TRG as indicator of efficacy of FLOT versus FOLFOX in perioperative chemotherapy for resectable gastric cancer patients (single institution experience).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16061-e16061
Author(s):  
Natalia P. Beliak ◽  
Rashida Orlova ◽  
Svetlana Kutukova ◽  
Natalia V. Zhukova ◽  
Pavel Balashov ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Chemotherapy Regimen ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Similar Efficacy ◽  
Nccn Guidelines ◽  
Locally Advanced Gastric Cancer ◽  
Drug Regimens ◽  
Folfox Chemotherapy ◽  
Gastric Cancer Patients

e16061 Background: Based on results German FLOT-4 study, the FLOT regimen could be considered the new standard chemotherapy regimen for perioperative strategy of resectable GC. Since more and more patients have received neoadjuvant treatment,the efficacy and side effect must be weighted before performing NACT. Two-drug regimens were preferred according to the NCCN guidelines in principle because of their lower toxicity. And three-drug regimens may be applied in medically fit patients with access to frequent evaluation during treatment, to ensure that they can still tolerate surgery after NACT. Methods: We analyzed the data of 79 patients with resectable locally advanced gastric cancer who received the FLOT or FOLFOX regimen as NACT. The group of patients with NAСT FLOT included 44 patients, including 32 men, 12 women. Age in the first group varied from 28 to 80 years, the median age was 59.0 (95% CI 54.1-62.0) The group of patients with the FOLFOX chemotherapy regimen included 35: 17 (48.6%) men and 18 women (51.4%). Age in the second group varied from 60 to 75 years, the median age in the second group was 67.5 (95% CI 62.2-71.0). The second group included significantly older patients U = 137.0; p = 0.0001. Results: The severity of drug pathomorphosis was assessed in a standard way according to the Mandard system, in the first group there were 5 patients - TRG1 (11.4%), 7 patients - TRG2 (15.9%), 9 patients - TRG3 (20.5%), 15 patients TRG4 (34.0%), 5 patients - TRG5 (11.4%), 3 patients it was not evaluated (6.8%). In the second group, 6 patients - TRG1 (17.1%), 2 patients - TRG2 (5.7%), 2 patients - TRG3 (5.7%), 16 patients - TRG4 (45.8 %), 7 patients - TRG5 (20.0%), for 2 patients it was not evaluated (5.7%). Complete pathomorphosis was not statistically different in both groups (p = 0.47). TRG 2 was not statistically different (p = 0.16). The number of registered cases of TRG3 in the first group exceeded (p = 0.06). The frequency of TRG4 and TRG 5 did not differ (p = 0.29). Major pathological regression (TRG1 + TRG2) was 27.3% in the first group and 22.8% (p = 0.65). A decrease in the stage in the first group occurred in 22 patients (50.0%), and in the second group - in 19 patients (54.3%), p = 0.70. yp≤ T2 was diagnosed in 21 out of 79 patients (26.6%), in the first group in 11 patients (25%), in the second group in 10 (28.6%), p = 0.72. Conclusions: the FOLFOX regimen showed similar efficacy in the tumor response grade rate compared to the FLOT regimen, therefore, these two regimes are interchangeable, especially among patients of the older age group or in patients with high risks of a four-component regimen.

scholarly journals Case Report: Neoadjuvant PD-1 Blockade Plus Concurrent Chemoradiotherapy in Unresectable Locally Advanced Gastric Cancer Patients

2021 ◽  
Vol 10 ◽  
Author(s):  
Jia Wei ◽  
Xiaofeng Lu ◽  
Qin Liu ◽  
Lin Li ◽  
Song Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Treatment ◽  
Complete Response ◽  
Locally Advanced Gastric Cancer ◽  
Programmed Death 1 ◽  
Gastric Cancer Patients

Programmed death 1(PD-1) blockade has shown promising efficacy in advanced gastric cancer. Here, we performed a retrospective analysis of three patients with locally advanced gastric cancer who received adjuvant PD-1 plus chemoradiotherapy as neoadjuvant treatment. Neoadjuvant sintilimab plus concurrent chemoradiotherapy had an acceptable side-effect profile. All three patients underwent surgical gastrectomy after a median of 3.9 months. A major pathological response occurred in two resected tumors and a pathologic complete response was observed in one patient. Our results suggest that PD-1 blockade combined with chemoradiotherapy is a promising strategy as a neoadjuvant therapy in patients with unresectable locally advanced gastric cancer.

scholarly journals A PHASE II TRIAL EXPLORING THE EXTENSIVE INTRA-OPERATIVE PERITONEAL LAVAGE (EIPL) AS A PROPHYLACTIC STRATEGY FOR PERITONEAL RECURRENCE IN LOCALLY ADVANCED GASTRIC CANCER: reporting postoperative morbidity and mortality after early closure

