Efficacy and Safety of Apatinib Combined with S-1 Plus Oxaliplatin as Neoadjuvant Treatment for Locally Advanced Gastric Cancer: A Multicenter, Prospective Study

2020 ◽  
Author(s):  
Jian-Xian Lin ◽  
Yan-Chang Xu ◽  
Wei Lin ◽  
Fang-Qin Xue ◽  
Jian-Xin Ye ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prospective Study ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Efficacy And Safety ◽  
Locally Advanced Gastric Cancer ◽  
Multicenter Prospective Study

scholarly journals 154P A multicenter, prospective study of apatinib plus chemotherapy as neoadjuvant treatment for locally advanced gastric cancer

2020 ◽  
Vol 31 ◽  
pp. S1300
Author(s):  
Y-H. Tang ◽  
F-H. Wang ◽  
G-J. Lin ◽  
J-X. Lin ◽  
C-H. Zheng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prospective Study ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Locally Advanced Gastric Cancer ◽  
Multicenter Prospective Study

Apatinib combined with SOX neoadjuvant therapy for locally advanced gastric cancer: A multicenter, single-armed, prospective study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 367-367
Author(s):  
Jian-Xian Lin ◽  
Changming Huang
Keyword(s):  
Gastric Cancer ◽  
Prospective Study ◽  
Neoadjuvant Therapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Gastric Surgery ◽  
R0 Resection ◽  
Resection Rate ◽  
Locally Advanced Gastric Cancer ◽  
Tumor Response Evaluation

367 Background: Molecular targeted therapy has made great progress in the treatment of gastric cancer. In some previous studies, apatinib, an oral small molecular of VEGFR-2 TKI, had been confirmed can improve OS and PFS with an acceptable safety profile in patients with advanced gastric cancer refractory to two or more lines of prior chemotherapy. However, there is limited evidence about the safety and feasibility of apatinib combined with SOX regimen as neoadjuvant therapy for locally advanced gastric cancer (AGC). Methods: This is a multicenter, single-armed, prospective study. Patients with AGC (cT2-4N+M0) without prior anti-cancer strategies were included. Patients were received 2 to 5 cycles (21 days a cycle) of neoadjuvant therapy using S-1 (po, 40-60 mg bid, day1-day14), oxaliplatin (iv, 130 mg/m2, day1), and apatinib (po, 500 mg qd). Apatinib was prohibited in the last cycle. The operation should be performed 2 to 4 weeks later of the neoadjuvant therapy. The primary endpoint was R0 resection rate. The secondary endpoint included safety, ORR, and DCR. Results: A total of 56 patients from 10 centers in China were recruited. There were 43 males and 13 females. The median age was 63.04 years (range 41-75 years). There were 43 patients with tumor response evaluation, 29 patients (67.4%) had partial response (PR), 12 patients (27.9%) had stable disease (SD), and 2 patient (4.6%) had progressive disease (PD). The ORR and DCR were 67.4% (29/43) and 95.3% (41/43), respectively. 36 patients received gastric surgery, the R0 resection rate was 97.2%, 3 patients had postoperative complication: one had intestinal obstruction and 2 had pneumonia (all Clavien-Dindo classification less than grade II). 46 patients were included for safety analysis. The incidence of adverse events (AEs) and grade 3/4 AEs were 84.8% (39/46) and 17.4% (8/46), respectively. The most common AEs were neutropenia (40%), low platelet count (40%), leucopenia (32.6%), vomit (13%). Conclusions: This prospective study shows that neoadjuvant therapy using apatinib plus SOX brings clinical benefit to AGC with a high disease control rate and tolerable adverse reactions. Clinical trial information: NCT 03192735.

Clinical outcomes of patients with gastric cancer according to pre and post-neoadjuvant chemotherapy PD-L1 immunohistochemistry (IHC) expression.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16569-e16569
Author(s):  
Heber Salvador de Castro Ribeiro ◽  
Wilson Luiz da Costa ◽  
Maria Dirlei de Souza Begnami ◽  
Celso Abdon Lopes Mello ◽  
Tatiane Neotti ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Cox Regression ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Cancer Center ◽  
Survival Outcomes ◽  
Surgical Specimen ◽  
Locally Advanced Gastric Cancer

