Shunji Endo
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Digestive Surgery,
   Position   Associate Professor
Article types 原著
Language English
Peer review Peer reviewed
Title A Phase II Study of Perioperative Capecitabine plus Oxaliplatin Therapy for Clinical SS/SE N1-3 M0 Gastric Cancer (OGSG 1601).
Journal Formal name:The oncologist
Abbreviation:Oncologist
ISSN code:1549490X/10837159
Domestic / ForeginForegin
Volume, Issue, Page 25(2),pp.119-e208
Author and coauthor Terazawa Tetsuji, Matsuyama Jin, Goto Masahiro, Kawabata Ryohei, Endo Shunji, Imano Motohiro, Fujita Shoichiro, Akamaru Yusuke, Taniguchi Hirokazu, Tatsumi Mitsutoshi, Lee Sang-Woong, Kurisu Yoshitaka, Kawakami Hisato, Kurokawa Yukinori, Shimokawa Toshio, Sakai Daisuke, Kato Takeshi, Fujitani Kazumasa, Satoh Taroh
Publication date 2020/02
Summary LESSONS LEARNED:Perioperative capecitabine and oxaliplatin (CapeOx) therapy showed favorable efficacy with sufficient pathological response. Small sample size limited the statistical power of this result. Perioperative CapeOx therapy showed good feasibility. Further studies with larger sample size are required to validate this novel approach.BACKGROUND:D2 gastrectomy followed by adjuvant S-1 is the standard therapy for patients (pts) with stage III gastric cancer (GC) in Japan; however, the outcome is not satisfactory. We examined the efficacy of perioperative capecitabine and oxaliplatin (CapeOx) in pts with GC.METHODS:The eligibility criteria included confirmed clinical T3(SS)/T4a(SE) N1-3 M0 GC according to the Japanese Classification (JCGC; 3rd English Edition). Three cycles of neoadjuvant CapeOx (NAC; capecitabine, 2,000 mg/m2 for 14 days; oxaliplatin, 130 mg/m2 on day 1, every 3 weeks) were administered, followed by five cycles of adjuvant CapeOx (AC) after D2 gastrectomy. The primary endpoint was the pathological response rate (pRR) according to the JCGC (≥grade 1b).RESULTS:Thirty-seven pts were enrolled on CapeOx. An R0 resection rate of 78.4% (n = 29) and a pRR of 54.1% (n = 20, p = .058; 90% confidence interval [CI], 39.4-68.2) were demonstrated. Among 27 pts who initiated AC, 21 (63.6%) completed the treatment. Grade 3-4 toxicities during NAC included neutropenia (8%), thrombocytopenia (8%), and anorexia (8%) and during AC included neutropenia (37%), diarrhea (4%), and anorexia (4%).CONCLUSION:Perioperative CapeOx showed good feasibility and favorable efficacy with sufficient pathological response, although statistical significance at .058 did not reach the commonly accepted cutoff of .05. The data obtained using this novel approach warrant further investigations.
DOI 10.1634/theoncologist.2019-0601
PMID 32043772