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
733 - Clinical experience: ramucirumab with FOLFIRI/XELIRI as a second line for patients with metastatic gastric cancer
Presenter: Tatiana Titova
Session: Poster Display session 2
Resources:
Abstract
2186 - Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer
Presenter: Ningning Li
Session: Poster Display session 2
Resources:
Abstract
3172 - Apatinib in combination with docetaxol and S1 chemotherapy in the first line treatment of metastatic gastric cancer
Presenter: Ling Xia
Session: Poster Display session 2
Resources:
Abstract
3982 - Parameters of local cellular immunity in metastatic gastric cancer
Presenter: Aleksandr Sagakyants
Session: Poster Display session 2
Resources:
Abstract
5102 - Germline pathogenic mutations in Chinese patients with gastric cancer identified by next-generation sequencing (NGS)
Presenter: Xiaotian Zhang
Session: Poster Display session 2
Resources:
Abstract
5012 - Inhibition of the PI3K pathway in HER2-positive gastric cancer
Presenter: Sinead Toomey
Session: Poster Display session 2
Resources:
Abstract
4803 - Investigation on gastric cancer susceptibility genes in Chinese early-onset diffuse gastric cancer
Presenter: Yi Feng
Session: Poster Display session 2
Resources:
Abstract
4778 - A correlation analysis between survival rate and the characteristic gene of gastric cancer based on bioinformatics analysis
Presenter: Yi-wen Zhang
Session: Poster Display session 2
Resources:
Abstract
4805 - Phase I study of apatinib combined with POF (paclitaxel plus FOLFOX) in patients (pts) with treatment-naïve advanced gastric cancer (TNAGC)
Presenter: Rongbo LIN
Session: Poster Display session 2
Resources:
Abstract
3248 - Second-line palliative systemic treatment for synchronous metastatic esophagogastric cancer: a population-based study
Presenter: Willemieke Dijksterhuis
Session: Poster Display session 2
Resources:
Abstract