Neoadjuvant Chemotherapy for Potentially Resectable Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIAO Shiming , WU Chen , JIANG Huaiwu

The Second Department of General Surgery, The Second Affiliated Hospital of Northern Sichuan Medical College, Mianyang 621000, Sichuan Province, China;

Corresponding author：

Keywords：

Stomach neoplasm; Neoadjuvant therapy; Neoadjuvant chemotherapy; Preoperative chemotherapy

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the current value of neoadjuvant chemotherapy (NAC) for potentially resectable gastric cancer.
Methods The recent 5-year literatures searched through the PubMed with the key words: stomach neoplasm, gastric cancer/carcinoma, neoadjuvant therapy/chemotherapy and preoperative therapy/chemotherapy as well as the relevant reports presented in the ASCO Annual Meeting in 2007 and 2008 were analyzed. The present status of NAC for advanced gastric cancer was summarized, the necessity and feasibility were evaluated, and the patients features for selecting, the predictors for response, the mainly existing problems and development trend of NAC were analyzed.
Results At present, there were 7 randomized control trails (RCT) published, and among them 3 were phase Ⅲ. It was safe, effective and feasible to most of trails in NAC for gastric cancer. However, it was still little to obtain survival benefit for NAC RCT, and short of randomized trial comparing strict preoperative chemotherapy to surgery alone or perioperative chemotherapy to surgery plus adjuvant chemotherapy. It remained lots of problems such as how to select the appropriate patients, the effective induced regimes and the predicted factors, the evaluated indices for response.
Conclusion NAC is a safe, feasible and efficient method to potentially resectable gastric cancer, but strict phase Ⅲ randomized trials are needed. In the future, substantial improvements of treatment outcome will likely depend on the novel drugs and molecular biological targeted therapies.

Citation： XIAO Shiming,WU Chen,JIANG Huaiwu. Neoadjuvant Chemotherapy for Potentially Resectable Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(8): 680-685. doi: Copy

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4. Foukakis T, Lundell L, Gubanski M, et al. Advances in the treatment of patients with gastric adenocarcinoma[J]. Acta Oncol, 2007; 46(3): 277-285.
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15. 陈志新, 张波. 胃癌综合治疗现状及展望 [J]. 中国普外基础与临床杂志, 2008; 15(1): 71-73.
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18. Songun I, Keizer HJ, Hermans J, et al. Chemotherapy for operable gastric cancer: results of the Dutch randomised FAMTX trial. The Dutch Gastric Cancer Group (DGCG)[J]. Eur J Cancer, 1999; 35(4): 558-562.
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22. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy in operable gastric and lower oesophageal cancer: final results of a randomised, controlled trial (the MAGIC trial, ISRCTN 93793971) [J]. J Clin Oncol (Meeting Abstracts), 2005; 23(16S): 4001.
23. Boige V, Pignon J, Saint-Aubert B, et al. Final results of a randomized trial comparing preoperative 5-fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07-FFCD 9703 trial[J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4510.
24. Zhang ZX, Gu XZ, Yin WB, et al. Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia (AGC)—report on 370 patients [J]. Int J Radiat Oncol Biol Phys, 1998; 42(5): 929-934.
25. Stahl M, Walz MK, Stuschke M, et al. Preoperative chemotherapy (CTX) versus preoperative chemoradiotherapy (CRTX) in locally advanced esophagogastric adenocarcinomas: First results of a randomized phase Ⅲ trial[J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4511.
26. Nio Y, Koike M, Omori H, et al. A randomized consent design trial of neoadjuvant chemotherapy with tegafur plus uracil (UFT) for gastric cancer—a single institute study[J]. Anticancer Res, 2004; 24(3b): 1879-1887.
27. Hartgrink HH, van de Velde CJ, Putter H, et al. Neo-adjuvant chemotherapy for operable gastric cancer: long term results of the Dutch randomised FAMTX trial[J]. Eur J Surg Oncol, 2004; 30(6): 643-649.
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31. Sym S, Chang H, Ryu M, et al. A phase Ⅱ study of neoadjuvant chemotherapy with docetaxel, capecitabine and cisplatin (DXP) in patients with advanced unresectable or intra-abdominal metastatic gastric cancer[J]. J Clin Oncol(Meeting Abstracts), 2007; 25(18S): 4640.
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34. Im S, Kim S, Kim J, et al. A phase Ⅱ trial of perioperative chemotherapy with folinic acid, 5-fluorouracil, and oxaliplatin in potentially resectable gastric cancer with regional lymph node metastasis [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4602.
35. Ajani JA, Mansfield PF, Crane CH, et al. Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome[J]. J Clin Oncol, 2005; 23(6): 1237-1244.
36. Newman E, Potmesil M, Ryan T, et al. Neoadjuvant chemotherapy, surgery, and adjuvant intraperitoneal chemotherapy in patients with locally advanced gastric or gastroesophageal junction carcinoma: a phase Ⅱ study[J]. Semin Oncol, 2005; 32(6 Suppl 9): S97-S100.
37. Fujitani K, Sasako M, Iwasaki Y, et al. A phase Ⅱ study of preoperative chemotherapy (CX) with S-1 and cisplatin followed by gastrectomy for clinically resectable type 4 and large type 3 gastric cancer: JCOG 0210[J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4609.
38. Imamura H, IIishi H, Tsuburaya A, et al. Randomized ph-ase Ⅲ study of irinotecan plus S-1 (IRIS) versus S-1 alone as first-line treatment for advanced gastric cancer (GC0301/TOP-002)[A/OL]. 2008 Gastrointestinal Cancers Symposium: Abstract 5.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Neoadjuvant Chemotherapy for Potentially Resectable Gastric Cancer

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