Anti-MET Targeted Therapy Has Come of Age: The First Durable Complete Response with MetMAb in Metastatic Gastric Cancer: Figure 1.

Gastric cancer is a leading cause of cancer death worldwide. Systemic treatment comprising chemotherapy and targeted therapy is the standard of care in advanced/metastatic gastric cancer. Comprehensive molecular characterization of gastric adenocarcinomas by the TCGA Consortium and ACRG has resulted in the definition of distinct molecular subtypes. These efforts have in parallel built a basis for the development of novel molecularly stratified treatment approaches. Based on this molecular characterization, an increasing number of specific genomic alterations can potentially serve as treatment targets. Consequently, the development of promising compounds is ongoing. In this review, key molecular alterations in gastric and gastroesophageal junction cancers will be addressed. Finally, the current status of the translation of targeted therapy towards clinical applications will be reviewed.

Download Full-text

Complete response of metastatic gastric cancer to chemoimmunotherapy

The Indian Journal of Medical Research ◽

10.4103/ijmr.ijmr_132_16 ◽

2017 ◽

Vol 146 (1) ◽

pp. 141 ◽

Cited By ~ 3

Author(s):

Kenji Ina ◽

Ryuichi Furuta

Keyword(s):

Gastric Cancer ◽

Complete Response ◽

Metastatic Gastric Cancer

Download Full-text

Retrospective review of modified dose docetaxel, cisplatin, and 5-flourouracil (DCF) for the treatment of first-line metastatic gastric carcinomas.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15175 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15175-e15175

Author(s):

Nuriye Özdemir ◽

Sercan Aksoy ◽

Tulay Eren ◽

Huseyin Abali ◽

Omur Berna Oksuzoglu ◽

...

Keyword(s):

Gastric Cancer ◽

Retrospective Review ◽

Progression Free Survival ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Median Number ◽

Hematological Toxicity ◽

First Line ◽

Gastric Carcinomas ◽

Grade 3

e15175 Background: Docetaxel, cisplatin, and 5FU (DCF) has been shown to be an effective regimen for metastatic gastric carcinomas. However, treatment-related adverse events is quite high with original dose DCF. We evaluated the outcomes of the metastatic gastric carcinomas who treated with modified dose DCF (mDCF) in our institution. Methods: A single institution retrospective review of patients with metastatic gastric cancer treated with three weekly mDCF from 1/2006 to 1/2013 was evaluated. Over this time period a standard order-set was in place in which cisplatin 60 mg/m2, 5FU 600 mg/m2 and docetaxel 60 mg/m2 was given three weekly. Tumor response was calculated retrospectively using RECIST criteria. Results: One hundred and ninety-one patients were included the study. The median age was 55 years (23 to 76), 74% were male, and 82% were chemo-naive. Eighty percent of the patients were metastatic at the time of diagnosis. The median number of cycles administered was 6 (2-10). Hematological toxicity was mild with grade 3/4 granulocytopenia in 25% of the patients, grade 3/4 thrombocytopenia in 4% of the patients, and grade 3/4 anemia in 9% of the patients. Neutropenic infection occurred in 9 (%5) patients. Grade 3/4 nausea/vomiting was reported by 10% of the patients, and diarrhea by 7%. A total of 19 (10%) patients had dose delays or dose reductions related to toxicity. Six (3%) patients had complete response and 43 (23%) patients had partial response. Stable disease were occurred in 83 (45%) patients and 56 (23%) progressive disease. Ninety percent of the patients have died with median follow-up of 8 months. Progression-free survival was 7 months (95% CI 6 to 7.8 m) and overall survival was 10 months (95% CI 8.7 to 11.2 m). Conclusions: mDCF has mild hematological toxicity and overall excellent tolerance in first line metastatic gastric cancer patients. Response rate and the survival of these patients with a minimal toxicity are comparable with the original dose DCF.

Download Full-text

A dose-escalation study of docetaxel, oxaliplatin and S-1 (DOS) as a first-line therapy for patients with unresectable metastatic gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.174 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 174-174

Author(s):

Yasushi Sato ◽

Tamotsu Sagawa ◽

Yasuo Takahashi ◽

Hiroyuki Ohnuma ◽

Kyoko Hamaguchi ◽

...

Keyword(s):

Gastric Cancer ◽

Febrile Neutropenia ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Maximum Tolerated Dose ◽

