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
2840 - Effects of Aerobic and Resistance Exercise on Android:Gynoid Fat Ratio in Breast Cancer Survivors
Presenter: Christina Dieli-Conwright
Session: Poster Display session 2
Resources:
Abstract
869 - Impact of Education for Breast self examination in Rural Indian Women on Early Detection - results of POC study
Presenter: Sneha Parchuri
Session: Poster Display session 2
Resources:
Abstract
1951 - Breast cancer incidence and survival in renal transplant patients: 35-year experience
Presenter: Michalis Kontos
Session: Poster Display session 2
Resources:
Abstract
2017 - The changing landscape of breast cancer incidence after treatment for Hodgkin’s disease
Presenter: Amelia Benjamin
Session: Poster Display session 2
Resources:
Abstract
1780 - Number of deliveries as a prognostic factor in different breast cancer subtypes
Presenter: Anniina Jääskeläinen
Session: Poster Display session 2
Resources:
Abstract
4650 - Effects of supervised and adapted exercise program in the quality of life and strength of breast cancer survivors: MAMA MOVE Gaia trial
Presenter: Ana Joaquim
Session: Poster Display session 2
Resources:
Abstract
4962 - Study On the Socioeconomic and Clinical Factors Affecting the Proportion of Breast Conserving Surgery in Chinese Women Breast Cancer
Presenter: Jin Zhang
Session: Poster Display session 2
Resources:
Abstract
5451 - Clinical decision making and multidisciplinary team meetings (MDMs) in early breast cancer. Is the agreement between planned and applied therapeutic program?
Presenter: Marco Giavarra
Session: Poster Display session 2
Resources:
Abstract
888 - The value of genetic counselling in breast cancer genetic testing and clinical management
Presenter: Vicki Kiesel
Session: Poster Display session 2
Resources:
Abstract
4005 - Elderly patients in the Japanese Breast Cancer Registry
Presenter: Masataka Sawaki
Session: Poster Display session 2
Resources:
Abstract