e16569 Background: The incidence, prognostic and predictive impacts of PD-L1 expression in locally advanced gastric cancer is unknown. We aimed to determine the expression of PD-L1 by CPS in the pre-treatment biopsy and surgical specimens of patients (pts) with gastric cancer who received neoadjuvant therapy and its association with pathological response and survival outcomes. Methods: Retrospective cohort of pts treated at a cancer center from 2007 to 2017. Pts with confirmed gastric or GEJ adenocarcinoma who received neoadjuvant treatment and curative-intent D2 surgery were included. Gastric stump tumors and those who had a total esophagectomy were excluded. Clinical data were obtained from medical charts. Biopsy samples and a tissue microarray with the most representative areas of the surgical specimen were used to detect PD-L1 IHC expression with 22C3 phamDx antibody. Results were analyzed using the CPS score. Overall and DFS survival included the Kaplan-Meier product-limit estimator in an ITT analysis and a Cox regression was used to obtain crude and adjusted HR for prognostic factors. Results: 270 pts were included: median age was 58.9 years, most (51.5%) had cT3-T4N+ stages, 45% had diffuse histology and 87.8% completed the preoperative regimen. 13% had a pCR, while 53% had minimal tumor regression. With a median follow-up of 60.3 months (CI 95% 54.7 – 65.8), the median OS and DFS were not reached. 11.4% of biopsies and 18.6% of surgical specimens had positive CPS, with a median score of 3 (IQR 2,0 – 7,5) and 9 (IQR 5.0 – 20.0) respectively. In 18.9% of paired samples the PD-L1 expression was found to be negative in the biopsy sample and positive in the surgical specimen. PD-L1 expression was neither associated with pathologic response after neoadjuvant chemotherapy, nor with survival outcomes. Conclusions: PD-L1 expression on the setting of locally advanced gastric cancer was low and it was different when biopsy and surgical specimens were compared. No impact on survival results could be detected. [Table: see text]

Clinical case of the neoadjuvant treatment with nivolumab in a patient with microsatellite unstable (MSI-H) locally advanced gastric cancer

2020 ◽  
Vol 13 (9) ◽  
pp. e236144
Author(s):  
Viacheslav Chubenko ◽  
Gamzat Inusilaev ◽  
Evgeny Imyanitov ◽  
Vladimir Moiseyenko
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumour Size ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Immune Checkpoint Blockade ◽  
Patients With Cancer ◽  
Locally Advanced Gastric Cancer ◽  
Programmed Death 1 ◽  
High Level

Locally advanced gastric cancer (GC) is often managed by neoadjuvant chemotherapy and surgery; however, pathological complete responses to preoperative systemic treatment are rare. Some GCs are characterised by high-level microsatellite instability (MSI-H) and therefore are potentially sensitive to anti-PD1 (the programmed death 1) therapy. Neoadjuvant immune checkpoint blockade demonstrated promising results in a number of trials involving various categories of patients with cancer; therefore, we considered feasible to offer preoperative nivolumab to a patient with T3N1M0 MSI-H GC. The patient experienced a reduction of the tumour size and the analysis of surgical material revealed complete elimination of tumour cells. MSI-H status deserves to be considered in future trials on patients with GC.

scholarly journals Delta-radiomics and response to neoadjuvant treatment in locally advanced gastric cancer—a multicenter study of GIRCG (Italian Research Group for Gastric Cancer)

2021 ◽  
Vol 11 (6) ◽  
pp. 2376-2387
Author(s):  
Maria Antonietta Mazzei ◽  
Letizia Di Giacomo ◽  
Giulio Bagnacci ◽  
Valerio Nardone ◽  
Francesco Gentili ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Multicenter Study ◽  
Research Group ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Locally Advanced Gastric Cancer

Neoadjuvant Treatment for Resectable Locally Advanced Gastric Cancer

2012 ◽  
pp. 155-166
Author(s):  
Domenico D’Ugo ◽  
Alberto Biondi ◽  
Ferdinando Cananzi
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Locally Advanced Gastric Cancer

scholarly journals Effectiveness and Safety of Apatinib Plus Chemotherapy as Neoadjuvant Treatment for Locally Advanced Gastric Cancer

2021 ◽  
Vol 4 (7) ◽  
pp. e2116240
Author(s):  
Jian-Xian Lin ◽  
Yan-Chang Xu ◽  
Wei Lin ◽  
Fang-Qin Xue ◽  
Jian-Xin Ye ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Locally Advanced Gastric Cancer

scholarly journals Oncological outcomes of laparoscopic versus open gastrectomy after neoadjuvant chemotherapy for locally advanced gastric cancer: a retrospective multicenter study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Islam Khaled ◽  
Pablo Priego ◽  
Hany Soliman ◽  
Mohammed Faisal ◽  
Ihab Saad Ahmed
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Open Gastrectomy ◽  
Oncological Outcomes ◽  
Locally Advanced Gastric Cancer ◽  
The Mean

Abstract Background The oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neoadjuvant chemotherapy have been investigated in a few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy in patients with locally advanced gastric cancer (GC) and to determine the advantages, preferences, and ease of use of the two techniques after chemotherapy. Methods We conducted a retrospective chart review of all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for three cycles, which was then repeated 6 to 12 weeks after the operation for four cycles. Results The hospital stay time and intraoperative blood loss in the LG group were significantly lower than those in the OG group. The mortality rate and the 3-year survival rate for patients in the LG group were comparable to those of patients in the OG group (4.6% vs. 9.7% and 68.3% vs. 58.1%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2–61.6) in the OG group compared with 43.3 (95% CI, 36.6–49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36–65.8) in the LG group compared with 50.9 months (95% CI, 44.6–57.2) in the OG group. Conclusion LG is a feasible and safe alternative to OG for patients with locally advanced GC receiving neoadjuvant chemotherapy.

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.

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