Dose Escalation Study ◽

Promising Alternative ◽

Level 3 ◽

Level 1 ◽

Level 2

174 Background: Although the triplet regimen of docetaxel/cisplatin/S-1 (DCS) has shown promising activity and conversion rate in patients with unresectable metastatic gastric cancer (UMGC) in Japan, it was accompanied by severe adverse events. Recent studies suggested that oxaliplatin was almost as active, and relatively less toxic, than cisplatin in combination regimens for UMGC and can therefore replace cisplatin. The aim of this study was to determine the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), recommended dose (RD), and preliminary efficacy of docetaxel/oxaliplatin/S-1 (DOS) instead of DCS in patients with UMGC. Methods: Previously untreated 16 patients with histologically proven UMGC were enrolled. Docetaxel and oxaliplatin were administered intravenously on day 8. S-1 was administered orally twice a day on days 1-14. Each cycle was repeated every 3 weeks. DLTs were evaluated during the first cycle of treatment. Three dose-escalations of DOS were used in this study namely, level 1 (50/100/80 mg/m2), level 2 (50/130/80 mg/m2), and level 3 (60/130/80 mg/m2). Results: Among the six patients, one patient each experienced DLTs (febrile neutropenia and diarrhea) at level 1 and 2 doses, respectively. While two more patients experienced DLTs (febrile neutropenia and diarrhea) after administration of level 3 doses. Therefore, two additional patients were enrolled into the study at level 2. However, both these patients subsequently exhibited DLTs (febrile neutropenia and diarrhea). Therefore, we concluded that the MTD and RD with this regimen were level 2 and level 1, respectively, and that the DLT were grade 3 diarrhea and febrile neutropenia. The overall response rate was 78% (7/9) of the patients with measurable lesions, consisting of two complete response and five partial responses. Five patients underwent conversion surgery. Conclusions: The RD of the 3-weekly DOS regimen in patients with UMGC was docetaxel at 50 mg/m2 and oxaliplatin at 100 mg/m2 on day 8 and S-1 at 80 mg/m2 on days 1-14. The efficacy and ease of administration make the regimen a promising alternative to DCS. A phase II study using this RD regimen is currently underway. Clinical trial information: 000015849.

Download Full-text

Comparison of efficacy of aspirin plus epirubicin, oxaliplatin, and capecitabine versus epirubicin, oxaliplatin, and capecitabine alone in patients with locally advanced and metastatic gastric cancer: A randomized clinical trial.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.384 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 384-384

Author(s):

Esha Jafa ◽

Biswajit Dubashi ◽

Smita Kayal ◽

Vikram Kate ◽

Rajesh Nachiappa Ganesh ◽

...

Keyword(s):

Gastric Cancer ◽

Clinical Trial ◽

Protocol Analysis ◽

Locally Advanced ◽

Progression Free Survival ◽

Response Rates ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Response To Treatment ◽

Significant Difference

384 Background: Aspirin was long known to prevent cancer, the last decade revealed its therapeutic role via varied mechanisms like inhibition of platelet activation, COX and PI3K pathway. Since PI3K/AKT/mTOR is one of the pathways activated in gastric cancer and Giampieri et al (2016) showed improved response rates, PFS and OS with addition of aspirin to capecitabine in heavily pretreated metastatic colorectal cancer,a cancer in which efficacy of aspirin is related to presence of PI3K mutations,we aimed to compare the efficacy of aspirin added to a standard regime EOX with EOX alone in locally advanced and metastatic gastric cancer. Methods: All patients with advanced gastric cancer coming to JIPMER,Department of Medical oncology between march 2017 to may 2019 were screened for eligibility in the trial.Those eligible were randomly assigned to standard EOX or standard EOX plus 150 mg of daily aspirin.Tumor measurements were performed at baseline,then after 3-4 cycles (interim response) and the response to treatment was assessed by the radiologist who was blinded to treatment arms according to RECIST1.1 criteria.Toxicity profiles were recorded as per CTCAE v 4.03.In per protocol analysis,response rates, PFS(progression free survival) and OS (overall analysis) were analysed for patients who received ≥3 cycles and had an evaluable interim response. Results: 95 patients were randomised.In per protocol analysis, 70 patients were included. The results are shown in table. Conclusions: No statistically significant difference was seen with respect to response rates, PFS, OS and toxicity, although there was a higher ORR (overall response rate=complete response,CR +partial response, PR) and OS seen in EOX plus aspirin arm. Clinical trial information: CTRI/2017/11/010651. JIPMER,Puducherry,India [Table: see text]

Download Full-text

Complete Response for More than 4 Years following Neoadjuvant FOLFOX and Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for a Patient with Advanced Gastric Cancer with Extensive Peritoneal Carcinomatosis

Case Reports in Oncology ◽

10.1159/000488978 ◽

2018 ◽

Vol 11 (2) ◽

pp. 305-310 ◽

Cited By ~ 1

Author(s):

Renata D’Alpino Peixoto ◽

Tercia Tarciane de Sousa ◽

Pedro Alexandre Ismael Amaral Silva ◽

Luciana Rodrigues de Meirelles ◽

Carlos Henrique Andrade Teixeira

Keyword(s):

Gastric Cancer ◽

Peritoneal Carcinomatosis ◽

Advanced Gastric Cancer ◽

Cytoreductive Surgery ◽

Therapeutic Option ◽

Residual Tumor ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Pathology Report ◽