2015 ◽  
Vol 52 (2) ◽  
pp. 161-164 ◽  
Author(s):  
Thales Paulo BATISTA ◽  
Mário Rino MARTINS ◽  
Euclides Dias MARTINS-FILHO ◽  
Rogerio Luiz dos SANTOS
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Phase Ii ◽  
Peritoneal Lavage ◽  
Locally Advanced ◽  
Open Label ◽  
Safety And Efficacy ◽  
Intention To Treat ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

Background The Extensive Intraoperative Peritoneal Lavage (EIPL) has been proposed as a practical prophylactic strategy to decrease the risk of peritoneal metastasis in gastric cancer. Objective To explore the safety and efficacy of the EIPL in our locally advanced gastric cancer patients. Methods This study is an open-label, double-center, single-arm phase II clinical trial developed at two tertiary hospitals from Recife (Pernambuco, Brazil). Results The study protocol was prematurely closed due to slow accrual after only 16 patients had been recruited to participate. Eight of them were excluded of the protocol study during the laparotomy, whereas four cases were also excluded from the per-protocol analysis. Two patients had died in hospital before 30 days and six were alive with no evidence of cancer relapses after a follow-up ranging from five to 14,2 months (median of 10.6 months). In the intention-to-treat analysis, three of eight patients suffered of gastrointestinal leakages and two of them had died. On a per-protocol basis, two of four patients presented this type of postoperative complication and one of them had died. All deaths occurred as a somewhat consequence of gastrointestinal leakages. Conclusion We could not make any conclusion about the safety and efficacy of the EIPL, but the possibility of this approach might increase the rate of gastrointestinal leakage is highlighted.

scholarly journals FEATURES OF EMERGENCY SURGERY IN PATIENTS WITH LOCALLY ADVANCED GASTRIC CANCER

2020 ◽  
pp. 108-112
Author(s):  
V. V. Boyko ◽  
I. V. Krivorotko ◽  
V. A. Lazirsky
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Surgical Intervention ◽  
Locally Advanced ◽  
Postoperative Mortality ◽  
Surgical Interventions ◽  
Second Stage ◽  
Locally Advanced Gastric Cancer ◽  
Surgical Tactics ◽  
Gastric Cancer Patients

Summary. Materials and methods. The work is based on an analysis of the results of surgical treatment of 418 patients with complicated locally advanced gastric cancer. Patients are divided into two groups: comparisons — 212, and the main — 206 patients who were treated from 2006 to 2010. and from 2011 to 2015 respectively. The complications rating was: bleeding in 252 (60.3 %) patients, stenosis in 89 (21.3 %), perforation in 15 (3.5 %), and their combination in 62 (14.8 %). Results and discussion. Radical operations were performed in 212 (50.7 %) patients, in 145 (34.6 %) — palliative and symptomatic. Postoperative complications occurred in 82 patients (19.6 %), postoperative mortality was 7.2 % (30 patients). A two-stage surgical tactics has been developed, which involves the implementation of minimally invasive endoscopic and endovascular surgical interventions at the first stage with the implementation of a delayed or planned surgical intervention at the second stage. Conclusions. Urgent operations decreased from 21.7 to 6.3 %, which reduced the number of palliative and symptomatic operations from 50.4 to 18.4 %.

scholarly journals Neoadjuvant therapy for locally advanced gastric cancer patients. A population pharmacodynamic modeling

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0215970 ◽  
Author(s):  
Patricia Martin-Romano ◽  
Belén P. Solans ◽  
David Cano ◽  
Jose Carlos Subtil ◽  
Ana Chopitea ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Therapy ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Pharmacodynamic Modeling ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

PILGRIM: Phase III clinical trial in evaluating the role of hyperthermic intraperitoneal chemotherapy for locally advanced gastric cancer patients after radical gastrectomy with D2 lymphadenectomy(HIPEC-01).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4538-4538
Author(s):  
Shu-zhong Cui ◽  
Han Liang ◽  
Yong Li ◽  
Yanbing Zhou ◽  
Kaixiong Tao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Locally Advanced ◽  
Control Group ◽  
Radical Gastrectomy ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

4538 Background: Gastric cancer remains the 3rd leading cancer related death worldwide due to early disease recurrence. We hypothesize that hyperthermic intraperitoneal chemotherapy (HIPEC) may effectively prevent local regional recurrence for locally advanced gastric cancer patients who received curative intent surgery. Methods: Pathology proven gastric cancer patients with clinical T3/T4NxM0 disease are eligible for the study and will be randomized to either control group, who will receive standard radical gastrectomy and D2 lymph node dissection or HIPEC group, who will receive the same surgery and HIPEC with paclitaxel x 2 within the first week after surgery. All patients will receive either XELOX or SOX adjuvant chemotherapy. The primary end point is overall survival. Results: 648 patients from 16 high volume gastric medical centers were enrolled between May, 2015 and March, 2019. 331 and 317 patients were randomized to control and HIPEC groups respectively. The median follow-up time is 12.1 months. The common grade 3/4 toxicities ( > 5%) in control and HIPEC groups are anemia 6% vs. 4.1%, intraabdominal infection 5.4% vs. 3.8%, pneumonia 9.7% vs. 9.8%, fever 10.6% vs. 11.4% and hypoalbunemia 15.1% vs. 16.7% respectively. All three perioperative death (within 30 days after surgery) occurred in control group. One patient died from duodenum stump leak which led to multiple organ failure. One patient died from anastomotic led to intraabdominal infection and shock. The 3rd death was suicide caused by severe depression. At the time of this report, the number of event has not reached for final efficacy analysis. Conclusions: It is safe to administer HIPEC to patients received radical gastrectomy with D2 lymph node dissection within one week of surgery. The primary analysis will be expected in one year. Clinical trial information: NCT02356276 .

