P-68 Response to neoadjuvant chemotherapy in gastric adenocarcinoma and gastroesophageal junction adenocarcinoma with FLOT-regimen in our setting

Purpose. This paper is aimed at comparing the short-term efficacy of the combination of docetaxel, oxaliplatin, and capecitabine (DOX) with the combination of oxaliplatin and capecitabine (XELOX) as neoadjuvant chemotherapy regimens for the treatment of patients with resectable gastric or gastroesophageal junction adenocarcinoma. Methods. A total of 300 patients aged 20-60 years with resectable gastric or gastroesophageal junction adenocarcinoma who were evaluated with cT3/4Nany were randomly assigned into 3 groups: DOX group ( n = 100 , treated with neoadjuvant DOX plus adjuvant XELOX), XELOX group ( n = 100 , treated with perioperative XELOX), and surgery group ( n = 100 , treated with adjuvant XELOX). Results. A total of 93, 92, and 95 patients were enrolled in the DOX, XELOX, and surgery groups, respectively. The pathological complete response (pCR) rate was 16.1% in the DOX group and 4.3% in the XELOX group ( P = 0.008 ). There were 56 (61.3%) patients in the DOX group who presented with surgical complications, 22 (23.9%) patients in the XELOX group, and 37 (38.9%) patients in the surgery group. The most common grade 3-4 adverse events in these three groups were neutropenia (32.3%, 30.4%, and 21.1%), leucopenia (21.5%, 22.8%, and 15.8%), nausea (15.1%, 16.3%, and 12.6%), and fatigue (10.8%, 7.6%, and 8.4%). Conclusions. Neoadjuvant DOX is an effective and feasible regimen and might represent an option for young and middle-aged patients with locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma.

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Computed Tomography (CT) Perfusion as an Early Predictive Marker for Treatment Response to Neoadjuvant Chemotherapy in Gastroesophageal Junction Cancer and Gastric Cancer - A Prospective Study

PLoS ONE ◽

10.1371/journal.pone.0097605 ◽

2014 ◽

Vol 9 (5) ◽

pp. e97605 ◽

Cited By ~ 22

Author(s):

Martin Lundsgaard Hansen ◽

Eva Fallentin ◽

Carsten Lauridsen ◽

Ian Law ◽

Birgitte Federspiel ◽

...

Keyword(s):

Gastric Cancer ◽

Computed Tomography ◽

Neoadjuvant Chemotherapy ◽

Prospective Study ◽

Ct Perfusion ◽

Gastroesophageal Junction ◽

Predictive Marker ◽

Gastroesophageal Junction Cancer ◽

A Prospective Study ◽

Response To Neoadjuvant Chemotherapy

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Real Life Experience of Patients With Locally Advanced Gastric and Gastroesophageal Junction Adenocarcinoma Treated With Neoadjuvant Chemotherapy: a Turkish Oncology Group Study

10.21203/rs.3.rs-884239/v1 ◽

2021 ◽

Author(s):

Tugba Basoglu ◽

cihan erol ◽

abdullah sakin ◽

ercan özden ◽

devrim çabuk ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Life Experience ◽

Gastroesophageal Junction ◽

Locally Advanced ◽

Real Life ◽

Disease Free Survival ◽

R0 Resection ◽

Toxicity Profile ◽

Life Study ◽

Gastroesophageal Junction Adenocarcinoma

Abstract PurposeNeoadjuvant chemotherapy(NACT) in gastroesophageal junction(GEJ) and gastric cancer(GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT in order to compare the efficacy and toxicity profile of different chemotherapy regimens in our country.Methods This retrospective multicenter study included locally advanced GC and GEJ cancer patients who received NACT, and had pathological response evaluation between 2007 and 2021. Relation between CT regimens and pathological evaluation were analyzed. Results A total of 728 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-68). Most frequent NACT regimens used were FLOT (65%), DCF (18%) and ECF (8.1%), respectively. In the total study group pCR rate was 8.2%, R0 resection rate 88.5%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (26.4%), and R0 resection (92.6%) were higher in FLOT arm (p= 0.005 and <0.001). Patients who received FLOT had significantly higher chemotherapy-related toxicity rate compared to patients who received other regimens (p=0.02).Median follow-up time was 17 months (range: 3-106 months). Estimated median overall survival (OS) was 59.4 months (95% CI: 32.9-86.0) and disease-free survival (DFS) was 47.6 months (95% CI: 24.4-70.8). The highest 5-year estimated OS rate was also shown in FLOT arm (58%). ConclusionIn our real-life study, FLOT regimen has superior survival outcome despite worse toxicity profile. Clinicians should tailor treatment regimens according to patients’ multifactorial status and comorbidities for to obtain best outcomes.

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Baseline neutrophil–lymphocyte ratio holds no prognostic value for esophageal and junctional adenocarcinoma in patients treated with neoadjuvant chemotherapy

Diseases of the Esophagus ◽

10.1093/dote/doz082 ◽

2019 ◽

Vol 33 (6) ◽

Cited By ~ 1

Author(s):

S J M van Hootegem ◽

B M Smithers ◽

D C Gotley ◽

S Brosda ◽

I G Thomson ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Roc Curve ◽

Prognostic Value ◽

Gastroesophageal Junction ◽

Optimal Cutoff ◽

Cutoff Value ◽

Cox Regression Analysis ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Gastroesophageal Junction Adenocarcinoma

SUMMARY Background: Several studies have reported that neutrophil–lymphocyte ratio (NLR) can predict survival in esophageal and gastroesophageal junction adenocarcinoma, as it reflects systemic inflammation. Hence, we aimed to determine whether baseline NLR holds prognostic value for esophageal adenocarcinoma patients treated with neoadjuvant chemotherapy (nCT) followed by surgery. Methods: We studied the data of 139 patients that received nCT before undergoing esophagectomy with curative intent, all identified from a prospectively maintained database (1998–2016). Pretreatment hematology reports were used to calculate the baseline NLR. A receiver operating characteristic curve (ROC-curve) was plotted to determine an optimal cutoff value. NLR quartiles were used to display possible differences between groups in relation to overall survival (OS) and disease-free survival (DFS) using the method of Kaplan–Meier. Cox regression analysis was performed to assess the prognostic value of NLR. Results: The median OS and DFS times were 46 months (interquartile range [IQR]: 19–166) and 30 months (IQR: 13–166], respectively, for the entire cohort. The ROC-curve showed that NLR has no discriminating power for survival status (area under the curve = 0.462) and therefore no optimal cutoff value could be determined. There were no statistically significant differences in median OS times for NLR quartiles: 65 (Q1), 32 (Q2), 45 (Q3), and 46 months (Q4) (P = 0.926). Similarly, DFS showed no difference between quartile groups, with median survival times of 27 (Q1), 19 (Q2), 36 (Q3), and 20 months (Q4) (P = 0.973). Age, pN, pM, and resection margin were independent prognostic factors for both OS and DFS. On the contrary, NLR was not associated with OS or DFS in univariable and multivariable analyses. Conclusion: Baseline NLR holds no prognostic value for esophageal and gastroesophageal junction adenocarcinoma patients treated with nCT in this study, in contrast to other recently published papers. This result questions the validity of NLR as a reliable prognostic indicator and its clinical usefulness in these patients.

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