Crs And Hipec

Background: Peritoneal carcinomatosis is usually a terminal disease with short median survival in patients with gastric cancer. Systemic FOLFOX is one of the most used regimens in the first-line treatment of metastatic gastric cancer. However, there is scarce evidence that cytoreductive surgery (CRS) and intraperitoneal heated chemotherapy (HIPEC) improves oncological outcomes of patients with advanced gastric cancer. Methods: Herein we present a case of a young woman with advanced gastric cancer with omental and peritoneal metastases who achieved an excellent response after 6 months of FOLFOX followed by CRS and HIPEC. Results: A 53-year-old woman was diagnosed with advanced gastric carcinoma, with extensive omental caking and several peritoneal implants measuring 2 cm at the largest diameter. The patient received mFOLFOX6 for 6 months with excellent clinical and radiographic response. She was then submitted to a D2 total gastrectomy followed by CRS and HIPEC with mitomycin. The final pathology report showed a focal adenocarcinoma in the stomach measuring 0.4 mm with no residual tumor in the peritoneum (ypT1ypN0). The patient has been well and disease free for more than 4 years. Conclusion: While still controversial, CRS followed by HIPEC may be a curative therapeutic option for highly selected patients.

Download Full-text

A phase II study of oxaliplatin with biweekly, low dose leucovorin and bolus and continuous infusion 5-fluorouracil (modified FOLFOX-4) as first line therapy for patients with advanced or metastatic gastric cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14052 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14052-14052

Author(s):

H. Kim ◽

H. Kwon ◽

S. Y. Oh ◽

B. G. Seo ◽

S. G. Kim ◽

...

Keyword(s):

Gastric Cancer ◽

Continuous Infusion ◽

Low Dose ◽

Overall Response Rate ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

First Line ◽

First Line Therapy ◽

Line Therapy ◽

Grade 3

14052 Background: To determine the activity and toxicities of low dose leucovorin (LV) plus fluorouracil (5-FU) regimen, combined with oxaliplatin every two weeks (modified FOLFOX-4), as a first-line therapy for patients with advanced or recurrent gastric cancer. Methods: Between January 2003 and March 2005, forty-five patients were enrolled in this study. Patients were treated with oxaliplatin 85 mg/m2 as a 2-hour infusion at day 1 plus LV 20 mg/m2 over 10 minutes, followed by 5-FU a 400 mg/m2 bolus and 22 hour continuous infusion of 600 mg/m2 5-FU at day 1–2. This treatment was repeated in 2 week intervals. Results: There was one patient (2.2%) demonstrated a complete response. Twenty patients (44.4%) showed a partial response. Overall response rate was 46.6%. Ten patients (22.2%) showed a stable disease and fourteen patients (31.1%) progressed during the course of the treatment. The median time to progression and overall survival time were 7.73 months (95% CI: 3.6–11.86 months) and 11.17 months (95% CI: 9.06–13.28 months) from the start of the chemotherapy, respectively. A total of 247 cycles were analyzed for toxicity. Major hematologic toxicities included grade 1–2 anemia (39.7%), neutropenia (30.4%), grade 3–4 neutropnenia (10.9%) and thrombocytopenia (9.3%).There were 12 cycles of neutropenic fever. The most common non-hematological toxicities were grade 2 nausea/vomiting (20%), grade 1–2 neuropathy (13.4%) and grade 3 diarrhea (2.2%). There was no treatment related death. Conclusions: The modified FOLFOX-4 regimen is safe and effective regimen as a first line therapy in advanced or metastatic gastric cancer. No significant financial relationships to disclose.

Download Full-text

Complete Response in a Patient With Chemorefractory EGFR-Amplified, PD-L1–Positive Metastatic Gastric Cancer Treated By Dual Anti-EGFR and Anti–PD-1 Monoclonal Antibody Therapy

JCO Precision Oncology ◽

10.1200/po.20.00239 ◽

2020 ◽

pp. 1180-1186

Author(s):

Natalie Reizine ◽

Bryan Peterson ◽

Stephanie Moya ◽

Yan Wang ◽

Yi-Hung Carol Y. H. Tan ◽

...

Keyword(s):

Gastric Cancer ◽

Monoclonal Antibody ◽

Antibody Therapy ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Monoclonal Antibody Therapy

Download Full-text

Importance of HER2 Work-Up and Treatment Even in Patients with Poor Performance Status: A Case Report

Case Reports in Oncological Medicine ◽

10.1155/2014/731581 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

Ali Suner ◽

Hakan Buyukhatipoglu ◽

Ozan Balakan ◽

Mehmet Emin Kalender ◽

Turgay Ulas ◽

...

Keyword(s):

Gastric Cancer ◽

Performance Status ◽

Poor Performance ◽

Complete Response ◽

Metastatic Gastric Cancer ◽

Poor Performance Status ◽

Her2 Overexpression ◽

First Line ◽

Work Up

Gastric cancer is one of most common types of cancers. Metastatic gastric cancer has a poor prognosis and is accepted as incurable at this stage. Treatment of metastatic gastric cancer did not progress substantially until new targeted agents have come out. Recently published ToGA trial showed promising results in HER2 overexpressing metastatic gastric cancer. In this case we present a case with an excellent complete response with anti-HER2 treatment. Most importantly, we wanted to emphasize (1) the importance of early determination of HER2 overexpression, and (2) to draw attention of anti-HER2 agents in the first line treatment even in patients with a poor performance status.

Download Full-text