scholarly journals Health-Related Quality of Life in Locally Advanced Gastric Cancer: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5934
Author(s):  
Romy M. van Amelsfoort ◽  
Karen van der Sluis ◽  
Winnie Schats ◽  
Edwin P. M. Jansen ◽  
Johanna W. van Sandick ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Locally Advanced ◽  
Metastatic Gastric Cancer ◽  
Locally Advanced Gastric Cancer ◽  
Related Quality ◽  
Health Related ◽  
Gastric Cancer Patients

Background: Current treatment strategies have been designed to improve survival in locally advanced gastric cancer patients. Besides its impact on survival, treatment also affects health-related quality of life (HRQOL), but an overview of reported studies is currently lacking. The aim of this systematic review was therefore to determine the short- and long-term impact of chemotherapy, surgery, and (chemo)radiotherapy on HRQOL in locally advanced, non-metastatic gastric cancer patients. Methods: A systematic review was performed including studies published between January 2000 and February 2021. We extracted studies published in Medline, Embase, and Scopus databases that assessed HRQOL in patients with locally advanced, non-metastatic gastric cancer treated with curative intent. Studies using non-validated HRQOL questionnaires were excluded. Short-term and long-term HRQOL were defined as HRQOL scores within and beyond 6 months after treatment, respectively. Results: Initially, we identified 8705 articles (4037 of which were duplicates, i.e., 46%) and ultimately included 10 articles. Most studies reported that short-term HRQOL worsened in the follow-up period from 6 weeks to 3 months after surgery. However, recovery of HRQOL to preoperative levels occurred after 6 months. After completion of chemoradiotherapy, the same pattern was seen with worse HRQOL after treatment and a recovery of HRQOL after 6–12 months. Conclusions: In patients with locally advanced, non-metastatic gastric cancer, HRQOL deteriorated during the first 3 months after surgery and chemoradiotherapy. However, the long-term data showed a recovery of HRQOL after 6–12 months. To implement HRQOL in clinical decision making in current clinical practice, more research is needed.

scholarly journals High expressions of CD10, FAP and GPR77 in CAFs are associated with chemoresistance and worse prognosis in gastric cancer

2021 ◽  
Author(s):  
Yilin Tong ◽  
Zehua Zhao ◽  
Jianjun Zhang ◽  
Wentao Wang ◽  
Yanmei Zhu
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Regression Model ◽  
Cancer Patients ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Predictive Values ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

Abstract Background As neoadjuvant chemotherapy (NCT) has been successfully introduced in gastric cancer (GC), more biomarkers are needed to evaluate the efficacy. Cancer-associated fibroblasts (CAFs) is associated with chemoresistance and prognosis. Three biomarkers, CD10, fibroblast activation protein-α (FAP) and G-protein-coupled receptor 77 (GPR77), have been proved to express in CAFs. However, their predictive values for efficacy of NCT and prognosis in gastric cancer is unknown. Methods Totally, specimens of 171 locally advanced gastric cancer patients who underwent NCT and D2 radical gastrectomy and matched preoperative biopsy specimens were retrospectively analyzed. Tumor regression grade (TRG) is reevaluated according to Mandard TRG. Expressions of CD10, FAP and GPR77 in CAFs before NCT (pre-) and after NCT (post-) were evaluated by immunohistochemistry. Survival curves on overall survival (OS) were obtained by Kaplan-Meier method, and differences were analyzed by log-rank test. Associations between categorical variables were explored by chi-square test or Fisher's exact method. Univariable and multivariate analyses were performed by logistic regression model and Cox proportional hazard regression model. Results High expressions of post-CD10, post-FAP, post-GPR77 and pre-CD10 were related to worse TRG (all p<0.05). In multivariable analysis, post- and pre-FAP were independent predictive factors to TRG (p<0.010). Post-CD10 (p=0.032) and post-FAP (p=0.013) were related to OS in univariable analysis, but none of biomarkers were independent prognostic factors in multivariable analysis. Conclusions Expressions of CD10, FAP and GPR77 in CAFs were related to chemoresistance and overall survival, and these biomarkers have predictive values for tumor regression and prognosis in locally advanced gastric cancer patients.

Sign in / Sign up

Export Citation Format

Share Document