Abstract 1402
Background
Neoadjuvant chemotherapy is promising to improve the survival of locally advanced gastric cancer. However, optimal regimen and duration of treatment have not been established. We previously reported the primary results of COMPASS-D trial (ASCO-GI 2019). Herein, we report the results of subgroup analyses of efficacy by baseline disease characteristics and demographics.
Methods
Patients with M0 and either T4 or T3 in case of junctional cancer or schirrhous type received 2 or 4 courses of cisplatin (60 mg/m2 at day 8) / S-1 (80 mg/m2 for 21 days with 1 week rest) or docetaxel (40 mg/m2 at day 1) / cisplatin (60 mg/m2 at day 1) / S-1 (80 mg/m2 for 14 days with 2 weeks rest) as neoadjuvant chemotherapy. Then, patients underwent D2 gastrectomy and adjuvant S-1 chemotherapy for 1 year. The primary endpoint was 3-year overall survival. Subgroup analysis was performed in each regimen (CS vs DCS) and duration (2 vs 4 courses), stratified by age, gender, esophageal invasion, macroscopic type, histological type, cT, and cN.
Results
Between Oct 2011 and Sep 2014, 132 patients were assigned to CS (n = 66; 33 in 2-courses and 33 in 4-courses) and DCS (n = 66; 33 in 2-courses and 33 in 4-courses). The 3-year OS was 58.1% in 2-courses CS, 58.1% in 4-courses CS, 48.5% in 2-courses DCS, and 71.9% in 4-courses DCS. Subgroup analyses were summarized in the table.Table:
778P
Subgroup | HR of 4-sourses (95%CI) | HR of DCS (95%CI) |
---|---|---|
Overall | 0.77 (0.43-1.22) | 0.80 (0.48-1.34) |
Age < 70 y.o. | 0.82 (0.45-1.52) | 0.88 (0.48-1.62) |
Age = > 70 y.o. | 0.49 (0.17-1.39) | 0.68 (0.26-1.76) |
Male | 0.53 (0.27-1.05) | 0.81 (0.42-1.54) |
Female | 1.22 (0.51-2.90) | 0.79 (0.33-1.87) |
Esophageal invasion- | 0.72 (0.40-1.31) | 0.71 (0.39-1.27) |
Esophageal invasion+ | 0.73 (0.24-2.17) | 1.06 (0.36-3.16) |
Schirrhous or large Type3 | 0.47 (0.22-1.00) | 0.82 (0.41-1.63) |
Non schirrous or large Type3 | 0.74 (0.23-2.41) | 0.50 (0.13-1.87) |
Differentiated | 0.37 (0.08-1.66) | 0.38 (0.09-1.71) |
Undiffirentiated | 0.66 (0.32-1.36) | 1.24 (0.63-2.43) |
cT3 or T4a | 0.66 (0.38-1.17) | 0.76 (0.44-1.32) |
cT4b | N/A | 2.33 (0.26-21.4) |
cN0 | 0.77 (0.32-1.86) | 0.74 (0.31-1.80) |
cN + | 0.66 (0.34-1.27) | 0.87 (0.46-1.66) |
Conclusions
The DCS regimen and duration 4-courses showed a beneficial tendency as a neoadjuvant setting regardless of disease characteristics and demographics. The 4-courses DCS is widely applicable to future phase III study to confirm of neoadjuvant chemotherapy for locally advanced gastric cancer.
Clinical trial identification
UMIN000006378.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
The Nongovermental Organization, Kanagawa Standard Anti-cancer Therapy Support System.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3608 - Prognostic impact of Body Mass Index (BMI) on overall survival in patients with metastatic breast cancer
Presenter: Khalil SALEH
Session: Poster Display session 2
Resources:
Abstract
2686 - Clinicopathological characteristics, survival and prognostic factors of breast cancer-related microangiopathic haemolytic anemia: a multicenter study
Presenter: Marion Alhenc Gelas
Session: Poster Display session 2
Resources:
Abstract
1565 - Metabolic tumor volume by 18F-FDG PET/CT is an independent prognostic factor in metastatic breast cancer
Presenter: Heekyung Ahn
Session: Poster Display session 2
Resources:
Abstract
4498 - Patient Preferences for breast cancer treatments: A Discrete Choice Experiment from four European countries
Presenter: Thomais Konstantopoulou
Session: Poster Display session 2
Resources:
Abstract
1423 - Palbociclib plus fulvestrant as second- or later-line therapy for patients with locally advanced, inoperable or metastatic HR+/HER2- breast cancer in Germany: Interim results of the INGE-B phase 2 study
Presenter: Diana Lüftner
Session: Poster Display session 2
Resources:
Abstract
2284 - Ventriculoperitoneal Shunt for CNS Metastasis in Breast Cancer: Clinical Outcomes Based on Intrinsic Subtype
Presenter: Hee Kyung Kim
Session: Poster Display session 2
Resources:
Abstract
4598 - Administration of chemotherapy for metastatic breast cancer near the end of life: a population registry study
Presenter: Luisa Edman Kessler
Session: Poster Display session 2
Resources:
Abstract
5706 - Prognostic value of histological growth pattern in patients operated for breast cancer liver metastases
Presenter: Ali Bohlok
Session: Poster Display session 2
Resources:
Abstract
1697 - Illness perceptions, quality of life and mood in metastatic breast cancer patients
Presenter: Isabel Domingues
Session: Poster Display session 2
Resources:
Abstract
1935 - Multidisciplinary Treatments Increases Overall Survival in Patients with Newly Diagnosed Stage IV Breast Cancer:An Analysis of 2010–2014 SEER Data
Presenter: Jian Zhang
Session: Poster Display session 2
Resources:
Abstract