, Yoshio Oka, Izumi Komoto, Shugo Ueda, Tomono Kawase, Jin Matsuyama, Toru Masuzawa, Yukinori Kurokawa, Toshimasa Tsujinaka, Toshio Shimokawa, Taro Satoh
発行年月	2026/05
概要	BACKGROUND:A multi-institutional phase II study (OGSG 1402) evaluated the efficacy and safety of neoadjuvant docetaxel, cisplatin, and S-1 (DCS) therapy for type 4 or large type 3 gastric cancers.METHODS:Patients with macroscopic type 4 or large type 3 gastric cancer received two or three cycles of neoadjuvant DCS therapy (docetaxel 40 mg/m2 and cisplatin 60 mg/m2 intravenously on day 1, and S-1 80-120 mg/body orally for 14 days, every 4 weeks), followed by gastrectomy with D2 lymphadenectomy. After R0 resection, adjuvant S-1 chemotherapy was administered for 1 year. The primary endpoint was the R0 resection rate.RESULTS:Between March 2015 and June 2018, 48 patients were enrolled, 47 of whom were eligible. The R0 resection rate was 68.1% (32/47, 95% confidence interval [CI] 52.9-80.9). Forty-two patients (89.4%) completed neoadjuvant chemotherapy (NAC). The most common grade 3 or 4 adverse event during NAC was neutropenia (23/47, 48.9%). Surgical morbidity of Clavien-Dindo grade IIIa or higher occurred in 8.5% (4/47) of patients. The pathological response rate, defined as grades 1b to 3, was 42.6% (20/47, 95% CI 28.3-57.8). The 5-year overall survival rate was 38.3% (95% CI 24.6-51.8) and the 5-year progression-free survival rate was 29.8% (95% CI 17.6-43.0).CONCLUSIONS:In patients with type 4 or large type 3 gastric cancer, neoadjuvant DCS therapy did not meet the predefined threshold for the R0 resection rate. Despite its acceptable feasibility and manageable toxicity, the addition of docetaxel to the S-1 plus cisplatin regimen is unlikely to provide a survival benefit for this high-risk population.TRIAL REGISTRATION:The study was registered with UMIN-CTR (number UMIN 000015631).
DOI	10.1007/s10120-026-01727-w
PMID	41843003